Monday Morning News & Notes
BA.5 wave rolls across Europe. More monkeypox cases
🦠Pandemic🦠
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Denmark’s Staten Serum Institute no longer updates COVID numbers on the weekends. It will table three days worth of data later today.
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University of Oxford Professor of Virology and Immunology Astrid Iversen, who served on an expert COVID panel in Denmark, is stressing that the country needs to get cracking with a fourth dose. Iversen says most of Denmark’s oldest populations, seniors 75 years old and older, had a booster dose seven to nine months ago.
“It is really important that the oldest and most vulnerable citizens in Denmark have the opportunity to get the fourth dose as soon as possible. There is not much immunity left when the third dose was given 5-6 months ago.”
Danish health authorities have given the green-light for elderly seniors and other vulnerable populations to get a fourth dose, but it requires a referral from their doctor. Iversen says to that end, some of the kinks don’t seem to have been worked out. She says she has been hearing from people that there seem to be “practical difficulties” with the system to facilitate doctors referrals. She says this needs to be fixed and fast.
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Region Midtjylland is working to ramp up vaccination capacity in preparation for another major inoculation push in Denmark this fall and winter. It isn’t just a fourth booster dose of COVID vaccines, as the five regions will also have to inoculate people against influenza and pneumonia beginning October 1.
Regional Council Chairman Anders Kühnau:
“We have many skilled employees who have been ready to help with the vaccination effort. Now we are once again increasing the capacity of the permanent vaccine centers. And is also working on entering into vaccination agreements in even more places in collaboration with others, such as general practitioners, pharmacies, and the municipalities. The goal is to ensure easy, safe and quick access to vaccination for everyone who is to be offered vaccination.”
The region will begin administering a fourth dose of the COVID vaccine for seniors in care at their care homes on September 15. Once the vaccination effort for everyone 50 years old and older gets into full swing on October 1, then the region will lean on its permanent vaccination sites. They are in Holstebro, Herning, Viborg, Silkeborg, Randers, Aarhus, and Horsens. This will likely be fleshed out using private vaccination clinics and family doctors.
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Region Syddanmark is reminding vulnerable populations like those with weakened immune systems, that they can now, with a doctors referral, get another COVID vaccine booster dose. As the region begins ramping up vaccination capacity and prepares for another fall inoculation campaign, it is now ending drop-in vaccinations. People who want to get vaccinated will have to book an appointment online
Like the other regions, Region Syddanmark will begin offering seniors in care and elderly seniors a second booster dose on September 15. This will be followed by opening up the vaccination to everyone 50 years old and older on October 1. It says further details on how the fall vaccination campaign will be carried out will be made public after the summer holidays.
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Climate change may increase the risk of new diseases and potentially lead to more pandemics in the future in Denmark. The University of Copenhagen and the Statens Serum Institute have completed a study examining climate change and the threat of diseases enabled by a warmer climate.
The study identified several migrating diseases that will likely land in Denmark soon or later, as well as the threat posed by mosquito borne diseases in a warmer wetter climate, last but not least food-borne diseases were also examined.
Five mosquito borne diseases topped the list. As a warmer climate enables population increases of insects, mosquitos, and ticks. The West Nile virus, already detected in the Netherlands and Northern Germany topped the list from the south. While Tularemia, or the hare plague, which has been moving south through Sweden. Hare plague when transmitted to humans, requires antibiotics for treatment.
Hare plague can cause disease in humans. Mostly with mild symptoms, but it requires treatment with antibiotics.
Senior Researcher René Bødker:
“We are very aware of the new mosquito-borne diseases in animals, because they can have an impact on which new zoonotic epidemics we humans risk being affected by in the future.”
The study also notes cases of salmonella and campylobacter, both foodxborne diseases, could also pose a risk. While the COVID pandemic beat down the numbers of a variety of viruses, since 2021, food borne diseases have been making a comeback with 63 outbreaks reported, up from 35 in 2020 and 51 in pre-pandemic 2019.
SSI Epidemiologist Luise Müller:
“2021 was particularly dominated by two major foodborne outbreaks: one outbreak with salmonella in herbal medicine that made 54 people sick, and one with Enteroinvasive E. coli, where 48 people became ill after eating spring onions. Both outbreaks were due to imported, raw products. It emphasizes the importance of having surveillance and emergency preparedness that can detect and stop outbreaks.”
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The Swedish Public Health Agency only updates COVID statistics once a week, every Thursday.
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The BA.5-driven infection wave has hit Sweden as coronavirus numbers shoot sharply upward. In its latest situation report, the Swedish Public Health Agency says the number of COVID infections rocketed up week to week, with cases increasing by 41% from week 24 to week 25. The agency says the BA.5 variant “now dominates in Sweden.”
