The Evening Report - Jan 19
An Omicron sub-variant is taking over in Denmark
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The Omicron variant is now not just dominant across Denmark, it is now taking over hospital and intensive care admissions. Last week the Danish National Board of Health said it was Delta variant infections dominating among ICU patients, but this week data from the Staten Serum Institut shows things are in flux.
The SSI says the proportion of Omicron infections among new hospital admissions has grown from 23% in mid-December to 86% of hospitalizations in the first week of January. And while ICU numbers overall have declined, Omicron cases among those with severe infections increased from 23% in week 51 to 43% in week 1.
Assistant Director Tyra Grove Krause says the ICU stats provide cause for hope.
“It is reassuring to see that the number of new inpatients in intensive care is decreasing as Omicron has become dominant among all inpatients. This supports that the risk of hospitalization is lower for Omicron than for Delta, as several foreign studies and Danish data now also suggest.”
The SSI figures there is probably “a small tail” of Delta variant infections in intensive care units even as Omicron takes over.
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A sub-variant of the Omicron strain is taking over in Denmark. The Staten Serum Institut says the parent Omicron stain, labeled BA.1, is declining as the sub-variant, labeled BA.2, now makes up almost half of all Omicron cases.
In the last week of December, BA.2 accounted for 20% of new infection cases, a proportion that rose to 45% by the second week of January. The institut says over the same period the share of the parent strain has fallen.
The SSI notes Omicron BA.2 is also on the rise in the UK, Norway, and Sweden.
The agency says work is underway to better understand the BA.2 sub-variant to determine if it is more infectious and the efficacy of vaccines against it. The SSI has already determined there is no increase in hospitalization risk.
The institut says one potential concern is that the difference between BA.2 and the parent Omicron strain in greater than the difference between Omicron and previous variants.
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Another record high. Denmark is reporting 38,759 COVID infections, including 2,285 reinfections, and 16 more coronavirus deaths in the last day.
Denmark also absolutely smashed all previous records for COVID cases as measured by testing date, with a whopping 40,153 positive results from tests taken on Monday, January 17.
Yesterday there were 493,870 corona tests, of which 224,485 were PCR tests equaling a positivity percentage of 17.26%.
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COVID hospitalizations (821) continued an upward climb (+11) while the number of infected people in an ICU (50) inched upward (+1) and of those the number on a ventilator (30) also crept up (+1) while admissions into a psychiatric ward (191) also rose (+4).
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The booster dose campaign in Denmark is now concentrating on reaching a few hundred thousand stragglers who have yet to get a 3rd shot.
National Board of Health Manager Steen Dalsgård Jespersen says this week they have sent out the lowest number of vaccination invitations seen in a month.
“It has been a successful revaccination effort, and the regions have done great work. Now it is about getting the last 500,000 invited, those who have not yet had a revaccination to actually book a time, because the winter is still with us, and the infection pressure is high.”
About 150,000 people have yet to book a vaccination appointment despite receiving invitations at least five weeks ago. The health board thinks COVID infections may be a factor, with anyone getting infected having to hold off getting a booster dose for at least four weeks.
That said, Jespersen notes, the data also shows an interesting correlation.
“Some of those who were invited a few weeks ago who have not been vaccinated yet live in the same 10 to 15 municipalities. We have to follow up on that.”
The health board did not name the municipalities in question.
Stragglers aside, the Sundhedsstyrelsen says the vaccination uptake across Denmark has been exceptional. 94% of everyone 65 years old and older has a booster dose. For those 85 and older, it is 97%. And the overall response rate across the board to an invitation to get boosted is at 97%.
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On the vaccination front, there were 31,741 total inoculations yesterday with most, 26,623, being booster doses.
To date, 82.4% of the total population have one dose, 80.2% have two, and 58% have a booster.
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The Danish National Board of Health says it has reviewed all the available evidence and is now issuing guidelines for administering a 4th vaccine dose to a select group of immunocompromised people. This would include people with diseases, or receiving treatment for a disease, that compromise their immune system, making them a higher risk for a coronavirus infection. This would include cancer patients, people on dialysis, those battling blood or bone marrow diseases, organ transplant recipients, and people being treated with immunosuppressive drugs.
