Friday 24 February 2023

COVID-19 Coronavirus and other virus UK and World News Update 24th February 2023

COVID-19 Coronavirus and other virus UK and World News Update 24th February 2023

World COVID Statistics: 679,392,534 reported cases and 6,796,421 losses of life.

"Almost everyone has at least one contact in their phone who will never pick up the phone again. Will never answer a text message "How are you?". These simple words have acquired a new meaning during the year of war. Every day, millions of Ukrainians have written or spoken this question to their loved ones millions of times. Every day, someone did not receive an answer. Every day, the occupiers killed our relatives and friends."
President Zelenskyy of Ukraine.

Bird Flu - what to report to DEFRA in the UK


Exactly a year after the first bombs fell on Kyiv, many countries have released statements hoping for peace. The Chinese message contains 12 points, never referring to invasion or war.  They include an offer of support to negotiate a peaceful settlement, and a promise to help with rebuilding post-war. They are also emphatic that nuclear, biological and chemical weapons must not be developed or used by any country, and that the sovereignty of countries must be respected in accordance with international law and the UN Charter.
They also have a pop at NATO and individual countries, saying that unilateral sanctions must stop, as it only agitates the situation and doesn't promote peace. 

“The Health Secretary will meet with the Royal College of Nursing on Wednesday to begin talks. The Royal College of Nursing will pause strike action during these talks.”
Joint statement from the Nursing Union RCN (Royal College of Nurses) and the Department for Health and Social Care on Tuesday. Scottish nurses have already paused strike action, now the rest of the UK follows, after the Government agreed to begin intensive talks.
"The talks will focus on pay, terms and conditions, and productivity enhancing reforms."
About blinking time. Let's hope it's productive. 

In other news, lots of other UK folk are still planning strike action. Coming up:
- Junior doctors in England 13th, 14th, 15th March. 
- Trains - RMT 16th, 18th, 30th March, 1st April. Network Rail 16th and 17th March. 
- Civil Servants 15th March
- Teachers - Scotland 28th Feb, 1st March / Wales 15th and 16th March / England NEU members 28th Feb in Northern, North West, Yorkshire & The Humber. 1st March in East Midlands, West Midlands, Eastern. 2nd March in London, South East, South West.
- Paramedics, emergency care assistants and call handlers 6th and 20th March
- Ambulance Workers who are UNITE members 6th and 20th March in North West, North East, West Midlands, East Midlands and Wales

240223 CMI Covid Actuaries cumulative excess deaths

This week's Continuous Mortality Investigation (CMI) report is far better than the last. In the week ending 10th Feb, we lost 3% more people than the equivalent week in 2019. This measurement accounts for changes to aging and population.
3% is devastating for all of those people, but less than a third of what we have been seeing for a long while. Let's hope its a new trend.
"CMI calculates 167,700 excess deaths in the UK since the start of the pandemic. That total has increased by 16,200 in the first six weeks of 2023."
Calculated excess deaths were 390, which is slightly lower than the 446 mentioning COVID on the death certificate. This is the opposite of the last few months, and means non-COVID deaths were lower than expected, a welcome reverse of the last few weeks.

After being asked to review their figures, the UK's Office for National Statistics (ONS) have amended their 'Age Standardised Excess Mortality in England' figures, including those which compare 'Ever vaccinated' to 'Unvaccinated'.
This isn't only direct COVID deaths, it is people who died from anything during that time. 
Especially in big COVID waves, before so many people had recovered from COVID infection and gained some protection via that route, the discrepancy was immense. In Spring and Winter of 2021, you were twice as likely to die if you were unvaccinated. Since Autumn 2022, your risk has remained fairly steadily around 10% higher, but the gap clearly widens each time we have a large wave of COVID infections and a surge in COVID-related deaths.
Proof if ever we needed any more, that being a 'vaccinated against COVID' person is overall safer than not... But there's a caveat...
This IS NOT just a measure of vaccine effectiveness.
This is a measure of the difference between people who got vaccinated, and people who didn't. There are many cultural and other differences here. People who are naturally cautious may be first in the queue to get vaccinated. People who have more of a devil-may-care attitude may be less likely to ever get vaccinated, more likely to be hit by a car or eat week old chicken. 
People from certain heritage, ethnic or social groups may be less likely to be vaccinated and more likely to have severe COVID illness, but also are often more likely to work in a face-to-face or physically demanding profession, and live in a multi-generational home.
On the other hand, less robust people, who are not expected to outlive their peers, are far more likely to be vaccinated.
The maths gets really tricky, and it's not surprising amendments occur.

