2019 Novel Coronavirus Covid-19 Discussion

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Mad Scientist
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#2732304 21-Jun-2021 21:04

DS248:
Re performance of the Pfizer-BioNTech vaccine in a minimal restrictions environment (not certain if the Delta strain is an issue there yet. They still have reasonably tight border restrictions)

As indicated in the plot below, there has been a sharp increase in new cases in Israel over the last week or so following their relaxation of restrictions at the start of the month. Currently showing a provisional figure of 75 new cases for today, the highest daily total in 7 weeks (and only just coming up to midday there).

A big change from the situation prior to June.

Still too early to know what the impact will be on deaths and severe illness (no deaths in the last ~8 days).

This is despite generally very high levels of vaccination (~78% of 20-29 year olds, and ~82% 30-39 year group. And even higher levels for higher age groups)

The current 'Oxford Stringency Index' for Israel (22.22) is identical to the figure for NZ. Only seven countries in the Oxford list with lower OSI values - Nicaragua and six African countries.

Do we know which strain(s) are breaking through

Scott3

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#2732315 21-Jun-2021 21:08

Handle9:

There's an ethical difference in the Australia and the other countries. Australia doesn't have endemic Covid so there is a significant ethical problem with approving an unproven treatment.

I doubt there is a shortage of AZ vaccines in the first world countries listed, So I think it is fair to assume that they are allowing mixed vaccines because of their better performance of safety over two AZ doses. (they could have just done like Aussie and said no mix & match)

Handle9

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#2732318 21-Jun-2021 21:17

Scott3:
Handle9:

There's an ethical difference in the Australia and the other countries. Australia doesn't have endemic Covid so there is a significant ethical problem with approving an unproven treatment.

I doubt there is a shortage of AZ vaccines in the first world countries listed, So I think it is fair to assume that they are allowing mixed vaccines because of their better performance of safety over two AZ doses. (they could have just done like Aussie and said no mix & match)

To get approval from the regulator that needs to be proven to be safe.

How do you do that without a large scale clinical trial? There's already been enough problems without an unproven treatment causing harm.

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#2732319 21-Jun-2021 21:20

That graph from Israel provides a useful data point. They are 61% vaccinated / 57% fully vaccinated and this is not enough on it's own to keep case's trending down in a relaxed restriction environment.

This is consistent with commentary that 70 - 80% of the total population needs to be vaccinated for herd immunity.

Also the vaccination rate curve is a little telling, and similar to that of Canada where there is a decrease in vaccination rate from 50 - 60% of the population being done. I think NZ will see similar. Once our big shipments land I think we will race up to 50 - 60% vaccinated, then hit a point where all the eager people have been vaccinated, and increasing amounts of effort will need to be exerted to encourage the rest of the population.

Hopefully pfizer approvals for age groups down to pre-schoolers come through by the end of the year. Having a greater eligible pool will help with herd immunity.

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#2732323 21-Jun-2021 21:30

Handle9:

To get approval from the regulator that needs to be proven to be safe.

How do you do that without a large scale clinical trial? There's already been enough problems without an unproven treatment causing harm.

Foreign regulators have given it approval, and deemed it safe, so clearly it can be done in the absence of a large scale clinical trail.

https://vancouverisland.ctvnews.ca/canada-approves-mixing-and-matching-second-vaccine-doses-b-c-yet-to-confirm-approval-1.5453131

I am far from an expert in the area, but suggest that the large scale clinical trial results for each brand, a desktop study on possible interactions, combined with multiple smaller studies on mix and match vaccines were sufficient for the foreign regulators.

It seems regulators are willing to step outside exactly what has been trialed in order to get better results for their community. For example the UK with a 12 week AZ dose spacing. Initially was approached with skepticism, but now is regarded as best practice.

Also lots of stuff doesn't get large scale trials in the vaccine industry, for example the interaction of that vaccine with the flu vaccine.

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#2732326 21-Jun-2021 21:35

Scott3:
Handle9:

To get approval from the regulator that needs to be proven to be safe.

How do you do that without a large scale clinical trial? There's already been enough problems without an unproven treatment causing harm.

Foreign regulators have given it approval, and deemed it safe, so clearly it can be done in the absence of a large scale clinical trail.

https://vancouverisland.ctvnews.ca/canada-approves-mixing-and-matching-second-vaccine-doses-b-c-yet-to-confirm-approval-1.5453131

I am far from an expert in the area, but suggest that the large scale clinical trial results for each brand, a desktop study on possible interactions, combined with multiple smaller studies on mix and match vaccines were sufficient for the foreign regulators.

It seems regulators are willing to step outside exactly what has been trialed in order to get better results for their community. For example the UK with a 12 week AZ dose spacing. Initially was approached with skepticism, but now is regarded as best practice.

Also lots of stuff doesn't get large scale trials in the vaccine industry, for example the interaction of that vaccine with the flu vaccine.

The rules are relaxed a little in an emergency situation. Australia and New Zealand are not in an emergency situation.

sbiddle

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#2732336 21-Jun-2021 21:42

Scott3:

That graph from Israel provides a useful data point. They are 61% vaccinated / 57% fully vaccinated and this is not enough on it's own to keep case's trending down in a relaxed restriction environment.

