Friday 20 January 2023

COVID-19 Coronavirus and other virus UK and World News Weekly Update 20th January 2023

COVID-19 Coronavirus and other virus UK and World News Weekly Update 20th January 2023

World COVID Statistics: 672,686,930 reported cases and 6,740,521losses of life.

"I just think we're really, really, really silly if we think that our health systems are just going to come back online and just start functioning at 100% again.... because our systems have lost elasticity, they've lost resilience, not gained it. And our health workers have been through one of the worst, probably, health experiences of the last 100 years or more. 
We owe them a huge debt of gratitude for what they've done for us over the last 3 years. And I don't think we're repaying that debt with the working conditions, with the protection, with the training or with the pay that they need to be able to take care of themselves and their families."
Dr Mike Ryan of WHO. Seconded. Always. 

RSV information UK HSA

"China's COVID prevention and control is still in a time of stress, but the light is ahead, persistence is victory. I am most worried about the rural areas and farmers. Medical facilities are relatively weak in rural areas, thus prevention is difficult and the task is arduous."
Chinese leader Xi Jinping with a warning and clear indication he's worried, in a Lunar New Year speech. 

This week's NHS England stats show a continued (and pretty rapid this week) fall in hospital admissions with COVID - down 27%. We are well into the dip, and I hope that reduction offers some relief to NHS staff. 
Adele Groyer of the COVID Actuaries worked out the peak of this wave for numbers infected in England was on Christmas Day. 

200123 COVID hospital stats for England from HSA

And the latest ONS Random Sampling backs that nicely. For the week ending 10 January 2023:
"The percentage of people testing positive for coronavirus (COVID-19) continued to decrease in England and Wales, and decreased in Northern Ireland and Scotland."
(Whoot!.. for now at least...)
- England,estimate 1,461,900, equating to 2.61% of the population (a decrease from 4.02% in the previous reference week), or around 1 in 40 people.
- Wales, estimate 121,600, equating to 3.94% of the population (a decrease from 5.16% in the previous reference week), or around 1 in 25 people.
- Northern Ireland, estimate 77,300, equating to 4.22% of the population (a decrease from 7.04% in the previous reference week), or around 1 in 25 people.
- Scotland, estimate 171,500, equating to 3.26% of the population (a decrease from 4.17% in the previous reference week), or around 1 in 30 people.

Ambulance handover times upon arrival at hospital should be 15 minutes or less. On December 19th and 28th England's ambulance service hit and passed a critical wall, with handover times across the country averaging over 1 hour 35 minutes. 
At one major 'unnamed South West hospital', at the end of December 2022, average ambulance handover waiting times (you're in the ambulance in the car park and you want to be in the hospital) averaged almost 14 hours for the first 90% of patients. Holy heck. 
(Sometimes stats count the first 90% for an average time, because counting every single person means oddities and rare events can give a less true picture and throw the average figures out. Goodness knows how long the other 10% waited beyond this.)
Wales - yours are as bad, or potentially worse. 
Thanks to Paul Mainwood for keeping an eye on this one. 

The end of year stats have been released from the UK's Continuous Mortality Investigation.
It is very clear that at the beginning of 2022 we had a fairly low number of deaths, and as we went into late Spring the mortality rates in all age groups didn't actually rise, but they didn't fall as expected either. And then they remained higher than usual for the rest of the year. 
The CMI doesn't just give raw figures, it adjusts for changes to the population, such as aging and growth. By those maths:
"Mortality in the second half of 2022 was higher than in the second half of any year since 2010{when comparable recording began}.
For 2022 as a whole, mortality was lower than in 2020 or 2021, but higher than in 2019.
At the end of 2022, the cumulative standardised mortality rate for 2022 was 0.8% below the 2012-2021 average but 4.5% above 2019, the last full year before the pandemic."
Looking at the stats by age gives better, if daunting, insight. Stuart McDonald, COVID Actuaries:
"....death rates for men over 65 and women over 45 tracked or beat the best years on record.
Conversely, death rates for men under 65 and women under 45 were among the highest seen in the last decade."
I have a horrible feeling that this is in part because the previous 2 years has already wiped out a lot of the people who wouldn't ever have survived a bad illness. Older people and carers (a huge number of whom are women over 45) suffered the most in 2020 and 2021, and are the groups who did better during 2022 in comparison to others. 

