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'Spreading at a rate we have not seen' – Omicron more resistant to COVID-19 vaccines – USA TODAY

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Dr. Scott Gottlieb talks about omicron

Dr. Scott Gottlieb meets with the USA TODAY Editorial Board to discuss the new omicron variant and what the future might hold for the pandemic.

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  • The new study from South Africa’s largest private health insurer shows that two shots of the Pfizer-BioNTech vaccine is just 33% protective against omicron.
  • Full vaccination against COVID-19 continues to provide 70% protection against severe disease, according to the Discovery Health study.
  • Omicron also appears to be able to reinfect people who had an earlier disease variant, with those infected longer ago at higher risk of reinfection.

The new omicron variant of the coronavirus is substantially more contagious and reduces the effectiveness of COVID-19 vaccines, a study from South Africa released Tuesday found.

Even though the variant so far seems to produce mostly mild disease, world health leaders warned it could bring a wave of illness that crushes health systems

“Omicron is spreading at a rate we have not seen with any previous variant,” said Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization.

“We underestimate this virus at our peril,” he said in a press conference Tuesday from Geneva. “Even if omicron does cause less severe disease, the sheer number of cases could once again overwhelm unprepared health systems.”

Early data from South Africa appears to show that people who are fully vaccinated are still largely protected against severe disease, according to early data released Tuesday by Discovery Health, South Africa’s largest private health insurer.

The omicron variant, which was first identified in southern Africa, appears poised to take over the world, as delta did before it. Omicron accounts for 90% of COVID-19 cases in South Africa and is a growing problem in Europe

It has now been found in 77 countries, Ghebreyesus said. It has been seen in at least 30 U.S. states, though the delta variant still dominates the American outbreak.

Formally identified the day before Thanksgiving, information on omicron’s characteristics – including how contagious and dangerous it may be – are just emerging.

The new study from Discovery Health shows that two shots of the Pfizer-BioNTech vaccine, which provided more than 90% protection against the original virus, is only 33% protective against omicron infection.

Full vaccination continues to provide 70% protection against severe disease, which seemed to hold up across high-risk groups, though it declined somewhat in people over 60 and even more in those over 70. 

“This is the first time we’ve had any data on that,” said Dr. Eric Topol, vice president for research at Scripps Research in La Jolla, California, and a national expert on the use of data in medical research.

“Seventy percent is definitely a dropdown. It isn’t great,” he said. “It was 95% effective severe disease when it was delta variant and then about 85% after six months of waning,” he said. 

Whether those numbers will continue to hold as more patients with omicron are studied isn’t yet clear, he said. “This is all still so new.”

Other research from Pfizer-BioNTech suggests that a third, booster dose can restore the original levels of protection at least for some period of time.

“The Omicron-driven fourth (wave) has a significantly steeper trajectory of new infections relative to prior waves,” Dr, Ryan Noach, CEO of Discovery Health, said in a statement. “National data show an exponential increase in both new infections and test positivity rates during the first three weeks of this wave, indicating a highly transmissible variant with rapid community spread of infection.”

Mild but dangerous

WHO officials chided nations that are focusing on offering boosters to their citizens while ignoring the lack of vaccines globally.

“The priority in every country and globally must be to protect the least protected, not the most protected,” Tedros said. 

Vaccine for poor countries has dealt with many setbacks over the past year, brought on by export restrictions, vaccine hoarding and regulatory delays, COVAX, the global vaccine alliance, said in a statement Tuesday. However, supply has increased since September.

Even if mild, omicron could easily overwhelm health systems even in highly developed nations said Dr. Michael Ryan, Executive Director of the WHO Health Emergencies Programme.

“If you have a huge wave of cases, you will see a lot of severity and you will see hospital systems coming under pressure,” he said.

He warned already stressed heath systems may fail, and urged they prepare now.

“Make sure you have the health workers in place, make sure you have the clinical trials in place. Make sure you’ve got oxygen supplies in place. Make sure that you’re vaccinating the unvaccinated,” Ryan said. “Make sure you’re taking every opportunity individually and at the community level to stop transmission where you can.”

The omicron variant is fueling misinformation about COVID: Experts explain why and how to spot false claims.

Omicron appears able to reinfect people who caught an earlier variant of the virus, and those infected longer ago are at higher risk of reinfection.

People infected in South Africa’s first wave early last year, have a 73% chance of reinfection, while those infected with the beta variant have a 60% chance of reinfection and those infected in its most recent delta wave face a 40% risk of reinfection with omicron, the new study showed.

That fits with findings from a preliminary briefing released by the United Kingdom on Friday showing an approximately three- to eight-fold increased risk of reinfection with the omicron variant, Topol said.

There has been some hope that omicron would cause fewer cases of severe disease than its predecessors, but that remains unclear.

The rate of hospital and intensive care unit admissions is lower than with other variants – 29% lower than with the first wave of infections early last year, according to the study. But that may be because so many South Africans recently recovered from infections with delta, Noach said. 

Children continue to show a relatively low rate of infection with omicron, as they have with earlier variants, the study showed.