This is consistent with commentary that 70 - 80% of the total population needs to be vaccinated for herd immunity.

It was interesting to hear Professor Nikki Turner on the radio this evening discussing the announcement today about the Pfizer rollout for 12-15yr olds but then going on to discuss endemic Covid and the fact that whenever it is that we do open our borders that we will then have Covid in NZ. She raised the very real issue that we may never actually see a level of vaccination in NZ that will deliver true herd immunity.

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Fred99

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#2732347 21-Jun-2021 22:01

I don't think they have CT of the Delta variant in Israel. They've maintained tight border controls even though case numbers have plummeted. The uptick in cases is from easing local restrictions.

At ~70% more contagious then 60% of the population vaccinated won't stop it. But they've also started rolling out vaccine to 12-15 years olds, as we'll be doing here.

They won't be able to keep the Delta variant out. Neither will we when we "open up". Children are probably going to have to be vaccinated to achieve an acceptable level of herd immunity.

The Delta variant was predictable, there will most likely be even more contagious variants arrive. There's no chance in hell that the C-19 pandemic is close to being over

Fred99

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#2732349 21-Jun-2021 22:07

sbiddle:

She raised the very real issue that we may never actually see a level of vaccination in NZ that will deliver true herd immunity.

Could be.
Then it becomes a political issue, as if you want Covid to not be a potential death sentence to transplant patients, cancer patients, people with immune disorders, and the elderly, the gormless selfish fools who fall into the definition of "anti-vaxxers" are going to have to be "encouraged" to change their minds.

DS248

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#2732357 21-Jun-2021 22:24

Fred99:

I don't think they have CT of the Delta variant in Israel. They've maintained tight border controls even though case numbers have plummeted. The uptick in cases is from easing local restrictions.

At ~70% more contagious then 60% of the population vaccinated won't stop it. But they've also started rolling out vaccine to 12-15 years olds, as we'll be doing here.

They won't be able to keep the Delta variant out. Neither will we when we "open up". Children are probably going to have to be vaccinated to achieve an acceptable level of herd immunity.

The Delta variant was predictable, there will most likely be even more contagious variants arrive. There's no chance in hell that the C-19 pandemic is close to being over

Having now done a bit more searching, at least part is (a) the Delta variant, and (b) school kids (largely under 16, hence unvaccinated)

Two school outbreaks, the second with 44 children testing positive - all Delta variant

https://www.timesofisrael.com/israel-said-eyeing-new-limitations-on-arrivals-amid-fears-of-delta-variant/

Under 20's are the only group with lower that 78% vaccination rate (on that only due to vaccinations having just started for children under 16)

Edit: Clarification re-vaccination of 12-15 year old children in Israel. Appears that was approved last month. Until now it has left vaccination of children up to the parents' preference. But following the two school outbreaks, they are likely to more actively encourage vaccination of children.

https://timesofindia.indiatimes.com/world/rest-of-world/israel-urges-adolescents-to-get-vaccinated-citing-delta-variant/articleshow/83711284.cms

DS248

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#2732362 21-Jun-2021 22:37

Fred99: ...

The Delta variant was predictable, there will most likely be even more contagious variants arrive. ...

Already a Delta-plus variant identified in India.

https://www.ndtv.com/india-news/delta-plus-variant-could-become-a-cause-of-concern-aiims-chief-2468125

"... WHO has said that this is a variant of interest but it could become a variant of concern ..."

Early days yet but by now it must surely clear that the West (& world) needs to act with more urgency in dealing with the situation in India and other high infection areas

Fred99

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#2732364 21-Jun-2021 22:49

Well that's a problem. Be interesting though to see how with relatively high adult vaccination rates what eventuates. According to Times of Israel, adults who have been vaccinated became infected - though no mention of severity of symptoms. 90% of new UK cases are now Delta variant.

Police were reportedly probing whether coronavirus infections among 11 kids at a school in Modiin were caused by a man who violated quarantine after returning from overseas.

<sigh>

DS248

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#2732365 21-Jun-2021 22:52

DS248:

... Currently showing a provisional figure of 75 new cases for today, the highest daily total in 7 weeks (and only just coming up to midday there). ...

Oops, transposed those numbers - currently standing at 57 for the day

Fred99

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#2732371 21-Jun-2021 23:08

DS248:

"... WHO has said that this is a variant of interest but it could become a variant of concern ..."

WHO took months to declare B1617.2 "Delta" a variant of concern, this despite good evidence it was moving to become the dominant strain, evidence that the symptoms were different, evidence that the mutation changed the spike protein with the likelihood that change made it more infectious, and evidence from in-vitro antibody neutralisation tests that it posed a risk for breakthrough from immunity from past infection or vaccination.

They were far too slow, the horse had already bolted long before they got "concerned". They've failed the world on Covid. The organisation needs to be reformed - the world needs an WHO - but their pandemic response has been worse than useless.

DS248

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#2732508 22-Jun-2021 08:59

DS248: ...

Oops, transposed those numbers - currently standing at 57 for the day

Except, now coming up to midnight there and the (still provisional) count for the day has jumped to 105. Up from an average of ~13/day ten days ago.

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