200122 Dr Mary Ramsey comments on latest UK COVID prevalence

UK Nurses Strikes:
Nurses who are RCN members (Royal College of Nursing) have voted for more strike action on 6th and 7th February. Most areas will be affected. 

UK Ambulance strikes:
10,000 GMB members (Paramedics, Emergency Care Assistants, call handlers and other staff ) have voted for more strike action:
- All GMB members 6th and 20th February, 6th and 20th March.
- West Midlands Ambulance Service also strike on 23rd January.
- North West Ambulance Service also strike on 24th January.
UNITE members have announced another 10 Ambulance Driver strikes in England, Wales and Northern Ireland. Strikes will affect different regions on different days:
- North East, East Midlands, Wales: February 6 and 20, March 6 and 20
- North West: February 6 and 22, March 6 and 20
- West Midlands: February 6 and 17, March 6 and 20
- Northern Ireland: January 26, February 16, 17, 23 and 24
Emergency care, and transport to lifesaving services should not be affected. 

(GMB is called GMB because lots of smaller unions amalgamated over time. It originated in 1889 in the shipping industry with 'Gas Workers and General Labourers', and unions who have joined since then include London tailors, who first formed a union as far back as 1417.)

Norovirus - stay home for 48 hours after a bad tummy

"Norovirus cases are rising and lab reports are currently about 1/3 higher than what we would see at this time of year. Rates have increased most in those 65 and over, however, we haven't seen an increase in care home outbreaks."
The UK Health Security Agency with a warning to regularly wash your hands with soap, and stay home for 48 hours after a bad tummy. Remember actual soap melts the fats that hold virus together. You have the power to kill millions in just 2 minutes.

Medical conditions risk ratio following SARS Cov 2 infection

"Long COVID is an often debilitating illness that occurs in at least 10% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. More than 200 symptoms have been identified with impacts on multiple organ systems. At least 65 million individuals worldwide are estimated to have long COVID, with cases increasing daily."
A massive US study on Long COVID was released last week. They looked at all areas of the body, symptoms of Long COVID, and risk of severe illness after COVID.
(This study clarifies a lot of what we already know, so no getting too demoralised.)
They could not pinpoint exact causes of Long COVID, but bits of virus hanging around in our bodies and causing havoc do seem to be plausible, and there is lots of evidence which seems to support that: 
"Several reports have pointed towards possible viral persistence as a driver of long COVID symptoms; viral proteins and/or RNA has been found in the reproductive system, cardiovascular system, brain, muscles, eyes, lymph nodes, appendix, breast tissue, hepatic tissue, lung tissue, plasma, stool and urine."
Indeed SARS-COV-2, the virus which causes COVID gets everywhere. It is not simply the lung condition we thought it was 3 years ago. 
Organ damage after COVID is commonly reported, with several studies finding 1 or more organs damaged in over 50% of participants, even a year later. (Are you still out of breath, or struggling with your eyesight, or a bubbly gut?) 
Cognitive impairment in patients with Long COVID was found to be on a par with the UK drink driving limit, or 10 years of aging. Lots of studies have shown various damage to the brain after COVID, including reduction in grey matter, blood clots and collections of proteins which can be early signs of Dementia (Are you still a bit too tired, or lacking concentration?)
Overall evidence suggests the poorlier we are with COVID, the more likely we are to develop Long COVID, so vaccines help in this respect, and it's possible they prevent some people developing the condition, but they won't offer full protection. Even people with very few symptoms can develop Long COVID, or at least discover they have it once they attempt to do something exciting or adventurous. 
There is some evidence to suggest that people with Long COVID are also more susceptible to reinfection. Harsh.
The study authors made points about lack of agreement and clarity when categorising illnesses, lack of understanding whether something is 'all in the patient's head' or actually physical and visible in a scan. They ask for continued research, training, Government funding and public health campaigns.
Their conclusion is fairly blunt:
"Long COVID is a multisystemic illness encompassing ME/CFS, dysautonomia, impacts on multiple organ systems, and vascular and clotting abnormalities. It has already debilitated millions of individuals worldwide, and that number is continuing to grow. On the basis of more than 2 years of research on long COVID and decades of research on conditions such as ME/CFS, a significant proportion of individuals with long COVID may have lifelong disabilities if no action is taken. Diagnostic and treatment options are currently insufficient, and many clinical trials are urgently needed to rigorously test treatments that address hypothesized underlying biological mechanisms, including viral persistence, neuroinflammation, excessive blood clotting and autoimmunity."
Repeatedly catching COVID really, REALLY is NOT good for your health. 

