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Delta coronavirus variant: scientists brace for impact

The rapid rise of the highly transmissible strain in the United Kingdom has put countries in Europe, North America and Africa on watch. When the first cases of the SARS-CoV-2 Delta variant were detected in the United Kingdom in mid-April, the nation was getting ready to open up. COVID-19 case numbers, hospitalizations and deaths were plummeting, thanks to months of lockdown and one of the world’s fastest vaccination programmes. Two months later, the variant, which was first detected in India, has catalysed a third UK wave and forced the government to delay the full reopening of society it had originally slated for 21 June. After observing the startlingly swift rise of the Delta variant in the United Kingdom, other countries are bracing for the variant’s impact — if they aren’t feeling it already. Nations with ample access to vaccines, such as those in Europe and North America, are hopeful that the shots can dampen the inevitable rise of Delta. But in countries without large vaccine stocks, particularly in Africa, some scientists worry that the variant could be devastating. “In my mind, it will be really hard to keep out this variant,” says Tom Wenseleers, an evolutionary biologist and biostatistician at the Catholic University of Leuven (KU Leuven) in Belgium. “It’s very likely it will take over altogether on a worldwide basis.” Delta, also known as B.1.617.2, belongs to a viral lineage first identified in India during a ferocious wave of infections there in April and May. The lineage grew rapidly in some parts of the country, and showed signs of partial resistance to vaccines. But it was difficult for researchers to disentangle these intrinsic properties of the variant from other factors driving India’s confirmed cases past 400,000 per day, such as mass gatherings. Delta data The Delta variant has been linked to a resurgence of COVID-19 in Nepal, southeast Asia and elsewhere, but its UK spread has given scientists a clear picture of the threat it poses. Delta seems to be around 60% more transmissible than the already highly infectious Alpha variant (also called B.1.1.7) identified in the United Kingdom in late 2020. Delta is moderately resistant to vaccines, particularly in people who have received just a single dose. A Public Health England study published on 22 May found that a single dose of either AstraZeneca’s or Pfizer’s vaccine reduced a person’s risk of developing COVID-19 symptoms caused by the Delta variant by 33%, compared to 50% for the Alpha variant. A second dose of the AstraZeneca vaccine boosted protection against Delta to 60% (compared to 66% against Alpha), while two doses of Pfizer’s jab were 88% effective (compared to 93% against Alpha). Preliminary evidence from England and Scotland suggests that people infected with Delta are about twice as likely to end up in hospital, compared with those infected with Alpha. “The data coming out of the UK is so good, that we have a really good idea about how the Delta variant is behaving,” says Mads Albertsen, a bioinformatician at Aalborg University in Denmark. “That’s been an eye-opener.” Denmark, which, like the United Kingdom, is a world leader in genomic surveillance, has also seen a steady rise in cases caused by the Delta variant — although far fewer than most other European countries. It is only a matter of time before the variant becomes dominant in Denmark, says Albertsen, but the hope is that its expansion can be slowed through vaccination, surveillance and enhanced contact tracing. “It’s going to take over,” he says, but “hopefully in a few months and not too soon.” Meanwhile, the Danish government is easing restrictions, not re-imposing them: restaurants and bars have been open for months to individuals who have been vaccinated or received a recent negative test, and, as of 14 June, masks are no longer required in most indoor settings. “It is looking good now in Denmark, and we are keeping a close eye on the Delta variant,” says Albertsen. “It can change quite fast, as it has done in the UK.” Cases of the Delta variant in the United Kingdom are doubling roughly every 11 days. But countries with ample vaccine stocks should be reassured by the slower uptick in hospital admissions, says Wenseleers. A recent Public Health England study1 found that people who have had one vaccine dose are 75% less likely to be hospitalized, compared with unvaccinated individuals, and those who are fully protected are 94% less likely to be hospitalized. US spread Delta is also on the rise in the United States, particularly in the Midwest and southeast. The US Centers for Disease Control and Prevention declared it a variant of concern on 15 June. But patchy surveillance means the picture there is less clear. According to nationwide sampling conducted by the genomics company Helix in San Mateo, California, Delta is rising fast. Using a rapid genotyping test, the company has found that the proportion of cases caused by Alpha fell from more than 70% in late April to around 42% as of mid-June, with the rise of Delta driving much of the shift2. Jeremy Kamil, a virologist at Louisiana State University Health in Shreveport, expects Delta to eventually become dominant in the United States, “but to be somewhat blunted by vaccination”. However, vast disparities in vaccination rates could lead to regional and local variation in cases and hospitalizations caused by Delta, says Jennifer Surtees, a biochemist at the University at Buffalo, New York, who is conducting regional surveillance. She notes that 70% of eligible New Yorkers have received at least one dose of vaccine — a milestone that triggered the lifting of most COVID-19 restrictions last week — but that figure is below 40% in some parts of the state. Communities with high proportions of African American and Hispanic individuals, where vaccination rates tend to be low, could be especially hard hit by Delta. “These are populations that are really at risk of a localized outbreak from Delta, so I think it’s really important to still keep tracking and watch this as