Unit Manager Bolette Søborg:
“We currently have a high level of infection, and the vaccines do not give the same degree of protection against the dominant Omicron variant. We have a strong focus on protecting the particularly vulnerable with a weakened immune system against the risk of a COVID infection, and therefore we now recommend a 4th dose for this select group.”
The guidelines issued by the healthcare board will help doctors assess and refer patients who would benefit from a 4th vaccination. An invitation will then be sent to a person’s e-Boks once the referral is made.
“Doctors will start visiting patients who meet the criteria. Therefore, it will take a week or so before people who qualify will receive their invitation and can book a vaccination appointment. They can get vaccinated in one of the country's vaccination centers, but it is also possible to be vaccinated at selected pharmacies, at some family doctors, or at private vaccination clinics.”
At least three months must have elapsed since a 3rd dose and the vaccine given will be the same as what the person previously had, either Pfizer or Moderna.
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Next week, Region Syddanmark will begin administering a fourth round of vaccinations to those with severely weakened immune systems. People in this group include those with blood and bone marrow diseases, those who have had organ transplants, people on dialysis, anyone being treated with immunosuppressive drugs, and those who have been on active chemotherapy to treat cancer.
The region says for immunocompromised people their Doctor will be responsible for assessing and referring people for a 4th dose. Once the Doctor issues a referral, a vaccination invitation will be sent to the person’s e-Boks.
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Not everybody is on board with the Danish government restoring the patient’s right to timely assessment and treatment. The Danish Medical Association says it is “paradoxical” to make the move now when Denmark is smashing daily COVID records.
Lægeforeningen Chair Camilla Rathcke spoke to Ritzau:
“We have a record number of daily infections and we also see pronounced coronavirus infections among staffing to such an extent that we have to decide daily whether we can get everything done.”
She believes hospitals are being especially challenged, by the dual crunch of COVID patients and staff being out sick.
On Tuesday, the Danish Health Ministry announced it would restore patient’s rights, which had been suspended in December due to the infection wave, by as early as this Friday. In Denmark, patients rights to a diagnosis after referral within 30 days and treatment within 30 days is enshrined in law. Those rights have been suspended three times during the pandemic so hospitals could have all hands on deck to deal with an influx of COVID patients.
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Sweden has added a record high 42,725 infections and 67 more deaths since yesterday’s update.
It also set a new record high of 37,886 corona cases yesterday as measured by testing date.
So far, 86.4% of the population 12 years old and older have one dose, 83% have two, and of those 18 years old and older, 38.5% have a booster dose.
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The sheer number of Omicron infections is fueling massive staffing shortages across the world and Sweden is no exception. The Confederation of Swedish Enterprise says a survey of businesses has found seven out of ten companies are struggling with staffing shortages due to coronavirus infections and those isolated as close contacts. Sweden requires a seven day isolation period for those who have been exposed to an infected person.
Acting Chief Economist Jonas Frycklund spoke to SVT:
“The current quarantine rules need to be changed. Either you remove it completely or you reduce the number of days.”
The survey found the hospitality and transportation industries have been impacted the most by pandemic-related staffing shortages.
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As Swedish businesses sound the alarm over critical staffing shortages due to so many people calling in sick due to COVID infections, it sounds like changes are coming to quarantine rules. Reports from Swedish media say the changes will be announced on Thursday.
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Region Stockholm continues to strain as Sweden sees record-high COVID infection numbers. There are 515 coronavirus patients in hospitals across the capital region and as of Wednesday afternoon it had 187 available beds, a slight increase from the 179 from the day before.
The region says the positivity percentage from COVID tests administered on Tuesday was an eye popping 58.5%.
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Omicron is dominant in Southern Sweden. Region Skåne is seeing what it calls a “sharp increase” in COVID activity.
Infection Control Doctor Eva Melander:
“We are seeing a considerable strain across society, especially on care and nursing. This is a consequence of so many people being off sick due to COVID and other respiratory infections. Many are at home as household contacts to positive cases. The high spread of infection entails a risk that it will increase further in the coming weeks.”
