Monday Morning News & Notes
Concerning indicators continue to mount in Denmark
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The UK Health Security Agency has deemed a sub-variant of the Delta strain as a ‘variant under investigation.’ AY.4.2 is the Delta variant with a few new mutations. The concern about this variant is that in the UK it seems to be outpacing the parent Delta strain in infection growth. The UK is seeing a new infection surge as cases shoot upward again.
On Sunday, the United Kingdom reported 39,962 new infections and 72 more virus deaths. In the previous five days daily infections have risen to around 50,000 a day. Over the last seven days, the infection growth has increased, as have fatalities, and hospitalizations.
AY.4.2 was first identified in the United Kingdom in July of this year and is now spread across England. There have been over 15,000 total cases confirmed so far. The variant has been reported in 33 countries to date, including Denmark.
The UK Health Security Agency is estimating that AY.4.2 is about 17% more contagious than the original Delta variant. For context, that’s almost twice as contagious as the original coronavirus that ignited the global pandemic in the spring of 2020. It also noted a slightly increased secondary attack rate in a household. This means when one person has it in a home, it spreads a little more quickly to others in the same house.
Like all new variants, there’s a lot we do not know yet about AY.4.2, and the biggest unanswered question right now is if it is vaccine resistant and if so, to what degree. We already know that vaccines, while still highly effective, are slightly less so against the Delta variant.
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As a mammoth flu shot campaign enters its fourth week, about 4% of children aged two to six years old have been vaccinated so far. This is the first time Danish health authorities have offered the influenza vaccine to children so young. This is due to concerns about decreased natural immunity due to COVID restrictions, which all but wiped out the last two flu seasons. At the moment the flu shot is available to priority groups including young children, seniors, vulnerable populations, and pregnant women. Children between two and six years old are being offered the vaccine as a nasal spray.
National Board of Health Unit Manager Bolette Søborg spoke to DR:
“Children between two and six years old have a special role in the spread of influenza and by vaccinating them, we can prevent up to 40% of the infection that is anticipated this influenza season.”
So far, about 826,000 people have been vaccinated against influenza this year. To date, the number of confirmed influenza cases remains fairly low despite fears of the possibility of a massive resurgent infection wave.
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Daily COVID infections in Denmark stayed above 1,000 each day through the weekend making it five straight days in a row. The last time that happened was in the beginning of January as the infection curve climbed down from the holiday high during the Alpha variant wave. On Friday Denmark reported 1,270 new infections, followed by 1,262 on Saturday, and then another 1,349 on Sunday. Over the same time period there were three more deaths pushing the to date total to 2,699.
Another alarm bell is the rising positivity percentage. With 67,192 PCR tests reported yesterday, that equals a positivity percentage of 2.01%, which is very high for Denmark.
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The bad indicators keep piling up. There are now 45 Danish kommunes with a COVID incidence rate over 100 per 100,000 citizens. Of those, 13 municipalities have incidence rates in the 200s, six are topping 300, and Ishøj has seen its incidence rate rocket up to an eye-catching 590.
In 42 of the municipalities with a COVID incidence rate of 100 or more, the infection activity is trending upward.
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Another telling statistic is hospitalizations (167) which also continues to rise (+11) while the number of infected people in an ICU (19) has also crept upward (+3) and of those the number on a ventilator (11) edged up as well (+2).
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Line ups outside North Jutland COVID testing sites are growing again. Region Nordjylland says the demand is such that it is now stepping in and increasing testing capacity.
The region is opening new testing sites in Dronninglund and Hadsund.
Region Manager Jacob Bertramsen:
“If you have the opportunity, we would strongly recommend that you go get tested outside the peak period if you want to avoid queues. This means that you should not arrive between 12:00 and 1:30, and that you do not show up at opening and closing hours. We have no interest in there being a queue, and testing is still an important tool in relation to infection containment. We are, of course, following developments closely and keeping an eye on whether there is a need to further upscale capacity.”
The region is testing about 5,000 people every day and it reports that those numbers have been steadily increasing over the last few weeks.
Five testing sites in the region in Dronninglund, Støvring, Brønderslev, Nykøbing, Læsø, and Hadsund do not require an appointment to get tested. While testing facilities in Skagen, Frederikshavn, Hjørring, Thisted, Aalborg, Hobro, and Aars operate two lines, one for those with an appointment, and the other for those without.