“There are indications that BA.5 can avoid the immune system and infect people who have been vaccinated or have had a previous infection, but there are also many indications that vaccines continue to protect against serious illness and death.”
The public health agency is warning that it expects infections to continue to rise in Sweden in the weeks ahead, and that means that hospitals will once again be under pandemic pressure.
There were just 16,000 tests taken across Sweden in week 25, roughly the same number as the week before. Of those, the positivity percentage was 18%, a five-point increase week to week. Keep in mind the pandemic situation is probably much worse as PCR testing is restricted to just seniors in care and people being admitted to hospital.
Nine intensive care admissions were reported in week 25, but the Swedish Public Health Agency adds that several regions are reporting an increasing number of COVID patients.
There were 24 COVID deaths in week 25. A number that is preliminary due to Sweden continuing to struggle with a backlog of processing pandemic deaths as it has for many months now.
State Epidemiologist Anders Lindblom:
“In previous summers, COVID has decreased, but in recent weeks we have seen an increase in the number of cases. It is likely that infections will continue to increase for a few more weeks, and thus more people will need hospital care. If infections sweep through hospital staff at the same time many take summer holidays, it could mean an increasing pressure on hospitals, even if it is a relatively small number.”
Lindblom is urging people to get vaccinated if they aren’t, and if they are eligible for a booster dose, then they need to get it as soon as possible.
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Strained but stable. That is how the hospital situation in Sweden’s capital region is being described by the people who would know best, chief physicians. The head doctors in Region Stockholm meet once a week to get a handle on the state of things. Hospitals are facing a crunch on two fronts, according to the lastest meeting. One is, of course, the rising number of coronavirus infections and the other is summer holidays as staffing becomes challenging.
Chief Physician Patrik Söderberg:
“All patients who need urgent and necessary medical care will receive it. But for those with lower medical priorities, it can sometimes mean longer waiting times. This is an example of the difficulty of both staffing summer care and at the same time offering healthcare employees a well-deserved holiday.”
With another variant-driven infection arriving in Sweden, doctors noted rising infection numbers and a decline in the number of available care beds.
“The pandemic is not over and coronavirus remains in society to a very high degree. Vaccinations still provide the best protection against severe infections. I understand that many now want to hang out close again and maybe see each other for a barbecue night with good friends. But if you feel the least bit sick, it is important that you stay at home and meet as few people as possible.”
The number of care beds in Region Stockholm dropped by 260 to 2,500 available beds in week 26.
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The Finnish Institute for Health only updates its COVID statistics once every week, on Thursdays.
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Finland’s epidemic is on a “clear downward trend” according to the Finnish Institute for Health. However, it also notes that the BA.4 and BA.5 variants are becoming more widespread, likely meaning another infection wave is imminent.
But so far, the number of infections cases, hospitalizations, intensive care admissions, and pandemic fatalities have all “decreased significantly” since the BA.2 wave peaked in April. The falling numbers are also being seen across all age groups.
The institute does warn that data on COVID deaths has been “inadequate” in the last few weeks, casting doubts about possible declining numbers there.
The Finnish vaccination strategy was recently updated to try and increase vaccination numbers, to provide a better buffer against another infection wave and to stave off having it reintroduce tougher restrictions. While offering another booster dose to elderly seniors and high risk populations, there is no plan yet in Finland for a broader vaccination effort But, it also promises that more news on that front will be coming during the summer ahead of heat is expected to be another infection wave this fall and winter.
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While the number of COVID cases increase in Germany again the country’s Chancellor is striking a similar tone as his counterpart in Denmark. Olaf Scholz dismissed any chance the heavy handed restrictions seen in the first two years of the pandemic would make a return.
Scholz, speaking to ARD, did say though, that face mask requirements will likely return this fall and winter.
“We will not close schools again, and I do not think we will need to introduce as extensive lockdowns as we have seen in the last few years. But I think it is good that you can expect face-masks to play a bigger role in the autumn and winter than they do now.”
Scholz is urging people to get vaccinated if they haven’t been already, and if they are vaccinated and are eligible for a fourth dose, they shouldn’t waste anytime getting it.
🇵🇹
Portugal has lifted all COVID travel restrictions. Incoming travelers will no longer have to use their EU COVID digital passport or other proof of vaccination to enter the country. Proof of a recent negative COVID test result is also no longer required.
