General Knowledge

Explainer: How worried should we be about the Omicron variant?

Nov 27 (Reuters) – The new Omicron coronavirus variant – identified first in South Africa, but also detected in Europe and Asia – is raising concern worldwide given the number of mutations, which might help it spread or even evade antibodies from prior infection or vaccination. News of the variant prompted countries to announce new travel restrictions on Friday and sent drugmakers scrambling to see if their COVID-19 vaccines remain protective. WHY ARE SCIENTISTS WORRIED? The World Health Organization on Friday classified the B.1.1.529 variant, or Omicron, as a SARS-CoV-2 “variant of concern,” saying it may spread more quickly than other forms of coronavirus. The Delta variant remains dominant worldwide, accounting for 99.9% of U.S. cases, and it is not yet clear whether Omicron will be able to displace Delta, said Dr. Graham Snyder, medical director, infection prevention and hospital epidemiology at University of Pittsburgh Medical Center. But the new variant has over 30 mutations in the part of the virus that current vaccines target. It is also suspected of driving a spike in new infections in South Africa. Omicron’s mutations are likely to render certain COVID-19 treatments – including some manufactured antibodies – ineffective, said Dr. David Ho, professor of microbiology and immunology at Columbia University. Experimental antiviral pills – such as Pfizer Inc’s (PFE.N) Paxlovid and Merck & Co Inc’s (MRK.N) molnupiravir – target parts of the virus that are not changed in Omicron, and these drugs could become even more important if vaccine-induced and natural immunity are threatened. THE UNKNOWNS Scientists say it could be several more weeks before they can define the type of disease caused by the variant, determine how contagious it is and identify how far it has already spread. Some note that other variants of concern, including Beta, which was also first detected in South Africa, were ultimately replaced by Delta. But the biggest question remains whether protection from COVID-19 vaccines – nearly 8 billion doses have been administered globally – will hold up. And, will people previously infected with the coronavirus be immune from infection with Omicron? Experts also don’t yet know whether Omicron will cause more or less severe COVID-19 compared to other coronavirus strains. BEST RESPONSE? Omicron has not yet been identified in the United States, but it is likely already here, scientists said. Even without the new variant, U.S. COVID-19 rates have increased in recent weeks, mainly in northern states, as people move indoors to avoid winter weather. Some countries have moved to limit travel from southern Africa. Beyond government restrictions, individuals should still assess their own vulnerability to COVID and tolerance for risk as they make travel decisions for the winter holidays, Snyder from University of Pittsburgh Medical Center said. He and others said vaccination should remain a priority despite questions about effectiveness against Omicron, because it is likely that they still remain protective to a certain extent. Everyone should also continue to wear masks, avoid crowds, ventilate rooms, and wash hands. “We have all those tools that will work against any variant,” said Dr. Eric Topol, director of the Scripps Research Translational Institute in La Jolla, California. Original Source : Deena Beasley/Reuters (Nov 2021)