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On the vaccination front to date, 76.2% of Denmark’s total population has one vaccine dose and 75% are fully vaccinated. In both cases the number of new inoculations continues to crawl along.
The bulk of all daily vaccinations is now booster doses with 6,980 3rd doses administered on Saturday. So far, 3.9% of the population has a booster shot.
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Region Midtjylland has added three new vaccination sites to meet booster shot demand. They are in Syddjurs, Norddjurs, and Favrskov. The region is also cutting down on drop in vaccinations.
The only vaccination center now taking walk-ins in the region is Vaccinationscenter Randers. Everywhere else will require an appointment to be booked online before showing up for a third dose.
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Sweden will table its first COVID update of the week on Tuesday.
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The Swedish Public Health Agency has tabled three new possible COVID scenarios for the next few months. The agency says they factored in things like a highly infectious Delta variant, increased contacts due to having no restrictions, and the seasonal effect with colder weather meaning for people inside.
The first scenario anticipates some increase in people rubbing elbows with one another and a resulting “continued spread of infection.”
The second scenario anticipates much more contact among the population with infections potentially reaching 2,500 per day in December and January. It also expects hospitalizations to increase albeit at lower levels than previous infection waves due to vaccinations.
Scenario three is the most dire. It assumes a large increase in people meeting and socializing with up to 5,000 daily infections as a result. However, it adds “this scenario is considered less likely.”
The Folkhalsomyndigheten says it believes what will play out will be somewhere in the range of the first or second scenario.
State Epidemiologist Anders Tegnell:
“The Public Health Agency's new scenarios point to a continued spread of infection. Each person's actions are decisive for how big the increase will be, and how well we manage to keep morbidity down. The most important thing now is that as many people as possible get vaccinated; that everyone who feels ill stays at home, and that unvaccinated people follow the special recommendations that apply to them.”
Tegnell adds if they have misread the situation and a much more serious infection surge occurs, they’ll take steps.
“Should the spread of infection increase dramatically and the burden on health care rise sharply, we are of course prepared to take measures such as reintroducing national restrictions.”
About 85% of the Swedish population over the age of 16 has at least one vaccine dose and almost 80% have both doses.
It’s worth noting the Swedish Public Health Agency’s last best guess in tabling potential scenarios for this last summer, anticipating very little infection activity, was woefully wrong.
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Unvaccinated children in school are more protected and suffer fewer infections when all the teachers and school staff around them have had both doses. That is the finding of a new report according to the Swedish Public Health Agency. It says the report shows a direct link between vaccination coverage and decreased rates of infection among children and young people.
Oddly it also found infection rates were higher for students 13 to 19 years old who were in distance education during the spring of 2021 than for those physically in class.
Department Head Britta Björkholm:
“We know that children of all ages are susceptible to the virus and can spread it. But vaccination of adults and young people against COVID also protects the children and young people who have not been vaccinated.”
The agency says infection rates were highest among young people 16 to 19 years old but then decreased the younger the children were.
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Norway has added 1,989 new infections and had one more coronavirus death over the last three days.
COVID hospitalizations (121) ICU numbers (32) and the number of people on a ventilator (11) are all unchanged since Thursday’s update.
So far, 77.86% of Norwegians 12 years old and older have had one vaccine dose and 69.02% have had both.
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The Norwegian Institute of Public Health says it will stick to offering children 12 to 15 years old just one vaccine dose. The agency says it will reassess the need for a second dose early in 2022. The agency says it needs more information before it can green-light two vaccine doses for young children.
The NIPH says “there is no basis” for a second dose because young children have a low-risk of suffering serious COVID infections. It estimates one vaccine dose offers kids 85% protection against serious cases of coronavirus and that, that protection remains in place for at least 16 weeks.
The agency says it will issue a new assessment on a second vaccine dose for kids, the risks of rare side effects, and the overall situation at the beginning of the new year.
So far, around 260,000 children used the age of 16 have been vaccinated with a single dose. That is about 70% of all children aged 12 to 15 years old.
