The Evening Report - Nov 3
Denmark to offer optional booster dose scheme. Finland touts hybrid immunity.
🦠Pandemic🦠
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People currently not eligible for a 2nd COVID vaccine booster dose in Denmark will soon be able to get boosted anyway, but it will cost them. The Danish Health Ministry says by mid-November booster doses will be available through private clinics, pharmacies, family doctors, and “others who choose to join the scheme.”
The hook is that unlike the state run vaccination program, where people can be vaccinated for free, this vaccination option means people will have to buy a vaccine dose. The cost? It could vary is all the ministry offers as an answer. It says the state will sell vaccine doses at a cost just covering handling and shipping costs, but the final price to consumers will depend entirely on the individual vaccine practice. “The total price for a vaccination can therefore vary.”
The ministry says there will be a ceiling on the number of available doses to sell through the optional scheme. This is to help ensure the state run vaccination program has enough supply. It does not specify what that “ceiling” is as far as a specific number of doses.
The vaccines offered through the optional scheme will also be the 1st generation variant-specific booster doses. That is the variant targeted vaccine that targets the original coronavirus strain and the BA.1 Omicron variant. The 2nd generation variant vaccine is designed to combat the original virus and the BA.4 and BA.5 variants are currently being offered through the state vaccination program.
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The fall booster dose campaign and the mild fall weather are contributing to an improving epidemic picture in Denmark. For the 3rd week in a row, the number of confirmed coronavirus infections has fallen. But, the number of PCR tests administered has also ebbed, falling by 3% week to week. The national positivity rate also dropped from 18% down to 14% according to the Statens Serum Institute’s latest weekly pandemic snapshot.
Senior Physician Bolette Søborg:
“We see that infection is generally decreasing, and that the group with the highest incidence of infection is no longer the 60-79 year olds as in previous weeks. This is probably because the vaccine effort is successful among the age groups that are covered by the offer of booster vaccination.”
The COVID incidence rate decreased across all five Danish regions last week. Region Sjælland has the highest incidence rate (135 per 100,000 people) while Region Hovedstaden (Metro Copenhagen) has the lowest (84). Region Midtjylland has the highest positivity percentage at 17%.
COVID wastewater surveillance shows decreasing levels of virus activity across the country and in all five Danish regions. Nationally, wastewater monitoring shows coronavirus activity dropping for three straight weeks. Both Region Sjælland and Region Syddanmark have seen a sharp drop in virus activity.
Looking at the COVID situation by age and there is mostly good news with confirmed infection numbers declining across most age groups. The only exception is an increase in case numbers among those 6 to 19 years old. It is worth noting that the biggest drop in infection activity is among those 50 years old and older. That is pretty clearly due to the ongoing booster dose campaign. The highest positivity percentage is among those 16 to 19 years old (21%) followed by 6 to 15 years olds (17%).
For a second week in a row, new COVID-related hospital admissions numbers are down. There were 462 infected people hospitalized last week, 152 fewer than the week before. The SSI says the decrease was particularly noticeable among those 70 to 89 years old, the group that continues to make up the largest proportion of new pandemic patients. There were 18 severely infected people admitted to an ICU last week. Just under half (48%) of all coronavirus-related hospitalizations were directly due to an infection as opposed to being infected but needing hospital care for another reason.
Another 61 lives were lost to the pandemic last week, 27 fewer deaths than the week previous. The institute notes it is seeing increased excess mortality rates (the number of deaths over the average) among elderly seniors 75 to 84 years old.
Another welcome sign is the decline in infection activity and deaths among vulnerable seniors in care. Last week, there were 119 confirmed infections, a number that has been dropping for four straight weeks now. While the number of pandemic fatalities dropped from 20 to 8 from one week to the next. However, the hospitalization rate for seniors in care has increased, with 22 admissions last week, eight more than the week prior. The positivity percentage among seniors in care is treading water at 3.6%.
Infection activity has also decreased among seniors care home staff and hospital workers.
On the vaccination campaign effort, the SSI says as of last week 62% of the population over the age of 50 had received a 4th dose. The vaccination rate rises to 75% for seniors 65 years old and older and to 87% looking at just seniors in care.