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What Endemic Covid-19 Means

KUALA LUMPUR, Sept 28 — The Covid-19 pandemic has become so much a part of our lives that the word no longer strikes fear but rather a sense of acceptance — an acceptance that this will be part of our lives. But what happens when the Covid-19 virus becomes the norm? Prof Dr Lokman Hakim Sulaiman, pro vice chancellor of research, International Medical University (IMU), and director of the Institute for Research, Development and Innovation (IRDI), talks about how we are evolving from a pandemic to an endemic stage. There has been much discussion lately about Malaysia entering the endemic phase in terms of Covid-19. The Ministry of Health recently announced that the country is on track to transition into this new phase by the end of October 2021. “When Covid-19 becomes endemic, what we are saying is that the infection will not go away, and will continue to be transmitted,” said Dr Lokman. “This is not to say that doom and gloom will be part of our path going forward. Rather, transitioning from a pandemic to an endemic stage is about the community seeing a growing number of people who are immune to the virus, either through surviving natural infection or through vaccinations.” “As less and less people are susceptible to the infection, the number of cases will not be as high as before,” said Dr Lokman. “Effective vaccines will be an important tool as the level of immunity in the population is very important to shift from the pandemic to endemic phase,” he added. Data from around the world have shown that Covid-19 vaccines have successfully brought serious cases down, and this will help drive us towards an endemic state faster. However, vaccination rates are not the only indicator of endemicity. A State Of Acceptance Being in an endemic phase means that infection is at a level that is acceptable or manageable. “This is a level which does not constitute a major public health problem — i.e. smaller numbers of infection, less hospitalisations, and fewer deaths,” said Dr Lokman. But what is considered “acceptable”? According to Dr Lokman, it is a complex and dynamic situation. Several factors will influence this such as the strength and duration of people’s immune protection, transmissibility of the virus itself, health care capacities to manage the infection and the public health interventions that are put in place. “It is also dependent on people’s behaviour — how they conduct themselves will either spread the infection or keep it in check,” he said.There is no prescribed universal level. “There will be variations between countries, and each country has to analyse their own circumstances and determine their own criteria for endemicity,” he said. “We have to ask ourselves, what is a number that we are comfortable with?” Are We There Yet? Does entering the endemic stage mean that we have reached the finish line and won the race? “No, just as we can move from pandemic to endemic, we can as easily make a U-turn back into an epidemic or pandemic status. New variants can push infections and cases back up to an unacceptable rate,” Dr Lokman explained. He gives the example of how the Delta variant has caused a resurgence of cases in some countries and how other newer variants of concern such as the Lambda and Mu are being closely monitored by the World Health Organization (WHO). He explains that as access to Covid-19 vaccines is not equal globally, a large proportion of the world’s population is still susceptible to the infection. “An emergence of a highly infectious variant can trigger a new epidemic which can escalate into a pandemic level in terms of global spread,” he warned. From Outbreak To Endemic To get a clearer picture, let’s take a look at how a disease goes from outbreak to epidemic and pandemic, and then to being declared endemic. An outbreak describes a sudden increase in the number of cases in a limited area, either in a place where cases were reported before or in a new area. “For example, in certain months of the year when the number of dengue cases are higher than usual, it’s called a dengue outbreak,” Dr Lokman explained. If an outbreak grows to affect larger areas with a much higher number of cases, an epidemic is said to have occurred. “An epidemic of dengue occurred in Malaysia in 2014 when the number of cases increased to a record high of almost 110,000 in that year compared to not more than 50,000 cases in the three decades before that,” he said, explaining that the terms outbreak, epidemic, pandemic and endemic are not just used for infectious diseases, but for other health conditions too. A pandemic, as we know, is an epidemic that has spread globally, such as Covid-19. Previous examples would be the Spanish Flu in 1918, which caused the deaths of more than 50 million people. More recently, just over ten years ago, the Influenza H1N1 pandemic affected the whole world over a short period of time. H1N1 is now endemic in many countries, and its occurrence is fairly stable. Helping us to visualise what living with Covid-19 endemicity will be like, Dr Lokman said: “Think about it like dengue and malaria which are both endemic in Malaysia and where cases are reported regularly every year.” Zero Covid-19 vs Endemic  Hoping to reach a similar end to the infections, some countries such as New Zealand have adopted a zero Covid-19 strategy — where lockdowns and strict travel parameters aim to completely wipe out the virus. But most countries have accepted that public health interventions alone are never going to stop infections. “In an endemic state, what we are looking at is public responsibility to help manage the disease. The public must continue to be educated on the importance of risk assessment and management so that they will take appropriate action to minimise the risk of being infected and infecting others,” said Dr Lokman.  However, while nationwide lockdowns will be phased out, other measures will need to

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Why health officials are watching new ‘lambda’ coronavirus variant