Children infected with omicron have so far had a 20% higher risk of hospital admission for complications than they did with earlier variants, according to Shirley Collie, chief health analytics actuary at Discovery Health.

“This is early data and requires careful follow up,” Collie said in a company press release. But the finding lines up with an earlier warning from South Africa’s National Institute for Communicable Diseases of an increase in hospital admissions for children under 5.

play

COVID-19 omicron variant is spreading quickly. Here’s what we know.

South African scientists identified a new COVID-19 variant which has now been reported in Belgium, Botswana, Hong Kong and Israel.

Just the FAQs, USA TODAY

Omicron is here: How to manage your anxiety about the new variant

Anecdotal reports from South African hospitals suggest that most young children hospitalized with COVID-19 tested positive on routine screening, after going to the hospital for an unrelated reason. 

“It’s a peculiarity that hasn’t been explained,” Topol said of the high rate of hospital admissions for children. “It hasn’t yet been seen in the United Kingdom, Denmark, Norway and other places hard hit by omicron.”

Collie said, “Children were 51% less likely to test positive for COVID19 relative to adults in the Omicron period, and overall, the risk of children being admitted to hospital for COVID19 complications remains low.”

The world shouldn’t focus only on the early data coming out of South Africa and the United Kingdom showing omicron might be milder, because when omicron gets to different populations it might behave differently, said Dr. Abdirahman Mahamud, WHO COVID-19 incident commander.

Even if omicron does prove to be milder, delta remains a threat.

“We are caught between two elephants, the delta and the omicron,” he said. “These are massive, angry elephants.”

Contact Elizabeth Weise at eweise@usatoday.com

Contact Karen Weintraub at kweintraub@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

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Over 1.2 million people died from drug-resistant infections in 2019 – study

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More than 1.2 million people died in 2019 from infections caused by bacteria resistant to multiple antibiotics, higher than HIV/AIDS or malaria, according to a new report published on Thursday.

Global health officials have repeatedly warned about the rise of drug-resistant bacteria and other microbes due to the misuse and overuse of antibiotics, which encourages microorganisms to evolve into “superbugs”.

The new Global Research on Antimicrobial Resistance report, published in The Lancet, revealed that antimicrobial resistance (AMR) was directly responsible for an estimated 1.27 million deaths and associated with about 4.95 million deaths. The study analysed data from 204 countries and territories.

“These new data reveal the true scale of antimicrobial resistance worldwide… Previous estimates had predicted 10 million annual deaths from AMR by 2050, but we now know for certain that we are already far closer to that figure than we thought,” said Chris Murray, co-author of the study and a professor at the University of Washington.

Last year, the World Health Organization warned that none of the 43 antibiotics in development or recently approved medicines were enough to combat antimicrobial resistance.

Cornelius Clancy, professor of Medicine at the University of Pittsburgh, said one of the ways to tackle AMR is to look at a new treatment model.

“The traditional antibiotic model that we’ve had for past number of decades since penicillin. I think it is tapped out.”

Most of 2019’s deaths were caused by drug resistance in lower respiratory infections such as pneumonia, followed by bloodstream infections and intra-abdominal infections.

AMR’s impact is now most severe in Sub-Saharan Africa and South Asia, while around one in five deaths is in children aged under five years.

There was limited availability of data for some regions, particularly many low and middle-income countries, which may restrict the accuracy of the study’s estimates.

Clancy said the focus has been on COVID-19 for the past two years, but AMR is a “long-term kind of challenge”.

 

(Reporting by Mrinalika Roy in Bengaluru; Editing by Krishna Chandra Eluri and Devika Syamnath)

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Study casts doubt on reliability of rapid antigen tests in kids; COVID transmission through breastmilk unlikely

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The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Rapid antigen tests may be unreliable in children

When used in children, rapid antigen tests for detecting the coronavirus do not meet accuracy criteria set by the World Health Organization and U.S. and UK device regulators, according to researchers who reviewed 17 studies of the tests.

The trials evaluated six brands of tests in more than 6,300 children and teenagers through May 2021. In all but one study, the tests were administered by trained workers. Overall, compared to PCR tests, the antigen tests failed to detect the virus in 36% of infected children, the researchers reported on Tuesday in BMJ Evidence-Based Medicine. Among children with symptoms, it missed 28% of infections. Among infected kids without symptoms, the tests missed the virus in 44%. Only about 1% of the time did the tests mistakenly diagnose the virus in a child who was not actually infected.

Given that more than 500 antigen tests are available in Europe alone, the authors said, “the performance of most antigen tests under real-life conditions remains unknown.” But the new findings “cast doubt on the effectiveness” of rapid antigen tests for widespread testing in schools, they concluded.

Breastmilk transmission of COVID-19 unlikely

A new study appears to confirm smaller, earlier studies that suggested nursing mothers are unlikely to transmit the coronavirus in breastmilk.