🇪🇺🦠
Another infection wave is building across Europe, driven by two new COVID variants. COVID infections across the EU last week increased by 27% compared to the week before, according to the latest pandemic assessment from the European Centre for Disease Prevention and Control. This is the fourth week of increasing infection numbers in Europe. The agency says infection rates are rising, particularly among seniors 65 years old and older, with 21 out of 26 countries reporting increasing coronavirus cases among elderly populations.
The centre warns:
“The increasing transmission among older age groups is starting to translate into increasing rates of severe disease.”
The ECDC says out of the ten countries with adequate testing and sequencing rates, the BA.4 or BA.5 variant is dominant in seven of them. In those seven countries, BA.4 or BA.5 accounted for 58.2% of all sequenced positive test results. The fading BA.2 variant came back in 35.5% of cases. 11% of positive test results were the BA.2 variant with the L442X mutations.
Of the 28 EU countries reporting data on hospital and/or intensive care admissions, 15 reported increasing trends in one or both categories.
The 14 day COVID death rate in the EU fell slightly week to week, going from 7.6 to 6.6 deaths per million population. That said, four countries, Cyprus, Iceland, Latvia, and Malta are seeing the number of pandemic fatalities increase.
In Europe, 72.7% of the total population has two vaccine doses and 52.7% have a booster dose.
In the next two weeks, the ECDC is forecasting that infection numbers and pandemic deaths will continue to rise for at least the next two weeks while hospital admissions will be stable.
“It should be noted that forecasts of cases are considered to be increasingly unreliable due to changes in testing criteria and reporting procedures. All current forecasts, in particular case forecasts, should be treated with caution.”
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COVID testing rates remain low across large swathes of Europe but its worth noting testing rates are beginning to increase again as the BA.5 variant sweeps through. Denmark for example, which was ‘greyed out’ out due to low testing levels the week before last, is now coloured orange and red last week.
🇪🇺🌏💉
Global health experts put the use of variant-specific vaccine doses under the microscope last week. The European Medicines Agency co-chaired a workshop involving health professionals and organizations from around the world. Among them were the US Food and Drug Administration, World Health Organization, and the International Coalition of Medicines Regulatory Authorities. Together, they agreed, Omicron-specific vaccines, if used as a booster, can enhance and increase protections. They also confirmed existing vaccines protections against symptomatic infection are being eroded, with new variants better able to avoid immune protections. But they added that vaccine protection against severe infection, hospitalization, and deaths continues to hold up.
Another interesting issue was also on the table, bivalent COVID vaccines. These are vaccines in development that are designed to target two specific coronavirus strains. The health experts said that one should be an Omicron strain and if so, it could be advantageous in increasing protections. But for now, they agreed, more data is needed, and in the interim any use of a bivalent vaccine should be as a booster only.
Any vaccine targeting the once dominant, and now largely vanished, Delta variant should be treated cautiously until clinical trials prove they are effective against Omicron variants.
The health authorities also warned that new, more threatening variants may continue to emerge rapidly and quickly asserting dominance. And pandemic responses need to be crafted around that reality.
🇺🇸 🦠💉
The US Food and Drug Administration has advised vaccine makers to update booster doses to specifically target the Omicron BA.4 and BA.5 sub-variants. There has been concern that Omicron-specific variant boosters may be aimed at the original strain and be less effective against its more mutated offspring.
FDA’s Dr. Peter Marks in a statement:
“As we move into the fall and winter, it is critical that we have safe and effective vaccine boosters that can provide protection against circulating and emerging variants.”
New🦠Variant Alert
Epidemiologists are warning that another Omicron sub-variant, BA.2.75, might be another source of concern. The strain was first identified in India, which is seeing infection numbers rise. Keep in mind its numbers are likely underreported.
The BA.2.75 variant has already spread to at least eight other countries Australia, Canada, Japan, Germany, New Zealand, the United Kingdom and the US.
Dr. Shay Fleishon is with Israel’s Central Virology Laboratory at Sheba Medical Center, and he called the new variant “alarming.” That said, he also stressed, as have others, that while the number of mutations in this strain are a cause for concern, there is still a lot we don’t know about the strain and its potential impacts.
🦠Study
We know that coronavirus is airborne and can be spread by inhaling droplets containing aerosolized virus particles, especially in close, confined spaces. But what about over longer distances? A recently published study has determined that airborne transmission can occur at a distance of two meters or more, but the virus needs some help to get it done.
The study can be found HERE.
Researchers examined infection outbreaks in quarantine hotels, in restaurants, on buses, in workplaces, and at event centers. It concluded that long-distance COVID transmission can occur in an enclosed setting if people aren’t wearing masks, there isn’t proper air ventilation, or if there is an activity like singing. Importantly, the study found no evidence of long distance airborne coronavirus transmission without one or more ‘helping’ factors.
