Emergence of a Deadly Coronavirus

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Vaccine Effectiveness

After you get your dose of the vaccine, you are not immune from COVID, at least not immediately. And therefore one needs to exercise a little caution until the vaccine takes hold in your body.

With the Pfizer-BioNTech vaccine, a study published in The New England Journal of Medicine in December found that protection doesn't start until 12 days after the first shot and that it reaches 52% effectiveness a few weeks later. A week after the second vaccination, the effectiveness rate hits 95%. In its application for authorization, Moderna reported a protection rate of 51% two weeks after the first immunization and 94% two weeks after the second dose.

Source: Why You Should Still Wear A Mask And Avoid Crowds After Getting The COVID-19 Vaccine

Different Approaches used in Vaccines Development

I read an article that discussed in great detail the different approaches used in developing the COVID-19 vaccines.

Throughout human history, we have been subjected to wave after wave of viral and bacterial plagues. One of the earliest known was the Babylon flu epidemic around 1200 B.C. The plague of Athens in 429 B.C. killed close to 100,000 people, the Antonine plague in the 2nd century killed 5 million, the plague of Justinian in the 6th century killed 50 million, and the Black Death of the 14th century took almost 200 million lives, close to half of Europe’s population.

Up until last year, vaccines had not changed very much, at least in concept, for more than two centuries. Most have been modeled on the discovery made in 1796 by the English doctor Edward Jenner, who noticed that many milkmaids were immune to smallpox. They had all been infected by a form of pox that afflicts cows but is relatively harmless to humans, and Jenner surmised that the cowpox had given them immunity to smallpox. So he took some pus from a cowpox blister, rubbed it into scratches he made in the arm of his gardener’s 8-year-old son and then (this was in the days before bioethics panels) exposed the kid to smallpox. He didn’t become ill.

Before then, inoculations were done by giving patients a small dose of the actual smallpox virus, hoping that they would get a mild case and then be immune. Jenner’s great advance was to use a related but relatively harmless virus. Ever since, vaccinations have been based on the idea of exposing a patient to a safe facsimile of a dangerous virus or other germ. This is intended to kick the person’s adaptive immune system into gear. When it works, the body produces antibodies that will, sometimes for many years, fend off any infection if the real germ attacks.

Using a killed or inactivated virus - Two Chinese companies, Sinopharm and Sinovac, have used this approach to develop vaccines for COVID-19 that are now in limited use in China, the UAE and Indonesia.

Inject a subunit of the virus, such as one of the proteins that are on the virus’s coat - The Maryland-based biotech Novavax is in late-stage clinical trials for a COVID-19 vaccine using this approach, and it is the basis for one of the two vaccines already being rolled out in Russia.

Insert the desired gene, using a technique known as recombinant DNA, into a harmless virus that can deliver the gene into human cells. - To make a COVID vaccine, a gene that contains instructions for building part of a coronavirus spike protein is edited into the DNA of a weakened virus like an adenovirus, which can cause the common cold. The idea is that the re-engineered adenovirus will worm its way into human cells, where the new gene will cause the cells to make lots of these spike proteins. As a result, the person’s immune system will be primed to respond rapidly if the real coronavirus strikes. AstraZeneca and Johnson & Johnson are using this approach. Two other vaccines based on genetically engineered adenoviruses are now in limited distribution: one made by CanSino Biologics and being used on the military in China and another named Sputnik V from the Russian ministry of health.

Fabricate a synthetic DNA Vaccine - Some of the developers of DNA vaccines, including Inovio, tried to facilitate the delivery into human cells through a method called electroporation, which delivers electrical shock pulses to the patient at the site of the injection. That opens pores in the cell membranes and allows the DNA to get in. The electric pulse guns have lots of tiny needles and are unnerving to behold. It’s not hard to see why this technique is unpopular, especially with those on the receiving end. So far, no easy and reliable delivery mechanism has been developed for getting DNA vaccines into the nucleus of human cells.

Create a synthetic mRNA Vaccine - Pfizer/BioNTech and Moderna vaccines are based on this method.

Source: mRNA Technology Gave Us the First COVID-19 Vaccines. It Could Also Upend the Drug Industry

Vaccines Administered by State



There is a three-fold variation from lowest to highest. Expect these percentages to change as capacity is built out, and communication in the allotment is improved. Production of vaccines is not the issue currently. It may become so later on.

Source = Tracking COVID-19 Vaccinations: A User's Guide

Why such a variation in vaccine utilization?
Well we are at the front end of the inoculation process. And the bugs in the distribution system need to be worked out. Some states have created monsters in their distribution planning documents. Too much red tape. Other states have taken the position of making sure they had the second dose in storage before they gave the first dose.