The region says a record number of COVID self-tests were taken last week, about. 39,000, with 44% reporting a positive result.
The highest infection activity, about 85% of all cases, is being seen among people 10 to 59 years old, but it notes infections are also rising in seniors 70 years old and older.
“Unfortunately, we still see more infections among seniors in special housing. The positive thing about it all is that most people, including the elderly, have mild infections.”
The region is asking people to stay home if they are sick and to limit their social contacts. It is also reminding people that due to testing demand outstripping supply, close contacts who are asymptomatic shouldn’t get tested.
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As tensions between Russia and Ukraine rise Sweden has dispatched a number of armed forces personnel to reinforce the strategically important island of Gotland, and it looks like COVID went along for the ride. Swedish Armed Forces on the island are dealing with an Omicron outbreak and have activated testing and isolation protocols to deal with it. Last week, the island saw about 1,001 cases.
Visby Garrison Operations Manager Fredrik Malmerfeldt told SVT they have their own testing resources so as not to add to the demand seen across Sweden.
“So far, it is a fairly small outbreak in the unit, compared to what it looks like in the rest of society. We feel we need to take our own responsibility and activate our own capacity, so that we are not a burden.
A number of different military units have been dispatched to Gotland and they are living in temporary housing around the Baltic island.
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Finland has registered 8,382 infections and one more corona death since yesterday’s update.
COVID hospitalizations (718) are up (+17).
So far, 76% of the total population has one dose, 72.9% have two, and 35.4% have a booster dose.
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The strain on hospitals continues to grow in the Finnish capital region. The Helsinki Metropolitan Area Corona Coordination Group is now recommending COVID restrictions be extended for another two weeks to try and mitigate infection spread. The group says cases are climbing and the burden on hospitals is also increasing. As of Tuesday there were 347 COVID patients in hospital across Metro Helsinki.
The group says all non-emergency care is being deferred so hospitals can be all hands on deck to deal with coronavirus patients. It says healthcare staff are being pulled from a number of other areas to care for COVID patients, get people vaccinated, and ensure all other urgent and necessary care is being done.
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The Finnish Institute for Health has added pregnant women to the list of those at high-risk for severe COVID infections. The health agency cites significant amounts of data on vaccination protection for expecting mothers, the Omicron spread, and the “aggravated epidemic situation” in making the assessment.
The institute says being pregnant increases the risk of getting COVID and having a severe infection requiring hospitalization and possibly intensive care. It also increases the risk of pre-eclampsia, a pregnancy complication where high blood pressure can damage internal organs like the liver or kidneys.
Chief Physician Hanna Nohynek:
“If a pregnant woman gets a coronavirus infection, the chances of having a premature birth increase. Coronary heart disease also increases the risk of blood clots, which is already higher in pregnant women than in others. Children born within a month of maternal coronary infection have an increased mortality rate during the first week of life compared to the mortality of children of vaccinated mothers.”
The Finnish healthcare agency emphasizes pregnant women can be vaccinated as normal, taking one, two, or all three doses throughout pregnancy or at any stage during pregnancy.
“Studies already published on the widespread use of the vaccine in pregnant women in different countries do not indicate any specific safety concerns for expecting mothers or the developing fetus.”
The agency is now urging women planning to get pregnant or who are already pregnant to get vaccinated.
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Norway added a record high 15,367 infections and 29 more pandemic deaths in the last day.
COVID hospitalizations (240) are up (+2) while the number of infected people in an ICU (72) and on a ventilator (47) are both down (each -2).
To date, 79.8% of Norwegians 12 years old and older have one dose, 73.5% have two, and 43.3% have a booster dose.
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Germany is again seeing record high daily COVID infections as the country’s public healthcare agency, the Robert Koch Institute, reports 112,323 new infections and another 239 pandemic deaths. It added 1,082 hospitalizations yesterday. There is 2,664 people in intensive care, 80 fewer than the day before. 11.8% of all intensive care beds in the country are now taken up by coronavirus patients.