The variant carries a number of mutations that could potentially aid its spread. A coronavirus variant known as “lambda” is gaining the attention of health officials as it spreads around the world. The variant, also known as C.37, was first detected in Peru in August 2020, according to the World Health Organization (WHO). On June 14, the agency designated C.37 a global “variant of interest,” or VOI, and named it lambda. VOI means the variant is increasingly showing up in communities and has mutations that are predicted to have some effect on viral characteristics, such as increased transmissibility. In contrast, officials use the term “variant of concern,” or VOC, once reliable data shows that the variant has increased transmissibility — such as what’s been seen with the delta variant — or other worrying features. So far, lambda has been detected in 29 countries, with high levels of spread in South American countries. In recent months, the lambda variant was detected in 81% of COVID-19 cases in Peru that underwent genetic sequencing, according to the WHO. And in Chile, the variant was detected in about one-third of cases, the WHO said.  Most recently, the variant popped up in the United Kingdom. On June 25, Public Health England reported six cases of the lambda variant, all of which were tied to overseas travel. Officials are monitoring the lambda variant because it carries a number of mutations that could potentially aid its spread. The variant has seven mutations in the virus’s “spike protein” compared with the original strain of SARS-CoV-2 detected in Wuhan, China. Some of these mutations have the potential to increase transmissibility of the virus or to reduce the ability of certain antibodies to neutralize, or inactivate, the virus, according to the WHO. For example, lambda has a mutation known as F490S located in the spike protein’s receptor-binding domain (RBD), where the virus first docks onto human cells. A paper published in the July issue of the journal Genomics identified F490S as a likely “vaccine escape mutation” that could both make the virus more infectious and disrupt the ability of vaccine-generated antibodies to recognize the variant. Still, these effects are theoretical at this point. “There is currently no evidence that this variant causes more severe disease or renders the vaccines currently deployed any less effective,” according to Public Health England. More studies are needed to see if these mutations really do affect how the virus behaves. Original source : www.livescience.com; by Rachael Rettner – Senior Writer 

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Coronavirus disease (COVID-19): Herd immunity, lockdowns and COVID-19

What is ‘herd immunity’? ‘Herd immunity’, also known as ‘population immunity’, is the indirect protection from an infectious disease that happens when a population is immune either through vaccination or immunity developed through previous infection. WHO supports achieving ‘herd immunity’ through vaccination, not by allowing a disease to spread through any segment of the population, as this would result in unnecessary cases and deaths. Herd immunity against COVID-19 should be achieved by protecting people through vaccination, not by exposing them to the pathogen that causes the disease. Read the Director-General’s 12 October media briefing speech for more detail.  Vaccines train our immune systems to create proteins that fight disease, known as ‘antibodies’, just as would happen when we are exposed to a disease but – crucially – vaccines work without making us sick. Vaccinated people are protected from getting the disease in question and passing on the pathogen, breaking any chains of transmission. Visit our webpage on COVID-19 and vaccines for more detail.  To safely achieve herd immunity against COVID-19, a substantial proportion of a population would need to be vaccinated, lowering the overall amount of virus able to spread in the whole population. One of the aims with working towards herd immunity is to keep vulnerable groups who cannot get vaccinated (e.g. due to health conditions like allergic reactions to the vaccine) safe and protected from the disease. Read our Q&A on vaccines and immunization for more information. The percentage of people who need to be immune in order to achieve herd immunity varies with each disease. For example, herd immunity against measles requires about 95% of a population to be vaccinated. The remaining 5% will be protected by the fact that measles will not spread among those who are vaccinated. For polio, the threshold is about 80%. The proportion of the population that must be vaccinated against COVID-19 to begin inducing herd immunity is not known. This is an important area of research and will likely vary according to the community, the vaccine, the populations prioritized for vaccination, and other factors.   Achieving herd immunity with safe and effective vaccines makes diseases rarer and saves lives.  Find out more about the science behind herd immunity by watching or reading this interview with WHO’s Chief Scientist, Dr Soumya Swaminathan.What is WHO’s position on ‘herd immunity’ as a way of fighting COVID-19? Attempts to reach ‘herd immunity’ through exposing people to a virus are scientifically problematic and unethical. Letting COVID-19 spread through populations, of any age or health status will lead to unnecessary infections, suffering and death. The vast majority of people in most countries remain susceptible to this virus. Seroprevalence surveys suggest that in most countries, less than 10% of the population have been infected with COVID-19. We are still learning about immunity to COVID-19. Most people who are infected with COVID-19 develop an immune response within the first few weeks, but we don’t know how strong or lasting that immune response is, or how it differs for different people. There have also been reports of people infected with COVID-19 for a second time.          Until we better understand COVID-19 immunity, it will not be possible to know how much of a population is immune and how long that immunity last for, let alone make future predictions. These challenges should preclude any plans that try to increase immunity within a population by allowing people to get infected. Although older people and those with underlying conditions are most at risk of severe disease and death, they are not the only ones at risk. Finally, while most infected people get mild or moderate forms of COVID-19 and some experience no disease, many become seriously ill and must be admitted into hospital. We are only beginning to understand the long-term health impacts among people who have had COVID-19, including what is being described as ‘Long COVID.’ WHO is working with clinicians and patient groups to better understand the long term effects of COVID-19.   Read the Director-General’s opening remarks at the 12 October COVID-19 briefing for a summary of WHO’s position.What do we know about immunity from COVID-19? Most people who are infected with COVID-19 develop an immune response within the first few weeks after infection. Research is still ongoing into how strong that protection is and how long it lasts. WHO is also looking into whether the strength and length of immune response depends on the type of infection a person has: without symptoms (‘asymptomatic’), mild or severe. Even people without symptoms seem to develop an immune response. Globally, data from seroprevalence studies suggests that less 10% of those studied have been infected, meaning that the vast majority of the world’s population remains susceptible to this virus. For other coronaviruses – such as the common cold, SARS-CoV-1 and Middle East Respiratory Syndrome (MERS) – immunity declines over time, as is the case with other diseases. While people infected with the SARS-CoV-2 virus develop antibodies and immunity, we do not yet know how long it lasts.  Large scale physical distancing measures and movement restrictions, often referred to as ‘lockdowns’, can slow COVID‑19 transmission by limiting contact between people. However, these measures can have a profound negative impact on individuals, communities, and societies by bringing social and economic life to a near stop. Such measures disproportionately affect disadvantaged groups, including people in poverty, migrants, internally displaced people and refugees, who most often live in overcrowded and under resourced settings, and depend on daily labour for subsistence. WHO recognizes that at certain points, some countries have had no choice but to issue stay-at-home orders and other measures, to buy time. Governments must make the most of the extra time granted by ‘lockdown’ measures by doing all they can to build their capacities to detect, isolate, test and care for all cases; trace and quarantine all contacts; engage, empower and enable populations to drive the societal response and more. WHO is hopeful that countries will use targeted interventions where and when needed, based on the local situation. Content source : WHO Q&A, 31st December 2020

