US possible resurgence, SA possible mistake

Genomic epidemiology identifies emergence and rapid transmission of SARS-CoV-2 B.1.1.7 in the United States

California, 7 February

https://www.medrxiv.org/content/10.1101/2021.02.06.21251159v1

B.1.1.7 variant of SARS-CoV-2, has gained a strong foothold across the world

Detection of the variant increased at a logistic rate similar to those observed elsewhere

Doubling rate of a little over a week

Increased transmission rate of 35-45%

Several independent introductions

From late November 2020

Onward community transmission, 40 states

U.S. is on a similar trajectory as other countries where B.1.1.7 rapidly became the dominant SARS-CoV-2 variant

Requiring immediate and decisive action to minimize COVID-19 morbidity and mortality

Florida

https://twitter.com/DrEricDing?ref_src=twsrc%5Etfw%7Ctwcamp%5Etweetembed%7Ctwterm%5E1358645754248761346%7Ctwgr%5E%7Ctwcon%5Es1_&ref_url=https%3A%2F%2Fnews.sky.com%2Fstory%2Fuk-covid-news-latest-updates-on-coronavirus-lockdown-and-vaccine-12212131
Super Bowl parties in Tampa (Dr Eric Feigl-Ding)

Hundreds of people, tightly packed, not wearing masks

B117 is becoming dominant in Florida

Quarantine for 14 days

South Africa suspends Oxford AZ vaccine

https://www.washingtonpost.com/world/europe/astrazeneca-oxford-vaccine-south-african-variant/2021/02/07/e82127f8-6948-11eb-a66e-e27046e9e898_story.html

https://www.news24.com/health24/medical/infectious-diseases/coronavirus/results-from-novavax-vaccine-trials-in-the-uk-and-south-africa-differ-why-and-does-it-matter-20210202

https://www.wits.ac.za/covid19/covid19-news/latest/oxford-covid-19-vaccine-trial-results.html

One million doses arrived

Minimal protection against SA variant

Health Minister Zweli Mkhize, rollout paused

Variant became dominant in November

No significant protection against illness, but all the cases of disease were mild or moderate

Vaccinated people will probably still allow ongoing transmission

As has been recently reported in those with prior infection

The study

Witwatersrand and Oxford

N = 2,000

Examined adults between 18 and 64

Seven sites in South Africa

Last summer and fall

B.1.351 (92% of all current cases in SA)

Eeek mutation, E484K

E = Glutamate

K = Lysine

N501Y as well

Three US states, Virginia

SA variant in the UK

https://news.sky.com/story/uk-covid-news-latest-updates-on-coronavirus-lockdown-and-vaccine-12212131

Cases, 147

Vaccine group

19 cases of covid-19 caused by the variant

Mild disease was defined as at least one symptom of COVID-19

Placebo group

20 cases

Suggests 10% effective

Or 22%

Participants in the trial were young and healthy

Median age 31

Therefore, severe disease protection unknown

Novavax and Johnson & Johnson, 50 to 60%

Janssen, (J and J) protected against moderate to severe disease

Might need to move from hoped for herd immunity to individual severe disease protection

Vaccine after effects

February 4, 2021

https://covid.joinzoe.com/post/vaccine-after-effects-more-common-in-those-who-already-had-covid

https://covid.joinzoe.com/post/covid-vaccine-pfizer-effects

Likelihood of experience one or more mild systemic after effects

N = 280,000

From a Pfizer/BioNTech vaccine dose

Data comes from a sub-sample, n = 40,000

Largest study group outside of trials

Up to 4th January, many HCWs

Not previously infected, 19%

Previously infected, 33%

Systemic after effects, Pfizer/BioNTech

Fatigue 9%

Headache 8%

Chills or shivers 4%

Most mild systemic after effects appeared in the first two days

Only 3% of people have any after effects beyond three days

Local effects, pain or swelling

After the first dose, 37%

After the second dose, 45%

At least one systemic effect (within 7 days)

After the first dose, 14%

After the second dose, 22%

Men, 13%

Women, 19%

Under 55s, 21%

Over 55s, 14%

Same study, vaccine hesitancy

Over one million app users

Yes, 95%

Unsure or unwilling, 5%

Main three reasons given by hesitant contributors

Long term side effects, 50.2%

Lack of knowledge, 37.2%

Concerns about potential adverse reactions, 30.9%

Source: Dr. John Campbell

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