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Pilih rakyat atau institusi perbankan?

PETALING JAYA: Kerajaan perlu menghalusi Pelan Pemulihan Negara (PPN) agar dilihat lebih mementingkan rakyat dan ratusan ribu perusahaan mikro, kecil dan sederhana (PMKS) yang sudah tentu terbeban sementara menunggu pembukaan ekonomi secara berperingkat pada fasa ketiga, September ini. Bagi mengurangkan bebanan PMKS yang terpaksa mengehadkan operasi dalam Perintah Kawalan Pergerakan (PKP), moratorium automatik, bantuan tunai serta subsidi upah amat ditagih bagi memastikan mereka dapat terus bertahan. Pengerusi Majlis Tindakan Ekonomi Melayu Bersatu Berhad (MTEM), Dr. Abd. Halim Husin berkata, perkara ini setidak-tidaknya mampu mengelakkan 40 hingga 60 peratus PMKS gulung tikar jika PKP diteruskan sepanjang tahun ini sebelum pembukaan ekonomi yang dijangka pada September. “Ini bukan hanya soal Keluaran Dalam Negeri Kasar (KDNK) dan penarafan bank, ini soal keprihatinan dan empati pemerintah pada kesengsaraan rakyat yang sedang berkorban demi negara.  “Kerajaan perlu membuat keputusan segera untuk memilih sama ada ingin zahirkan kasih sayang pada 30 juta rakyat atau institusi perbankan dan pinjaman berlesen. Yang mana lebih penting untuk kesejahteraan negara dan bangsa,” katanya dalam kenyataan. Jelas Abd. Halim, kerajaan perlu menerima hakikat untuk mencapai imuniti kelompok memerlukan masa dan tidak mungkin berlaku dalam tempoh satu atau dua bulan lagi. Oleh itu tegasnya, kerajaan perlu tampil dengan pelan yang lebih mengikut saranan Majlis Raja-Raja yang menekankan aspek utamakan nyawa dan kehidupan rakyat serta kaedah menangani wabak Covid-19 bersifat inklusif dan mendapat sokongan penuh rakyat pelbagai peringkat. “Berdasarkan laporan Laksana, hanya 20 peratus atau 25,605 PMKS sahaja yang berjaya mendapat bantuan daripada RM12.06 bilion yang ditawarkan. Jumlah itu terlalu kecil berbanding keseluruhan PMKS di negara ini yang masih tidak mendapat sebarang manfaat. “Laporan Jabatan Perangkaan terkini juga menunjukkan pendapatan isi rumah maksimum B40 telah menurun sebanyak lapan peratus menyebabkan lebih 600,000 orang dari kategori M40 telah tergelincir ke kategori B40. “Jika dilihat daripada fakta dan data ini, adakah Program Strategik Memperkasa Rakyat dan Ekonomi Tambahan (​Pemerkasa Plus) itu sudah mencukupi? Adakah nyawa dan keperluan isi rumah yang bergantung pada 80 peratus PMKS yang tidak mendapat manfaat adalah kurang penting dan tidak mendesak?” jelasnya. Sebelum ini, lebih 100 pertubuhan bukan kerajaan (NGO) terdiri daripada pelbagai lapisan masyarakat yang memperjuangkan ekonomi, pengguna, PMKS, agama dan ramai lagi pemegang taruh ekonomi menuntut kerajaan mempertimbangkan pelaksanaan moratorium automatik bagi membantu perusahaan kekal beroperasi dalam tempoh mencabar ini. Sumber : Utusan Online

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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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