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Mental Health During Pandemic

Coping with Stress The COVID-19 pandemic has had a major effect on our lives. Many of us are facing challenges that can be stressful, overwhelming, and cause strong emotions in adults and children. Public health actions, such as social distancing, are necessary to reduce the spread of COVID-19, but they can make us feel isolated and lonely and can increase stress and anxiety. Learning to cope with stress in a healthy way will make you, the people you care about, and those around you become more resilient. Stress can cause the following: Feelings of fear, anger, sadness, worry, numbness, or frustration Changes in appetite, energy, desires, and interests Difficulty concentrating and making decisions Difficulty sleeping or nightmares Physical reactions, such as headaches, body pains, stomach problems, and skin rashes Worsening of chronic health problems Worsening of mental health conditions Increased use of tobacco, alcohol, and other substances It is natural to feel stress, anxiety, grief, and worry during the COVID-19 pandemic. Below are ways that you can help yourself, others, and your community manage stress. Healthy Ways to Cope with Stress Take breaks from watching, reading, or listening to news stories, including those on social media. It’s good to be informed, but hearing about the pandemic constantly can be upsetting. Consider limiting news to just a couple times a day and disconnecting from phone, tv, and computer screens for a while. Take care of your body. Take deep breaths, stretch, or meditateexternal icon. Try to eat healthy, well-balanced meals. Exercise regularly. Get plenty of sleep. Avoid excessive alcohol, tobacco, and substance use. Continue with routine preventive measures (such as vaccinations, cancer screenings, etc.) as recommended by your healthcare provider. Get vaccinated with a COVID-19 vaccine when available. Make time to unwind. Try to do some other activities you enjoy. Connect with others. Talk with peopleexternal icon you trust about your concerns and how you are feeling. Connect with your community- or faith-based organizations. While social distancing measures are in place, try connecting online, through social media, or by phone or mail. Helping Others Cope Taking care of yourself can better equip you to take care of others. During times of social distancing, it is especially important to stay connected with your friends and family. Helping others cope with stress through phone calls or video chats can help you and your loved ones feel less lonely or isolated. Content source : National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases

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Why you can’t compare Covid-19 vaccines

What a vaccine’s “efficacy rate” actually means. In the US, the first two available Covid-19 vaccines were the ones from Pfizer/BioNTech and Moderna. Both vaccines have very high “efficacy rates,” of around 95%. But the third vaccine introduced in the US, from Johnson & Johnson, has a considerably lower efficacy rate: just 66%. Look at those numbers next to each other, and it’s natural to conclude that one of them is considerably worse. Why settle for 66% when you can have 95%? But that isn’t the right way to understand a vaccine’s efficacy rate, or even to understand what a vaccine does. And public health experts say that if you really want to know which vaccine is the best one, efficacy isn’t actually the most important number at all. Content source : www.vox.com