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The Norwegian Institute of Public Health is urging people who are immunocompromised to go get a booster dose. The agency says over 60,000 people with severe immune deficiency have taken a third vaccine dose. But it is concerned that there are a number of people who need extra protection against coronavirus but have not yet shown up for a third shot.
Chief Physician Sara Viksmoen Watle:
“Every week now, we constantly see that more of those with severely weakened immune systems take the 3rd dose, and that is very good. At the same time, we believe that some have either not received the offer or have not had the opportunity to take advantage of the invitation to get a booster shot.”
Watle says people with weakened or compromised immune systems are extra vulnerable to coronavirus. They also would have less protection from two doses than the rest of the population. A third booster shot will increase their protection against infection. She says it is extra important that people who suffer from weakened immune systems go get another dose.
Norway is prioritizing vulnerable populations for a booster shot including people with organ or bone marrow transplants; those in active dialysis, people with HIV, cancer patients, and others.
Seniors 65 years old and older and elderly people in nursing homes are also able to get a booster shot.
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The Finnish Institute for Health hasn’t updated COVID statistics since Friday when they went into the weekend with 449 infections and six more corona deaths.
We will get a better idea of the situation there when they table a catch-up update later today.
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The Finnish Institute for Health says it is anticipating the country’s vaccination coverage will reach 80% of the population 12 years old and older by the first week of November. However, it cautions this is dependent on current inoculation rates holding steady.
The health agency is also warning in its latest weekly COVID assessment that the pressure on the hospital system, especially specialized healthcare, is substantial. It says over the last three weeks the number of patients needing specialized care has increased from 58 to 103. For those admitted to intensive care over the same period numbers went from 23 to 34 patients. As elsewhere in the world, the institute says it is unvaccinated people being admitted to hospital in numbers far higher than people with one or both doses. The agency says unvaccinated people 12 to 79 years old, are 19 times more likely to be hospitalized than those who have both doses. For an unvaccinated person 50 to 79 years old the risk of being admitted to specialized or intensive care is 28 times higher than those in the same age group who are fully vaccinated.
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For a second week in a row the Finnish wastewater COVID surveillance system showed an overall drop in levels of infection activity. Regionally wastewater plants in Hämeenlinna, Kouvola, Oulu, and Vaasa saw coronavirus rates increase. While facilities in Espoo, Helsinki Jyväskylä, Kuopio, Lappeenranta, Tampere, Turku, and Rovaniemi saw rates fall.
The wastewater surveillance system in Finland has been very successful in providing advance notice of coronavirus activity often before it shows up in community testing.
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Belgium may be seeing the start of a fourth infection wave as it registered daily COVID numbers on Thursday, Friday, and Saturday the country hasn’t seen in almost a year. Daily infections have exceeded 6,500. The last time number were that high was on November 12 of last year. Hospitalizations have also shot up with over 1,000 coronavirus patients, the highest number since June. The country’s COViD commissioner, Pedro Falcon, says the majority of people being hospitalized are unvaccinated.
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Austria has had enough of vaccine skeptics. The country’s Chancellor Alexander Schallenberg spoke to the German newspaper Der Zeit over the weekend to say his government is ready to impose a curfew on the unvaccinated. He says the curfew will be levied if the number of COVID patients in ICUs exceeds 600. Currently there are about 224 people in intensive care. Schallenberg says there will be some exceptions for unvaccinated people to be out past curfew for work, shopping for necessities, and other vital tasks. 64% of Austrians have at least one vaccine dose.
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Today, the European Medicines Agency will table its decision on whether to authorize a Moderna booster vaccine dose for everyone 12 years old and older. If approved a third shot would be administered six months after a second dose. The EMA says it’s also working with Moderna on an application from the vaccine maker to extend use of its vaccine to children under the age of 12. This would come while Scandinavian countries limit use of the Moderna vaccine for those under 30, especially men, due to concerns over rare side effects impacting the heart.
Currently, Pfizer/BioNTech has applied to authorize its vaccine for use in Europe for children aged 5 to 11 years old. A decision from the EMA is a few months away.
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Europe’s pharmaceutical watchdog is also going over data on administering a booster for those who have had the one-shot Johnson & Johnson vaccine. The agency says it is seeing “promising results” from studies on giving a second or third dose of a vaccine different from the one initially received.