So far, 75.2% of the population has one vaccine dose, 72.9% have two, and 48.3% have a booster dose.
WHO🦠🌍
The pandemic is “nowhere near over.” That is the assessment from the Director of the World Health Organization Dr. Tedros Adhanom Ghebreyesus, who notes countries across Europe, like Denmark, continue to shatter daily COVID infection records. Dr. Tedros continues to warn against considering the Omicron variant as being significantly milder than previous variants. He says this gives the general public a false sense of safety.
“There is no doubt that Omicron causes hospitalizations and deaths, and even less serious cases lead to a high pressure on healthcare.”
And Omicron aside, Dr. Tedros also warns that coronavirus may not be done throwing curveballs at us yet with the real possibility of more concerning variants to come.
The latest World Health Organization COVID epidemiological update published on Tuesday night, showed infection cases around the world increased by 20% last week. Deaths increased only slightly, but that still translates to 45,543 lives lost to the pandemic in just one week.
WHO COVID Technical Lead Maria Van Kerkhove says that is far too many lives lost especially when we have so many tools to prevent infection spread and vaccines to protect people. She says the world needs vaccination equity.
“In the last seven days, almost 19 million cases were reported to the WHO. The true number of cases is higher and this spike is causing a significant burden on health systems around the world because hospitalizations are also increasing due to Omicron.”
COVAX💉
The international COVAX collaboration seems to not only be short of millions of doses to get everyone vaccinated in developing countries, it is also very short on cash. CEO Seth Berkley says the organization is basically out of money and it needs a significant cash infusion to continue the work of getting people in poor countries vaccinated, something the World Health Organization says is key to closing the door on the pandemic.
The United Nations and WHO-supported vaccine alliance was formed to acquire and deliver vaccine doses to developing nations.
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Canada reported 21,164 COVID infections yesterday while losing another 148 lives to the coronavirus. Due to an array of testing woes across the country, daily infection numbers are likely very underreported.
The data is a little behind, but the Public Health Agency of Canada continues to see those who are unvaccinated represent the lions share of cases, hospitalizations, and deaths.
The Canadian vaccination effort has so far administered 31,676,251 1st doses (82.84% of the total population) while 29,699,649 people (77.67%) have two doses, and of those 12,950,657 are fully vaccinated with three doses.
Due to an array of testing issues, we are now focusing on hospital numbers and the positivity percentage for the provinces as a more accurate assessment of the pandemic situation.
In Ontario, hospitalizations (4,132) dropped (-51) while ICU numbers (589) crept upward (+9). The province also suffered another 60 pandemic deaths. Reports suggest the Ford government may soon begin easing restrictions.
Quebec hospital admissions (3,425) increased slightly (+8) while intensive care numbers (285) also edged downward (-8). The province reported 88 more corona deaths on Wednesday. It has a positivity percentage of 14.86%.
Record high hospitalizations in Newfoundland and Labrador with 18, an increase of four, while ICU numbers inched up by one to a total of four ICU patients. The positivity percentage is 20.87%.
Nova Scotia saw admissions (83) rise (+10) and intensive care numbers (12) decreased slightly (-3). The province has had three more deaths.
New Brunswick saw record high hospitalizations (123) after numbers rose (+10) while ICU numbers (11) headed the other way (-5). The province has registered four more deaths.
Manitoba saw hospitalizations (631) increase (+11) while ICU numbers (50) inched up (+2). The province also suffered 12 more pandemic deaths.
Saskatchewan continues to see hospitalizations (199) climb (+10) with 21 people in intensive care. The province’s positivity percentage has dropped from 40% down to 31%
Alberta continues to see hospitalizations (1,089) increase on Tuesday (+82) while ICU numbers (104) also rose (+10). The province saw nine more deaths. It has a positivity percentage of 38.8%.
In B.C. hospitalizations (854) hit a record high as they remain on an upward march (+35) while ICU numbers (112) also continued to climb (+13). There has been two more deaths in the province. The positivity percentage also continues to shoot upward, going from 15.46% to 19.63%.