From my perspective, I feel it is important to get people vaccinated ASAP. Open the floodgates. This is a seasonal virus and the winter season brings the most deaths. So getting vaccines in the most vulnerable will save the most lives. Once people stop dying, society will begin the process of returning to normality.

Who Lives and Who Dies!

Why some people develop cytokine storms and others don't is unknown, but the answer likely involves an individual's genes, perhaps those that encode a set of proteins known as the Major Histocompatibility Complex (MHC).

A team of researchers at New York University (NYU) report that deadly cases of COVID are linked to autoantibodies, i.e., antibodies that attack the body. In other words, COVID appears to trigger an autoimmune response in some people.

Specifically, the authors examined the levels of antibodies against Annexin A2, a protein found in the lungs that plays an important role in anti-inflammatory processes and maintaining the structure of blood vessels. Antibodies that target it, therefore, may exacerbate respiratory problems caused by COVID.



The researchers analyzed the antibody levels in 86 patients who were hospitalized with COVID. Of these patients, 28 were not critically ill, 36 were critically ill, and 22 died. Using logistic regression, the authors were then able to determine an association between antibody level and death. Indeed, using margins analysis, the team showed that the probability of death increased as a patient's anti-Annexin A2 antibody levels increased.

Source: Deadly COVID Cases Linked To Antibodies That Attack The Lungs

Innovation at Work

I came across an article about another type of facemask, called a Microclimate Air. It is always interesting to see what humans will come up with. It surrounds your entire head with a filtered bubble.



It is a space travel-inspired helmet that uses state of the art HEPA filters for both inlet air and outlet air. used in airplanes, this filter can clear 99.97% of particles as small as 0.03 micros. equipped with a patent-pending ventilation system, the helmet uses two high-powered fans to pull air through the HEPA filters in the mask, keeping it fresh and fog free.



[Therefore it protects YOU from exposure and also the other guy is you have the virus.] Your head resides inside its own, COVID-free ecosystem.



It weighs approximately 2 lbs, and has removable washable fabric and 4-hours of battery life. Another article wrote: AIR has a battery life of about five hours with a six-foot-long cable that allows users to continue wearing the mask while charging.

[Since this is being advertised for airline travel, four hours seems a little short for those going overseas.]

Probably the greatest downside of this concept is the price. At $299, it is a little steep especially since an N95 mask is priced at around [$1 each pre-covid, and $4 each at present]

This concept might be better applicable in a hospital or nursing home setting. Also if you add an activated carbon filter and beef up the shell, it might be very usable to protect police officers/national guard from teargas exposure.

Sources:
* A Breath of Fresh Air
* Magary: I tested the dumbest PPE of all time - the Rich Guy COVID Helmet

Here is the latest updates:

Progress of COVID inoculations

According to the coronavirus vaccine tracker, the U.S. has now administered 15.71 million vaccine doses.

Globally 46.38 million vaccinate doses have been given with the U.S., China and U.K. in the top three positions. The U.S. and China are vying for first place. In this update, many other countries are starting to show up on the scoreboard. I expect India will make its presence known shortly and will be a top contender.

Source: Coronavirus vaccine tracker[/quote]

Chinese Lockdown

A quarantine camp is being constructed to house 4,000 people and is located on the outskirts of Shijiazhuang, the provincial capital of Hebei province, which surrounds the country's capital, Beijing.



A sudden rise in cases has alarmed officials and raised concerns ahead of the Lunar New Year, the county's most important annual festival, during which hundreds of millions of people are expected to travel to visit family members.

In an effort to contain the outbreak, authorities placed Shijiazhuang under lockdown on January 8, with all 11 million residents barred from leaving the city.

More than 20,000 citizens from 12 villages in Shijiangzhuang have since been relocated to other quarantine sites as a preventative measure.

The Chinese government on January 16 claimed to finish construction on a 1,500-room hospital in Nangong, located south of Beijing. The hospital, the Communist Party alleged, was reportedly built in five days and is one of six hospitals being constructed in Nangong. The combined facilities will create 6,500 rooms in the city for coronavirus patients. Roughly 650 people are currently being treated for the Chinese coronavirus in Nangong and Shijiazhuang, according to Xinhua on Saturday. The federal government is currently overseeing the construction of a 3,000-room hospital in Shijiazhuang.

Over 22 million people are now in lockdown in China. The outbreak is concentrated in Shijiazhuang, the provincial capital of Hebei province, which surrounds Beijing. Shijiazhuang is a critical transport and manufacturing hub for the region. As a result of its close proximity to the outbreak, parts of the capital are now under lockdown, too.

China’s National Health Commission said on January 16 that the government is struggling to contain the new coronavirus outbreaks, as they are spreading at an exceptionally high rate.