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The EMA says it has also been “in constant dialogue” with Merck over its COVID treatment antiviral drug ‘molnupiravir.’ If approved for use, the drug, taken as a pill, would become the first ever oral coronavirus treatment, potentially opening a new front on the war against COVID. Studies have shown the drug can reduce the risk of hospitalization or death in newly diagnosed coronavirus patients. The European Medicines Agency says it expects an application from Merck, triggering a rolling review, by this week.
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On Friday, Pfizer/BioNTech said its COVID vaccine for young children aged five to 11 years old has shown to have 90.7% efficacy. There were 2,268 children in the clinical trials. However, the trials were designed to measure the amount of neutralizing antibodies produced by the child size vaccine dose and not so much on measuring the efficacy against the virus. The company has derived an efficacy estimate based on the number of infections in the group who were administered a placebo versus the group actually vaccinated.
Outside advisors to the U.S. Food and Drug Administration are scheduled to meet tomorrow to vote on whether to recommend the FDA authorize the vaccine for use among younger children. On Friday, the FDA itself will publish its review of the evidence submitted by Pfizer.
As for what happens next, if the FDA approves the vaccine for children five to 11 years old then the U.S. Center for Disease Control and Prevention will meet on November 2 and 3. It’ll then make a recommendation on how the doses should be administered. Once it signs off on that, then it’ll mean a green light for states to begin vaccinating children in the new age group.
Yesterday America’s top Doctor, Anthony Fauci, spoke to ABC’s ‘This Week’ to confirm if all the dominos fall as they should, then children five to 11 years old will begin to be vaccinated well before Christmas.
“If all goes well, and we get the regulatory approval and the recommendation from the CDC, it is entirely possible, if not very likely, that vaccines will be available for children from 5 to 11 within the first week or two of November.”
Pfizer/BioNTech has applied to both American and European health officials to authorize use of its vaccine for young children five to 11 years old.
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The World Health Organization continues to condemn the administering of vaccine booster shots across many western nations. The WHO says it is a travesty that while people get a 3rd dose, in over 50 countries, healthcare workers and at-risk groups elsewhere remain completely unvaccinated.
WHO Director General Dr. Tedros Adhanom Ghebreyesus says a new working paper estimates that COVID has claimed the lives of 115,000 healthcare workers between January 2020 and May of this year. He says this is an “indictment” on higher-income countries.
“That is why it is essential that health workers are prioritized for vaccination. Data from 119 countries suggests that on average, 2 in 5 health and care workers globally are fully vaccinated. But of course that average masks a huge difference across regions and economic groupings. In Africa, less than 1 in 10 health workers have been fully vaccinated. Meanwhile, in most high-income countries, more than 80% of health workers are fully vaccinated. More than 10 months since the first vaccines were approved, the fact that millions of health workers still have not been vaccinated is an indictment on the countries and companies that control the global supply of vaccines. High and upper-middle income countries have now administered half as many booster shots as the total number of vaccines administered in low-income countries.”
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Thailand will drop COVID entry restrictions, including a mandated quarantine, for fully vaccinated travelers from 47 countries on November 1. Among the countries Thailand is opening its doors too are Australia, the United Kingdom, Denmark, the USA, and Germany. Incoming travelers must have both vaccine doses and still have to have a negative COVID test to enter the country.
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Public Health Canada no longer updates its COVID dashboard over the weekends. We will have to wait for later today to get a better sense of the pandemic situation there.
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So far, 29,629,477 1st vaccine doses (77.49% of the total population) have been administered while 27,983,173 people (73.19%) are fully vaccinated.
A number of provinces do not report on the weekends. As for those who do….
Ontario added 743 coronavirus infections over the weekend. Of those, 511 are people who are either unvaccinated or who have a single dose. There are 138 people on hospital and 137 in an ICU. Today, the province is lifting capacity limits in virtually every setting that requires a vaccine passport for entry. This covers everything from restaurants and movie theatres to casinos and sports arenas.
Quebec reported 880 infections and six more corona deaths in the last 48 hours.
There were 467 infections and another six fatalities in Saskatchewan on Saturday and Sunday.
Yesterday, New Brunswick logged 51 new infections and one more virus death.