The variant story is changing from the usual one dominant variant, which has been the pandemic pattern until now in Denmark, to a mixed bag of a number of different virus strains. Technically, the BA.5 variant remains dominant, making up about 91% of sequenced positive test results last week. But a closer look shows no less than five BA.5 sub-variants are behind that number led by BA.5.2 (11.10%) and BA.5.2.1 (10.52%). Also in the mix are BF.7 (9.40%), BQ.1.1 (10.76%), and BQ.1 (4.63%). Matter of fact, there were no less than 98 variants identified across Denmark last week. Of those, all but nine were Omicron sub-variants of one strain or another.
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COVID hospitalizations (417) continue to drop (-10) while the number of severely infected people in an ICU (16) crept up (+1) and of those the number on a ventilator (9) is unchanged day to day.
Infection admissions to a psychiatric facility (69) have dipped (-1).
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Denmark has reported 632 #COVID19 infections (underreported), including 258 reinfections, and 12 more coronavirus deaths in the last day.
With 6,622 PCR tests taken Wednesday that equals a positivity percentage of 9.54%, over 7 days, it is 13.35%.
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After COVID restrictions all but wiped out the annual flu season for several years, without any pandemic restrictions, the Statens Serum Institute is anticipating a return to normal this winter.
But, the agency also stresses that it is difficult to forecast how the flu season will play out, largely because it depends on what influenza strain might be dominant. The SSI is expecting it will be either the influenza A strains (H3N2), A(H1N1), or the influenza B strain ‘Victoria’.
The H1N1 and the influenza B strains are the least risky of the three, rarely causing serious sickness or hospitalization. Current flu vaccines also work well against both. The H3N2 flu bug is more serious and tends to be a problem among vulnerable seniors. It is associated with more serious bouts of the flu and more hospitalizations. The flu shot is also much less effective.
“At present, it is not possible to predict which virus type will dominate in Denmark.”
Prior to the COVID pandemic, the flu season usually began in November before peaking around February.
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According to the Statens Serum Institute’s sentinel surveillance program other than COVID, it was the rhinovirus that was the second most frequently detected respiratory virus in the country.
🇸🇪
Sweden has added 6,708 infections (wildly underreported) and suffered another 191 corona deaths since its last weekly update.
COVID hospitalizations (770) are up (+34) while the number of severe infection cases in an ICU (17) is unchanged week to week.
To date, 88.1% of the population 12 years old and older has one vaccine dose and 86.3% have two. Of those 18 years old and older, 66.4% have a booster shot. 79.5% of seniors 65 years old and older have had a 2nd booster dose.
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The Swedish Public Health Agency usually does a weekly COVID update but hasn’t published one for some weeks now. I am unsure if they have ended the practice or if it is on a hiatus.
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The Swedish Public Health Agency has halted the use of the Novavax COVID vaccine for all young people 30 years old and younger. The agency is citing a study from Australia finding that the protein-based vaccine might pose an increased risk of myocarditis and pericarditis, inflammation of the heart muscle. It says the overall risk still remains small, but as a precautionary measure it has suspended the use of the vaccine for younger people.
Vaccination Unit Head Sören Andersson:
“We are following the situation closely and are awaiting more data. But those who are younger and recently vaccinated with Nuvaxovid need not worry. The risk is very small and you can continue with the next dose with another vaccine.”
Sweden, like the other Nordic countries, relies mostly on the two mRNA COVID vaccines from Pfizer/BioNTech and Moderna. The Public Health Agency says it has only administered about 7,000 doses of the Novavax vaccine.
🇫🇮
Finland has registered 11,984 coronavirus infections and had 173 more pandemic deaths in its latest weekly update.
COVID hospitalizations (1,082) have increased (+85).
So far, 79.7% of the total population has one vaccine dose, 76.7% have two, while 54.1% have one booster dose, and 17.5% have a 2nd.
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The Finnish Institute for Health is touting the benefits of hybrid immunity as providing strong and long-lasting protection against severe COVID infections, hospitalizations, and death. It says hybrid immunity (vaccination and having had a COVID infection) provided “the most powerful and long-lasting protection” for at least a full year in 95% of cases studied. The agency conducted what it called a meta-analysis of 26 scientific publications on immune protection to arrive at its conclusion.