The lockdown is likely to widen, for two reasons. First, there are concerns about more contagious variants of the virus getting a foothold in China, such as the one that originated in the United Kingdom. While China still imposes significant restrictions on travel and a mandatory supervised quarantine period, there is enough movement, especially overland, to make that a plausible fear.

Second, the Lunar New Year—the most important annual festival for Chinese families—is approaching on Feb. 12. Last year, the coronavirus erupted just before the holiday. Making sure people don’t have to spend another festival week in lockdown by crushing the outbreak now is critical, both for China’s own public relations and for the benefit of the domestic economy. The Lunar New Year is a big spending week.
Sources:

* China builds massive Covid-19 quarantine camp for 4,000 people as outbreak continues
* China: Coronavirus Surge Leaves 11 Regions Under Lockdown
* China Puts Millions of People Back Under Lockdown

China's Vaccine

Beijing suffered another setback this week after the Chinese-developed COVID-19 vaccine proved far less effective than its foreign counterparts. The vaccine was already lagging behind in trials, in part because China’s relative coronavirus success left it with a smaller pool of data to draw on, forcing it to outsource to countries such as Brazil.

But at 50.2 percent efficacy, the final product is only just over the standard for deployment. Earlier results claimed higher efficacy, but the Brazilian trial authorities downgraded the results when applying better standards.

Chinese state media is trying to spin the failure as a success, but it is a big hit for Beijing as vaccine diplomacy heats up and countries without homegrown efforts seek to inoculate their populations. China has already promised tens of millions of doses to Belt and Road countries, but elites in those countries are now likely to seek more effective U.S. or European vaccines.

It’s likely that China will try to develop a second vaccine using the techniques that were so successful in the United States—and possibly by reverse-engineering other countries’ technologies or stealing intellectual property.

Source: China Puts Millions of People Back Under Lockdown

Aerosol Transmission

As the number of new cases of COVID-19 and deaths continue to increase in Nigeria, and elsewhere in the world, it’s time to review how this disease is transmitted. Even among those that seem to observe the safety protocols, there have been infections. Initially, the consensus was that the disease is spread by droplets that don’t go beyond six feet. But as scientists began to beam more light on the virus, they found compelling evidence that the spread of the virus cannot be explained by droplets infection alone. The Nigeria Center for Disease Control (NCDC) cannot continue to play catch up, or “follow follow”, as we call it here. Nigeria, and indeed Africa should lead the world when it comes to infectious disease. Even the world agrees we have the experience.

Mask wearing remains a game changer, if only everyone will agree to wear it. For healthcare workers it might mean the minimum type of mask to be worn should be an N-95. Where that is not available double-masking with the surgical mask might help.

While lockdown remains the most effective way of stopping the virus in its track, its effect on the economy is heavy. But if people can avoid any form of gathering or clustering, it will go a long way towards stemming the tide. Gatherings, especially in an enclosed place have a higher risk of generating aerosol transmission. For the avoidance of doubt, gatherings include parties, night clubbing, weddings, naming ceremony, chieftaincy title ceremony, protests, political events, NIN [national identification number] registration, church and mosque worship and so on.

Doors and windows should be open as much as possible. The dampers in air-conditioning units should be adjusted. If possible the filters should be upgraded. Portable air cleaners can be used, germicidal ultraviolet technologies installed to kill or remove virus particles found in the air.

Source: Air transmission of coronavirus

Risky Proposal

In order for a vaccine to be approved it needs to undergo a strict round of testing to ensure it is safe and effect. But currently some individuals are proposing to throw all that out the window for expedience. The Moderna and Pfizer vaccines each require two doses which are given a few weeks apart. But apparently some individuals (probably politicians) are recommending a "mix and match" approach. Individuals would receive one dose of one type of vaccine and another dose of a different type. All done without any testing. This is a really risky and unscientific proposal.

Refer to Can COVID-19 vaccines be mixed and matched?

Different Variants of COVID-19

One of the problems with viruses it that they mutate. And COVID-19 is no exception. There are at least three variants of note at the moment. One is called the B501.V2 also known as 20C/501Y.V2, B.1.351 lineage and South African COVID-19 variant. The variant was first detected in the Nelson Mandela Bay metropolitan area of the Eastern Cape province of South Africa and reported by the country's health department on 18 December 2020. The two other variants I will call the U.K. variant and the Brazilian variant.