The study concludes:
“These results highlight the importance of assessing ventilation, especially in indoor spaces where people meet others from outside their household. Particular attention should be given to ventilation in settings with activities that might increase the number of respiratory particles, for example, singing. Where ventilation is assessed to be inadequate, improvements should be made.”
🇨🇦
Due to the Canada Day long weekend, the Public Health Agency did not update its COVID numbers last Friday, meaning they haven’t been updated since June 24. PHAC only updates pandemic numbers in Canada once a week, every Friday.
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The Canadian government has extended travel-related COVID rules until at least September 30. This means use of the ArriveCan app will continue to be required for inbound travelers.
The Public Health Agency of Canada says a pause on mandatory random COVID testing on all fully vaccinated travelers will continue until at least mid-July. The agency says it is also continuing plans to move COVID testing for airlines travelers outside of airports to testing sites, or pharmacies.
For people crossing into Canada by land, they will continue to face the possibility of being selected for mandatory random coronavirus testing.
All restrictions on unvaccinated or not fully vaccinated travelers remain in place with all testing requirements for travel including a 14 day quarantine on arrival and mandatory testing on days one and eight of their isolation.
🦠Monkeypox🦠
The number of monkeypox cases within Europe now exceeds 4,000, according to the latest situation update from the European Centre for Disease Prevention and Control. It says as of June 28, there were 4,177 confirmed monkeypox cases across 31 countries throughout Europe. 99.5% of all infection cases were men, and of those, 44% were between the ages of 31 to 40 years old and 39% were HIV positive. The majority of infections involve a rash and symptoms like a fever, fatigue, muscle pain, vomiting, diarrhea, chills, a sore throat, or a headache. To date, there has yet to be a monkeypox-related death in the European region.
Of potential concern, the ECDC notes ten infection cases are reported to be healthcare workers. Investigations are underway to determine if the infections were due to being exposed to monkeypox while on the job.
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Germany’s Health Agency, the Robert Koch Institute, says the country now has 1,054 confirmed monkeypox cases across its 16 German states. It adds “further cases are to be expected.”
🇪🇺💉
Europe’s pharmaceutical watchdog has begun a review to determine if a smallpox vaccine, Imvanex, can work against monkeypox. The European Medicines Agency says the similarities between the two viruses could mean the vaccine might be able to be effective at vaccinating against both. Initial laboratory studies have suggested Imvanex may trigger an antibody response to monkeypox. If all this proves true using further data, the one fly in the ointment would be that supplies of the vaccine are pretty limited.
🇺🇦/ 🇷🇺 War
Norway and the United Kingdom have collaborated on getting more heavy weapons to Ukraine. The two countries have reached a deal where Norwegian MLRS weapons (Multiple Launch Rocket Systems), which are needing some major refurbishment, will go to the UK, be repaired and updated and then be included in a heavy weapons shipment to Ukraine.
Defense Minister Bjørn Arild Gram:
“Norway and the United Kingdom are collaborating on the donation of long-range MLRS rocket artillery to Ukraine. We must continue our support for Ukraine so that they can continue their struggle for freedom and independence. More weapons are needed, and this is a highly demanded capacity for Ukraine that we would not have achieved without close cooperation with the United Kingdom.”
Norway will donate at least three MLRS systems to Ukraine in the initial shipment.
“This is a weapon that has range and precision, and which is therefore a significant contribution. Our guns require extensive upgrading, therefore we have agreed with the British that they receive Norwegian guns so they can send some of theirs to Ukraine. This is an example of good cooperation between allies.”
Along with the heavy weapons, Norway is also sending 5,000 hand grenades to Ukraine.
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It is not just weapons. Norway is also sending Ukraine some serious financial help. It is increasing financial support to Ukraine by 10 billion Norwegian kroner (about $1.3 billion Cdn) over two years. The money will go to humanitarian aid, reconstruction work, and of course, weapons.
Prime Minister Jonas Gahr Støre:
“We stand together with the Ukrainian people. Russia's invasion of Ukraine has created the biggest crisis in Europe since World War II. The war has dramatic consequences for the Ukrainian people, who are completely dependent on outside help. The invasion also threatens security in Europe. We help support the Ukrainians' struggle for freedom. They are fighting for their country, but also for our democratic values.”
The Norwegian Foreign Affairs ministry estimates that 4.8 million people have fled Ukraine and 7.1 million have been displaced within the country due to Russia’s invasion.
The EU estimates that the costs of reconstruction and long-term assistance will amount to billions of euros.