Chief Physician Hanna Nohynek:
“Of course, you should remember that good and long-lasting protection can be obtained in several ways. The already recommended corona vaccine doses alone provide excellent protection against severe infection. You also get very good protection with two doses of the vaccine. Basically healthy working-age people who are vaccinated currently have a very low risk of being hospitalized due to a COVID infection.”
But, Nohynek touts the findings of the agency’s meta-analysis on hybrid immunity as well.
“Additional information about the protection provided by hybrid immunity and its duration is important in terms of our vaccination recommendations, because the Finnish population also has antibodies that indicate previous coronavirus infection. A large proportion of children over the age of 12 and adults of working age have hybrid immunity formed as a result of the combined effect of coronavirus infection and vaccination.”
The meta-analysis also found that just getting a coronavirus infection provided about 65 to 70% protection against an Omicron infection, but only for about two to three months. Over the course of a year, the immune protection from an infection drops to about 25% according to the health institute.
The institute also hints strongly that booster doses are not an ideal long-term solution to battling the coronavirus.
“If you have had an infection and received two vaccine doses, the protection against a new infection decreases steadily over the course of six months. After the third dose, short-term protection against infections is achieved again. From the point of view of infection protection, even those who have the disease benefit from vaccinations in the short term, but additional doses do not provide significant benefit, as the protection against infections always drops to a lower level again after a short time. People should therefore be vaccinated again and again, which is not a reasonable use of resources. In addition, new, protection-circumventing variants may arise, in which case infection protection may be lower than this in practice.“
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Finnish health authorities are sticking to their guns in not offering a 2nd booster dose for people working in the health or social care sectors. The Finnish Institute for Health says the evidence just isn’t there to support offering booster doses to healthy adults and young people.
Chief Physician Hanna Nohynek:
“We are constantly monitoring the COVID situation and any new research information on vaccines. If necessary, we will change our vaccination recommendations on medical and epidemiological grounds. Currently, there is not enough research data to support the recommendation of booster doses for health and social care professionals this fall and winter.”
Nohynek admits it is a hot topic right now, but notes the desire to get vaccinated is not enough of a reason to change public health policy.
“The wish or desire to receive a booster dose is not a sufficient basis for giving a recommendation.”
The institute adds that anyone working in hospitals or senior care homes who qualify for a booster dose due to their age or belonging to a vulnerable group can go get one. But, the risk for healthy vaccinated adults of severe infection from the Omicron variants is very low.
As for the variant specific vaccines approved for use in Europe.
“There is still not enough research evidence on whether the protection against infection provided by the variant preparations that came into use in the fall is better and longer-lasting than the original corona vaccines. If vaccines are intended to provide indirect protection, i.e., to protect patients and social security professionals by vaccinating them, they should be so effective that basically healthy adults should take them. An uncertain effect is not a reason to recommend a booster vaccine.”
🇩🇪
Germany recorded 78,629 new infections and lost another 281 lives to the coronavirus on Wednesday.
It also added 2,903 more hospitalizations, while ICU numbers (1,556) declined a little (-22). As a percentage of all intensive care beds in the country, COVID patients are using 7.4%.
To date, 77.9% of the total population has one vaccine dose, 76.3% have two, and 62.4% have a booster shot.
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A child health working group in Germany has presented the results of their examination of the pandemic and its impacts on children and young people. Among the group’s findings was that children were not vectors of infection.
German Health Minister Karl Lauterbach:
“The studies showed that children and young people were not infection drivers. Therefore, we have to consider for the winter ahead: contact reduction, forming small social groups, masks for adults, and proper indoor ventilation. Closing daycare centers is medically inappropriate.”
🇨🇦
The Public Health Agency of Canada updates its COVID statistics once a week every Friday afternoon.
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Health Canada has given the green-light to Moderna newest variant specific vaccine targeting the original coronavirus strain and the BA.4 and BA.5 variants. The agency says its review determined the bivalent vaccine was “safe and effective.”
“Clinical trial results showed that a booster dose of the bivalent Moderna Spikevax vaccine triggers a strong immune response against both Omicron (BA.4/BA.5) and the original SARS-CoV-2 virus strains.”
The agency says any side effects were mild and were not any different than previously approved mRNA vaccines.
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Canadian healthcare officials are warning that for people who have not had a booster dose, that having two shots is no longer protection enough.
University of Alberta Infectious Disease Physician Dr. Lynora Saxinger spoke with the CBC:
“I think it's very important that people be aware that two doses is no longer enough. People who haven't had boosters at all should be making getting a fall booster a major priority."