Multiple COVID-19 variants are circulating globally:

* In the United Kingdom (UK), a new variant called B.1.1.7 has emerged with an unusually large number of mutations. This variant spreads more easily and quickly than other variants. Currently, there is no evidence that it causes more severe illness or increased risk of death. This variant was first detected in September 2020 and is now highly prevalent in London and southeast England. It has since been detected in numerous countries around the world, including the United States and Canada.
* In South Africa, another variant called 1.351 has emerged independently of the variant detected in the U.K. This variant, originally detected in early October, shares some mutations with the variant detected in the U.K. There have been cases caused by this variant outside of South Africa, but it has not been detected in the U.S.
* In Brazil, a variant called P.1 emerged and was identified in four travelers from Brazil, who were tested during routine screening at Haneda airport outside Tokyo, Japan. This variant contains a set of additional mutations that may affect its ability to be recognized by antibodies. This variant has not been detected in the U.S.

Now the one of immediate concern is the South Africa variant. It has spread outside South Africa and currently 174 cases of this variant have been discovered in: United Kingdom, Switzerland, Finland, Japan, Australia, Zambia, France, South Korea, Sweden, Norway, China, Austria, Botswana, Ireland, Brazil, the Netherlands, Canada, Israel, New Zealand, Germany, Belgium, Taiwan and Denmark.

So why is this variant special? Scientists noted that the variant can attach more easily to human cells because of three mutations in the receptor-binding domain (RBD) in the spike glycoprotein of the virus: N501Y[5][8] (a change from asparagine (N) to tyrosine (Y) in amino-acid position 501), K417N, and E484K. Two of these mutations, E484K and N501Y, are within the receptor-binding motif (RBM) of the receptor-binding domain (RBD).

Preliminary findings on Wednesday add to growing evidence that the South Africa variant escapes the neutralization power by antibodies in convalescent plasma. In the preliminary findings posted Wednesday, researchers said the mutated strain nearly dodged, if not obviated, protection offered by the plasma treatment.

The 501Y.V2 variant involves nine mutations on the virus’ spike protein, which the virus uses to infect cells. This worries scientists because recently developed vaccines and therapeutics target the proteins, raising worries that changes could impact the efficacy of treatments and vaccines.

"This lineage exhibits complete escape from three classes of therapeutically relevant monoclonal antibodies," reads the findings. "Furthermore 501Y.V2 shows substantial or complete escape from neutralizing antibodies in COVID-19 convalescent plasma."

Researchers said the data emphasize the risk of re-infection, "and may foreshadow reduced efficacy of current spike-based vaccines." The team tested convalescent plasma from coronavirus patients against the 501Y.V2 strain, and 48% of 44 samples "had no detectable neutralization activity," study authors wrote. "These data also have implications for the effectiveness of SARS-CoV-2 vaccines, which are principally based on immune responses to the spike protein," reads the paper, urgently calling for "rapidly adaptable vaccine design platforms, and the need to identify less mutable viral targets for incorporation into future immunogens." [In other words, some of the current vaccines may be ineffective or less effective for this variant.]

Separate research out Tuesday also suggested mRNA vaccines (like those developed by Pfizer and Moderna) may require updates to maintain effectiveness against new strains.

[I wonder if that might be the reason why China has gone back to hard lockdowns. One case of this variant showed up in China on 6 January 2021. This probably means that each year one will need a COVID vaccine shot to target the predominant strain of the virus present, just like they do for the influenza virus each year. If only the world would focus on the aerosol transmission threat and target using existing technology to combat it.]

Sources:
* New COVID-19 Variants
* 501.V2 variant
* South African coronavirus variant may lower vaccine efficacy, 'escapes' plasma therapy: scientists

^ The virus is winning.

India Beginning Vaccine Production

India has began supplying coronavirus vaccines to its neighboring countries, as the world’s largest vaccine making nation strikes a balance between maintaining enough doses to inoculate its own people and helping developing countries without the capacity to produce their own shots. Of the more than 12 billion coronavirus vaccine doses expected to be produced this year, rich countries have already bought about 9 billion, and many have options to buy even more. This means that Serum Institute, which has been contracted by AstraZeneca to make a billion doses, is likely to make most of the vaccines that will be used by developing nations.

Source: Asia Today: China records new cases, defends response

Complexity of Giving Shots

The vaccination campaign so far has proved more complex than coronavirus testing, Rite Aid Corp. Chief Executive Officer Heyward Donigan said Monday. Vials filled with Pfizer Inc. and BioNTech SE’s formula boast five and sometimes six doses, and Moderna Inc.’s includes enough to give 10 shots — which means if a vial is opened to vaccinate one person, the pharmacist needs to find other eligible people to vaccinate before the vial expires within hours. This can create a logistical hurdle and an ethical dilemma.

“We would all agree that we don’t want doses going unused in this particular dynamic,” Donigan says, “But it is extremely complicated to figure out how to find the right people, the most vulnerable, in that moment, in that day, without having things go to waste.”

Source: Virus Update: Amazon Offers Help With Distribution; NYC Delays Vaccinations After Moderna Shortage