Long COVID possible symptoms Nature Study
Colin Furness, Epidemiologist at the University of Toronto’s Faculty of Information, is speaking out against 'immunity debt' -  the theory that 2 years inside has allowed our immunity to become lazy. He  believes that COVID infections are to blame for weakened immunity - which is why we are all suffering more from flu and RSV and everything else. He points out that we actually have been mixing again for a long while now, so the idea of 'immunity debt' is wearing thin...

Kraken Watch.
XXB.1.5 now accounts for 73% of COVID cases in North America. Blimey that was quick to take over - weeks not months - it was just 1% of US cases at the end of November. Expect the same when it gets a good foothold wherever you live, because it is super, super fast. Kraken will happily infect you even if you've had Omicron variants before and are well vaccinated, but vaccines are still preventing hospitalisation. There is nothing at all to suggest it is more dangerous. The issue for politicians and healthcare leaders, as has been the case forever, is speed = volume. Even with 1/10th of people developing severe illness, if you have too many sick people all at once, it will still overwhelm healthcare. 
Latest variant information from the UK HSA is that XXB.1.5 now accounts for 4.5% of UK cases, and obviously that is growing. 

Variant Watch:
In the UK not only do we have the Kraken variant bursting onto the scene, we already have our own super catchy variant that's still increasing - CH.1.1. One of these is most likely to be the next to completely take over the UK - after they battle it out between themselves. Importantly, neither seem more dangerous to the individual than the BQ.1 we have had for the last couple of months. 
Bearing in mind most of our sequenced cases for that holiday week are from care homes and older people, so it may not be truly representative:
"Of all UK sequenced samples from 26 December 2022 to 1 January 2023" 
51.3% BQ.1 (V22OCT-01)
19.5% CH.1.1 (V-22DEC-01)
7.2% BA.5 (VOC-22APR-04)
4.9% BA.2.75 (V22JUL-01)
4.5% XBB.1.5 (V-23JAN-01)
3.6% XBB (V-22OCT-02)
These variants really do move quickly - they've barely had chance to label them (look at the dates they were classified by UKHSA).

Hoax Of The Day:
There's no evidence a spike in Myocarditis (inflamed heart) in young people is due to mRNA vaccines - there is lots of evidence to show it's due to COVID infection itself. We all know COVID infection can cause Myocarditis, and we know millions of young people are catching COVID each month. The R.P. Shah Memorial Trust for Kids And Global Health are clearly bored by misinformation:
"I am seeing a deluge of cardiac issues in India - especially in young BUT we have never had mRNA vaccines , the problem is not the mRNA vaccines BUT the Covid."
You can't be clearer than that.