Between March and September 2020, researchers obtained multiple breastmilk samples from 110 lactating women, including 65 with positive COVID-19 tests, 36 with symptoms who had not been tested, and a control group of 9 women with negative COVID-19 tests. Seven women (6%) – six with positive tests and one who had not been tested – had non-infectious genetic material (RNA) from the virus in their breastmilk, but none of the samples had any evidence of active virus, according to a report published on Wednesday in Pediatric Research. Why breastmilk would contain coronavirus RNA but not infectious virus is unclear, said study leader Dr. Paul Krogstad of the David Geffen School of Medicine at UCLA, “Breastmilk is known to contain protective factors against infection, including antibodies that reflect both the mother’s exposure to viruses and other infectious agents and to vaccines she has received,” he noted.

The U.S. Centers for Disease Control and Prevention (CDC) advises that before breastfeeding, bottle-feeding, or expressing milk, women with COVID-19 should wash their hands or use hand sanitizer with at least 60% alcohol. The CDC also recommends that they wear a mask when within 6 feet (1.8 meters) of the baby.

New technique may speed vaccine, antibody drug development

Researchers are working on a way to speed development of vaccines and monoclonal antibody drugs for COVID-19 and other illnesses, shortening the time from collection of volunteers’ blood samples to identification of potentially useful antibodies from months to weeks.

As described in Science Advances on Wednesday, the new technique employs cryo-electron microscopy, or cryoEM, which involves freezing the biological sample to view it with the least possible distortion. Currently, “generation of monoclonal antibodies involves several steps, is expensive, and typically takes somewhere on the order of two to three months, and at the end of that process you still need to perform structural analysis of the antibodies” to figure out where they attach themselves to their target, and how they actually work, explained Andrew Ward of Scripps Research Institute in La Jolla, California.

In experiments using the new approach to look for antibodies to HIV, “we flipped the process on its head… by starting with structure,” Ward said. Because cryoEM affords such high resolution, instead of having to laboriously sort through antibody-producing immune cells one by one to identify promising antibodies, the process of identifying antibodies, mapping their structure and seeing how they are likely to attack viruses and other targets goes much faster, he added. “The ongoing COVID-19 pandemic has highlighted the need for such robust and rapid technologies,” his team concluded.

Click for a Reuters graphic on vaccines in development.

 

(Reporting by Nancy Lapid; Editing by Bill Berkrot)

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Vaccination plus infection offered most protection during Delta surge, U.S. study shows – CBC News

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Protection against the previously-dominant Delta variant was highest among people who were both vaccinated and had survived a previous COVID-19 infection, according to a report published Wednesday by the U.S. Centers for Disease Control and Prevention (CDC).

The report also found those who had previously been infected with COVID-19 were better protected against the Delta variant than those who were vaccinated alone, suggesting that natural immunity was a more potent shield than vaccines against that variant, California and New York health officials reported on Wednesday.

Protection against Delta was lowest among those who had never been infected or vaccinated, the CDC report continued.

“The evidence in this report does not change our vaccination recommendations,” Dr. Ben Silk of the CDC and one of the study’s authors told a media briefing.

“We know that vaccination is still the safest way to protect yourself against COVID-19,” he said.

The findings do not apply to the Omicron variant of the virus, which now accounts for 99.5 per cent of COVID-19 cases in the United States.

Study includes data from May to November

For the study, health officials in California and New York gathered data from May through November, which included the period when the Delta variant was dominant.

It showed that people who survived a previous infection had lower rates of COVID-19 than people who were vaccinated alone.

That represented a change from the period when the Alpha variant was dominant, Silk told the briefing.

“Before the Delta variant, COVID-19 vaccination resulted in better protection against a subsequent infection than surviving a previous infection,” he said.

In the summer and fall of 2021, however, when Delta became the predominant circulating iteration of the virus in the United States, “surviving a previous infection now provided greater protection against the subsequent infection than vaccination,” he said.

But acquiring immunity through natural infection carries significant risks. According to the study, by Nov. 30, 2021, roughly 130,781 residents of California and New York had died from COVID-19.

The analysis did not include information on the severity of initial infection, nor does it account for the full range of illness caused by prior infection.

One important limitation to the study was that it ended before administration of vaccine booster doses was widespread.

WATCH | Experts agree the science behind booster shots is sound:

The safe science behind COVID-19 booster shots

5 days ago

Duration 1:55

While some Canadians who have received their booster shots have later tested positive for COVID-19, medical experts agree that the science behind booster jabs is sound. 1:55

‘Clearly shows’ vaccines provide safest protection

Dr. Erica Pan, state epidemiologist for the California Department of Public Health, said in an email that the study “clearly shows” that vaccines provide the safest protection against COVID-19 and they offer added protection for those with prior infections.

“Outside of this study, recent data on the highly contagious Omicron variant shows that getting a booster provides significant additional protection against infection, hospitalization and death,” Pan said.

Silk said the CDC is studying the impact of vaccination, boosters and prior infection during the Omicron surge and expects to issue further reports when that data becomes available.

So far, Omicron has proven to evade some level of immunity from both vaccination and previous infection, but vaccines are still largely preventing serious illness and death.

An Israeli hospital on Monday also said preliminary research indicates a fourth dose of leading mRNA-based vaccines provides only limited defence against infection from the variant.

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