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Studies find Omicron related hospitalisations

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Adult hospitalisations from Omicron-related SARS-CoV-2 (COVID-19) were less severe than Delta and the Pfizer-BioNTech vaccine (also known as Comirnaty and BNT162b2*) remains effective in preventing not only hospitalisation, but severe patient outcomes associated with COVID-19, two new research studies have found.

The University of Bristol-led research, funded and conducted in collaboration with Pfizer Inc., as part of AvonCAP, is published in The Lancet Regional Health – Europe.

In the first paper ‘Severity of Omicron (B.1.1.529) and Delta (B.1.617.2) SARS-CoV-2 infection among hospitalised adults: a prospective cohort study in Bristol, United Kingdom’  researchers assessed whether Delta SARS-CoV-2 infection resulted in worse patient outcomes than  Omicron SARS-CoV-2 infection, in hospitalised patients

The study aimed to provide more detailed data on patient outcomes, such as the need for respiratory support.

The research demonstrated that Omicron infection resulted in less serious outcomes than Delta in hospitalised patients. Compared to Delta, Omicron-related SARS-CoV-2 hospitalisations were 58% less likely to need a high level of oxygen support, 67% less likely to need ventilatory support (such as a ventilator) or more critical care, and 16% less likely to have a hospital admission which lasted for more than three days.

Dr Catherine Hyams, Post-Doctoral Clinical Research Fellow, Principal Investigator for the AvonCAP study and one of the study’s lead authors at the University of Bristol, said: “By finding out the reduced requirement of increased oxygen support and total positive pressure support, including non-invasive ventilation, our analysis should contribute to future hospital care and service planning assessments.

“However, the impact of lower severity Omicron-related hospitalisation must be balanced with increased transmissibility and overall higher numbers of infections with this variant.”

The research team suggest there should be ongoing evaluation of the severity of new variants of SARS-CoV-2, along with careful planning of healthcare resource to avoid healthcare systems being overwhelmed.

Dr Leon Danon, Associate Professor in Infectious Disease Modelling and Data Analytics, in the Department of Engineering Mathematics and one of the study’s lead authors, added: “These results have been published at a time when China is experiencing a resurgence of COVID-19 and may be useful in helping to understand what is happening there.”

The second paper – ‘Effectiveness of BNT162b2 COVID-19 vaccination in prevention of hospitalisations and severe disease in adults with SARS-CoV-2 Delta (B.1.617.2) and Omicron (B.1.1.529) variant between June 2021 and July 2022: a prospective test negative case-control study’ – provides the first estimates of two- or three-dose Pfizer-BioNTech COVID vaccine effectiveness against hospital admission for more than three days and against respiratory difficulty requiring oxygen or ventilatory support.

Many studies have reported the effectiveness of the COVID-19 mRNA vaccines against hospitalisation, but few have assessed the effectiveness against clinically relevant measures of COVID-19 severity. Using detailed clinical data from Bristol’s two hospital Trusts – North Bristol NHS Trust (NBT) and University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) –  researchers estimate the effectiveness of two- or three-doses of the (original/monovalent) Pfizer-BioNTech vaccine against hospitalisation for infection with either Delta or Omicron SARS-CoV-2 variants.

The study showed that receipt of two-doses of Pfizer-BioNTech vaccine may result in an 83% reduction in the rate of hospitalisation due to Delta SARS-CoV-2 infection, compared to the unvaccinated. Two doses also prevented severe in-hospital outcomes due to Delta SARS-CoV-2 infection, reducing the likelihood of a hospital admission lasting more than three days by 63%.  The researchers also found that two doses of this vaccine reduced the risk of a patient needing increased oxygen or ventilatory support by 52% and 59%, respectively.

Receipt of three-doses of Pfizer-BioNTech vaccine was also found to be effective in reducing Omicron infection severity, compared to the unvaccinated, including in older adults, reducing the risk of hospitalisation for more than three days with Omicron SARS-CoV-2 by 56%, and decreasing the risk of needing high-level oxygen or ventilatory support by 42% and 59%, respectively. This is additional evidence that Pfizer-BioNTech vaccine is effective in reducing hospital admissions due to Delta and Omicron SARS-CoV-2 infection.

Dr Anastasia Chatzilena, Postdoctoral Research Associate in the Department of Engineering Mathematics, and a lead author of the study, said: “Our research has shown the Pfizer-BioNTech vaccine provides effective protection against hospitalisation from Delta and Omicron infection and has significant benefits in terms of preventing severe disease, including critical care admission and respiratory failure.

“However, the benefit provided by vaccination decreases over time which appears to be more pronounced in older adults, so careful ongoing monitoring of vaccine effectiveness and SARS-CoV-2 disease severity for emerging variants remain important.”

This research is part of AvonCAP, an ongoing collaborative surveillance project funded by Pfizer Inc., which records detailed information on every adult patient admitted to Bristol’s two large NHS hospital Trusts, NBT and UHBW, with symptoms, signs and/or X-ray evidence of acute disease in the lungs.

* The Pfizer-BioNTech vaccine (also known as Comirnaty and BNT162b2) is indicated for active immunisation to prevent COVID-19 caused by SARS-CoV-2, in individuals 12 years of age and older.


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Canada to donate up to 200,000 vaccine doses to combat mpox outbreaks in Africa

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The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.

It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.

Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”

Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.

Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.

A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.

On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.

Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”

But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”

“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.

Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.

Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.

Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.

“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.

“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”

This report by The Canadian Press was first published Sept. 13, 2024.

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

The Canadian Press. All rights reserved.

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How many Nova Scotians are on the doctor wait-list? Number hit 160,000 in June

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HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.

The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.

Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.

“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”

The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.

A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.

Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.

“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.

Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.

The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.

“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.

This report by The Canadian Press was first published Sept. 11, 2024.

The Canadian Press. All rights reserved.

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Newfoundland and Labrador monitoring rise in whooping cough cases: medical officer

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ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.

Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.

Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.

Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.

The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.

“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.

Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.

Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.

Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.

A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.

This report by The Canadian Press was first published Sept. 10, 2024.

The Canadian Press. All rights reserved.

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