Dr. Isaac Bogoch, an infectious diseases specialist at the University of Toronto, noted that while vaccines are a very effective tool to combat COVID infections “but additional vaccines won't do a lick of good if people don't take them.”
“I hope people get those vaccines. But it's especially important for people who are at greater risk for severe infections. This is exactly who we're seeing in hospitals: People over the age of 60 years old, and people with underlying medical conditions that put them at greater risk."
🇺🇦/ 🇷🇺 War
☢️ 🇷🇺 🇺🇦
The International Atomic Energy Agency is once again raising the alarm about the possibility of a nuclear accident at Europe’s largest nuclear power plant, the Zaporizhzhya Nuclear Power Plant in Ukraine. The power plant has again had all of its external power sources cut off due to Russian shelling and is now operating on back-up power and diesel generators. But, with four reactors in cold shutdown and two more about to join them, the plant has only enough fuel to supply back-up power for about 15 days.
IAEA Director General Rafael Mariano Grossi says this is untenable:
“This is an extremely concerning development that again demonstrates the plant’s fragile and vulnerable situation. Despite the best efforts of the plant’s courageous staff to stabilize the external power situation in recent weeks, the Zaporizhzhya Nuclear Power Plant has again lost all access to off-site electricity. For now, it receives the power it needs from the on-site diesel generators. But this is clearly not a sustainable way to operate a major nuclear facility. Measures are needed to prevent a nuclear accident at the site. The establishment of a nuclear safety and security protection zone is urgently needed.”
Grossi says that he has been engaged in high-level talks with both Ukraine and Russia in recent weeks aimed at reaching an agreement and implementing a protection zone around the nuclear power plant as soon as possible.
🇩🇰/ 🇺🇦
The Danish military says its contribution to an international effort helping to train Ukrainian soldiers is entering its final phase. The training program, hosted in the United Kingdom, has offered Ukrainian recruits a five week training program to help them fight the Russian army.
The Danish armed forces say the latest phase of the training has focused on trench warfare and breaking through enemy defenses. It says Ukrainians have also been trained in a “new type of weapon” shooting over longer ranges.
All the Nordic countries, Canada, Australia, the United Kingdom, and others, have taken part in the international boot camp to help train Ukrainian troops.
🇩🇰/ 🇱🇻
A contingent of Danish soldiers is packing up and preparing to come home as their six month rotation in NATO’s defensive lines in Latvia has come to an end. A new batch of Danish soldiers, equipment, and gear, have already arrived in the Baltics to replace them for a new rotation.
🇸🇪 🇫🇮/ 🇹🇷
NATO Secretary General Jens Stoltenberg was in Turkey Thursday to try and break through the country’s opposition to Sweden and Finland’s applications to become members of the alliance. 28 of the 30 NATO member countries have ratified the ascension protocols leaving just Hungary and Turkey as the last two hurdles.
Bloomberg News is reporting, citing Turkish sources, that the country will continue to drag its feet on holding a vote to ratify, or not, the two NATO applications. It says a vote is unlikely to be held in Turkey before the country’s next general elections in June of next year.
On Thursday, Stoltenberg attempted to get the Turks onboard meeting with the Turkish defense minister in Istanbul. He says that his message was that Sweden and Finland have lived up to all their obligations and that it is time for Turkey to stop playing games and welcome the two countries in to NATO.
“Finland and Sweden have significantly increased cooperation with Turkey to fight terrorism.”
On Friday, Stoltenberg will meet with Turkish President Recep Tayyip Erdogan to again lobby for Turkey to stop opposing the two Nordic NATO applications.
Next week, new Swedish Prime Minister Ulf Kristersson will also pay a state visit to Turkey and also pay the Turkish President a visit to try and win Turkey’s support for his country joining NATO.
🇳🇴/ 🇺🇦
According to Norwegian news agency NRK, Ukrainian soldiers are receiving training for highly specialized air defense systems in Norway. The United States is donating the NASAM air defense batteries, a short to medium range ground-to air missile system, to Ukraine. But, the missile system is built by a Norwegian company called Kongsberg. So far, about 100 Ukrainian soldiers have received training on the new air defense system designed to protect against everything from drones to fighter jets.