End of 2022 Cumulative standardised mortality by age and gender
Research published in Nature in December found a rare hidden vulnerability which makes a small percentage of people more susceptible to Myocarditis and some other conditions when exposed to COVID through vaccination or infection. It was 1 1/2 times as likely to trigger after vaccination, but 2 1/2 times as likely with infection.

Chinese officials must have read my post on Friday, because by Saturday morning they had announced that between 8th Dec 2022 and 12th Jan 2023, in total 59,938 people had died from COVID in Chinese hospitals.
This is a huge (but not unexpected) number of people, and utterly devastating.
The additional (almost 55,000) people died from causes other than pneumonia and respiratory failure.
China have answered criticism of their reporting, so thank you for that China, although it's nothing anyone is glad to hear. Bear in mind this only includes those with a positive test who died in hospital (the UK at one point used this exact method of counting - and it isn't necessarily a true picture).

China's leadership are going to suffer from the fallout of dropping Zero COVID in such dramatic style, especially Xi Jinping. Now relatives of elderly people who have died are protesting that their loved ones were not protected, and there are some concerns that travelling and gathering for the Lunar New Year may not be wise.
To add to the Chinese leadership woes, hordes of unhappy Zero-COVID workers are suddenly without work, and nasty violent protests have broken out. Companies which provided mass testing have no income, but obviously the workers are demanding to be paid for work done - and many are losing their jobs. Factories are still moving slowly as it'll take a good while to get back to pre-COVID productivity, so other employment is not so easy to find. 
Learn from us China - these people have worked really hard in unpleasant conditions for 3 years, they deserve gratitude and genuine reward, not a quick thanks and abandonment. 

The official word in China is not to fret or worry, hardly anyone gets really ill, everything's fiiiine - and to ensure it remains so, the Chinese National Cyber Administration have brought in online censorship to ensure "in-depth rectification of false information and other issues to prevent gloomy sentiments”. 
Keep it lovely people. 
They also announced crackdowns on fake virus treatments, “online rumours related to the epidemic” and “fabricating patient experiences”. 
Erm... yeah... Happy Lunar New Year on Sunday to any of my readers who celebrate. Have fun but stay sensible. 

There's a great article in Nature this week about our immune system 'Imprinting' on the first version of COVID that it meets.
It's really complicated, but in simple terms, your body will always have a more effective response to the first COVID variant it fights, and it'll always be a little more blasé when it meets different, but similar variants. Sometimes your body won't even bother to create brand new antibodies, but just keep going with the ones it made before.
This could help explain why people seem to catch Omicron variants over and over - although their chance of becoming very ill is massively reduced.  
The world moves in cycles. Part of the reason more older people survived the Spanish flu back in 1918 was likely to be because it was a similar flu variant to the first one they caught decades earlier as children.

Scottish teachers have been striking since before Christmas, now teachers in England and Wales who are members of the NEU (National Education Union) will be joining them.
Schools will be affected on a maximum 4 of the possible 7 dates when action is planned:
Wednesday, 1 February: all eligible members in England and Wales.
Tuesday, 14 February: Wales.
Tuesday, 28 February: Northern, North West, Yorkshire & The Humber regions. 
Wednesday, 1 March: East Midlands, West Midlands, Eastern regions.
Thursday, 2 March: London, South East, South West regions.
Wednesday, 15 March: all eligible members in England and Wales.
Thursday, 16 March: all eligible members in England and Wales.
University lecturers, school support staff and college teachers are also striking, possibly on the same days, but in unrelated disputes. 

(Train Drivers from ASLEF will also walk out on 1st and 2nd February, and Civil Servants 1st Feb.) 

Flu can affect anyone

Fees for University courses in England have been frozen at £9,250 for two years. In Wales, tuition fees are capped at £9,000, Northern Irish students pay £4,630, and Scottish students study for free.
Student loans and grants probably won't even cover today's basic living expenses.
Because of this, the Welsh Government are going to increase student maintenance support by 9.4% for 2023/24. England's increase is demoralising. NUS Wales President Orla Tarn: 
“I’m delighted that the Welsh Government has chosen to support its students and deviate from the pitiful 2.8% rise in maintenance loans recently announced by the UK Government for university students in England."
I don't think you're the only one Orla. 