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Benefits of Getting a COVID-19 Vaccine

COVID-19 vaccination will help keep you from getting COVID-19 All COVID-19 vaccines currently available in the United States have been shown to be safe and effective at preventing COVID-19. Learn more about the different COVID-19 vaccines. All COVID-19 vaccines that are in development are being carefully evaluated in clinical trials and will be authorized or approved only if they make it substantially less likely you will get COVID-19. Learn more about how federal partners are ensuring COVID-19 vaccines work. Based on what we know about vaccines for other diseases and early data from clinical trials, experts believe that getting a COVID-19 vaccine also helps keep you from getting seriously ill even if you do get COVID-19. Getting vaccinated yourself may also protect people around you, particularly people at increased risk for severe illness from COVID-19. Experts continue to conduct studies to learn more about how COVID-19 vaccination may reduce spread of the virus that causes COVID-19. Once you are fully vaccinated, you can start doing more After you are fully vaccinated for COVID-19, you may be able to start doing some things that you stopped doing because of the pandemic. For example, you can gather indoors without masks with other people who are fully vaccinated. We are still learning how vaccines will affect the spread of COVID-19. Until we know more about how vaccines will affect the spread of COVID-19, people who are fully vaccinated against COVID-19 should keep taking precautions in public places like wearing a mask, staying 6 feet apart from others, avoiding crowds and poorly ventilated spaces, and washing your hands often. People are not considered fully vaccinated until two weeks after their second dose of the Pfizer-BioNTech or Moderna COVID-19 vaccine, or two weeks after a single-dose Johnson & Johnson’s Janssen COVID-19 vaccine. You should keep using all the tools available to protect yourself and others until you are fully vaccinated. COVID-19 vaccination is a safer way to help build protection COVID-19 can have serious, life-threatening complications, and there is no way to know how COVID-19 will affect you. And if you get sick, you could spread the disease to friends, family, and others around you. Clinical trials for all vaccines must first show they are safe and effective before any vaccine can be authorized or approved for use, including COVID-19 vaccines. The known and potential benefits of a COVID-19 vaccine must outweigh the known and potential risks of the vaccine before it is used under what is known as an Emergency Use Authorization (EUA). Watch a video explaining an EUA. Getting COVID-19 may offer some protection, known as natural immunity. Current evidence suggests that reinfection with the virus that causes COVID-19 is uncommon in the months after initial infection, but may increase with time. The risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody (immune system) response without having to experience sickness. Both natural immunity and immunity produced by a vaccine are important parts of COVID-19 disease that experts are trying to learn more about, and CDC will keep the public informed as new evidence becomes available. COVID-19 vaccination will be an important tool to help stop the pandemic Wearing masks and staying 6 feet apart from others help reduce your chance of being exposed to the virus or spreading it to others, but these measures are not enough. Vaccines will work with your immune system so it will be ready to fight the virus if you are exposed. A growing body of evidence suggests that fully vaccinated people are less likely to be infected without showing symptoms (called an asymptomatic infection) and potentially less likely to spread the virus that causes COVID-19 to others. However, further investigation is ongoing. Stopping a pandemic requires using all the tools we have available. As experts learn more about how COVID-19 vaccination may help reduce spread of the virus that causes COVID-19, CDC will continue to update its recommendations to protect communities using the latest science. COVID-19 vaccines are safe and effective We understand that some people may be concerned about getting vaccinated now that COVID-19 vaccines are available in the United States. While more COVID-19 vaccines are being developed as quickly as possible, routine processes and procedures remain in place to ensure the safety of any vaccine that is authorized or approved for use. Safety is a top priority, and there are many reasons to get vaccinated. None of the COVID-19 vaccines can make you sick with COVID-19 None of the COVID-19 vaccines contain the live virus that causes COVID-19 so a COVID-19 vaccine cannot make you sick with COVID-19. Learn more Facts about COVID-19 Vaccines Content source: National Center for Immunisation and Respiratory Diseases (NCIRD), Division of Viral Diseases

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