Moderna have announced trial results for a new mRNA vaccine for RSV (Respiratory Syncytial Virus). The large scale trial involved 37,000 adults aged 60 years or older in 22 countries.
The vaccine has been found to be safe, and Moderna report that 'primary efficacy endpoints have been met', including vaccine efficacy of 83.7%  against RSV-associated lower respiratory tract disease (as defined by two or more symptoms).
Based on these excellent results, Moderna intends to submit for regulatory approval in the first half of 2023. 
RSV is something that would make most of us a bit ill for a couple of days, but it can regularly be overwhelming for older people, those with other conditions and young babies. It is the leading cause of Bronchiolitis in infants. 

Bird Flu dos and don'ts plus what to report UK Gov

Jacinda Ardern, New Zealand's Prime Minister throughout the pandemic, has announced her resignation. She was the only first world Western leader with the balls to pull up the drawbridge as soon as she spotted a threat, and if she hadn't been on her own, she'd have beaten COVID. Sadly the rest of the world let her down. 
Jacinda has faced 3 years of horrific backlash over her strict COVID policies, long lockdowns and transport bans, but has kept the official COVID mortality rate in New Zealand down to 750 losses of life per 1 million of the population (UK 2,951 / USA 3,366 / Canada 1,299 / Germany 1,960). The New Zealand economy in 2021 performed on a par with the UK, Belgium, Germany, Canada, UAE or Hong Kong. 
I believe she will find herself firmly on the right side of history. 
In her resignation speech, she said:
“I am leaving, because with such a privileged role comes responsibility... the responsibility to know when you are the right person to lead and also when you are not. I know what this job takes. And I know that I no longer have enough in the tank to do it justice. It’s that simple... I hope I leave behind a belief that you can be kind but strong, empathetic but decisive, optimistic but focused... That you can be your own kind of leader, one who knows when it’s time to go."
Jacinda leaves the post on 7th February. I wish her all the best, and I hope we see her again in a global role - after she's got married and spent time with her family... 

Jacinda ardern herd immunity

It is the weekend once again - comes around quick sometimes! Have a good one, treat yourself to something nice, and enjoy this dip in case numbers while it lasts. 

Stay Sensible, Happy New Year!, Save The NHS...

Some people.  They all have a favourite song..

Countries / Cases / Losses of life (plus figures added YESTERDAY in the full 24 hours until midnight GMT):

World 672,529,064 (+224,987) 6,739,715 (+1,775)
Japan 31,819,310 (+96,392) 64,220 (+451)
S. Korea 29,927,958 (+29,816) 33,104 (+47)
USA 103,808,542 (+22,430) 1,128,330 (+225)
Taiwan 9,284,479 (+18,399) 15,977 (+48)
Brazil 36,713,006 (+15,922) 696,148 (+480)
Germany 37,659,518 (+9,710) 164,585 (+194)
Russia 21,876,336 (+5,914) 394,569 (+40)
France 39,472,273 (+4,992) 163,708 (+64)


Hospital admissions / Infections UK Stats

Ambulance handover times:

Nurses strike

Ambulance Strikes UK:

Long COVID study

Immunity Debt



Myocarditis via Tachycardia in women

China reports almost 60,000 deaths since lifting strict 'zero Covid' policy


Moderna RSV

Strikes UK
twice as big if no agreement is reached
Ambulance workers (GMB) strike announcement 1pm weds
University staff strikes

Uni students


UK privatised the 'NHS Bank'

There's a very realistic thread on Twitter about vaccination success, from Professor Francois Balloux, Director of University of London Genetics Institute. 
In summary:

Kier Starmer has announced that he wants to

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