240223 CMI Covid Actuaries weekly excess deaths last 26 weeks

The ONS have also updated the age standardised COVID deaths. There we can see truly immense discrepancy until (we must assume) protection via surviving COVID kicked in. Over Winter 2021/22, you were 6 times as likely to die with COVID listed as a factor if you were unvaccinated. This Spring so far your chances are around 1.5x as likely.
It seems some anti-vaxxers are struggling to get their heads round these figures, I've seen a few confused comments. There's just no way to make them say anything else - vaccines prevent deaths. 

Reuters had an interesting article this week about Long COVID - "Long haulers". People who developed Long COVID in the first waves, and have had to fight for recognition and help. Finally things are changing, and the number of new people developing long term symptoms has reduced, but some of you have been poorly for a long, long time. 
Even now, a lot of people still believe Long COVID symptoms such as extreme fatigue, confusion or muscle weakness can be 'walked off', like a stitch, despite our ability to scan and biopsy people, and find leftover bits of virus, teeny tiny blood clots, and damage where the virus has destroyed your cells to replicate itself. 

240223 Cumulative Mortality CMI Report COVID Actuaries

The UK Government's MHRA (Medicines and Healthcare Regulatory Agency) have authorised an updated bivalent COVID booster jab. Moderna's (Spikevax)..."adapted COVID-19 vaccine targets both the original coronavirus (SARS-CoV-2) and the Omicron BA.4 and BA.5 sub-variants".
This new version is already authorised in Canada and the USA. It goes a little beyond the current Pfizer and Moderna 2-pronged attack, with a more deliberate 'skeleton key' to fit the 2 major Omicron family variants. In the last 4 weeks, over 99% of samples sent to GISAID (the world COVID variant tracker) appear to have been Omicron BA.4 and BA.5 sub-variants.

While we're on the subject of variants. The UK's 2 fast-spreaders are still doing their thing, and ripples are beginning to show:
"XBB.1.5 and CH.1.1 (and associated sublineages) continue to show growth advantage in England in all models. It is likely that the growth of both CH.1.1. and XBB.1.5 are contributing to the current increase in COVID-19 incidence and that they will continue to increase overall transmission as they become more prevalent."
We're expecting this. Still no sign that either are in any way more dangerous, but once they pick up speed, they're astoundingly fast.
XXB.1.5 is nicknamed The Kraken, CH.1.1 has no exciting name as yet.

240223 GISAID Variants

The UK ONS random sampling shows a steady rise in COVID cases in the week ending 14th Feb:
"The percentage of people testing positive for coronavirus (COVID-19) continued to increase in England, Wales and Scotland, and the trend was uncertain in Northern Ireland."
- England, estimate 1,223,000, equating to 2.18% of the population (1.88% in the previous reference week), or around 1 in 45 people.
- Wales, estimate 55,300, equating to 1.79% of the population (1.50% in the previous reference week), or around 1 in 55 people.
- Northern Ireland, estimate 29,700, equating to 1.62% of the population, or around 1 in 60 people.
- Scotland, estimate 114,800, equating to 2.18% of the population (1.83% in the previous reference week), or around 1 in 45 people.

The World Health Organisation are worried about healthcare workers.
Professor Jeremy Farrar, director of Wellcome and incoming Chief Scientist at the World Health Organisation, was interviewed in The Guardian and is quoted as saying:
“This is a global issue, which I think is hugely concerning. It’s certainly true in this country.”
“The resilience of healthcare workers, broadly defined from ambulance drivers to nurses to doctors, to care workers in social care, etc. They’re shattered. They are absolutely shattered.”
Yep. You think you're tired... try doing another 8 hour shift right now to cover a colleague. And repeat... for 3 years.

240223 CMI Covid Actuaries age standardised all cause death past 12 months

Midazolam is a drug which (in the UK) is given to people to make them more comfortable during the final hours of life. It can also suppress breathing, especially when taken with Morphine - which is also given to patients who are in pain. During the first wave of COVID in the UK, in Spring 2020, use of Midazolam leapt to over twice what it had been before. There is some debate as to whether it was given to patients who may have survived, and it's use hastened their death.
It is human nature that anyone who lost their loved one before they should will want to find answers, and someone or something to blame.
The use of many treatments and drugs for respiratory and other conditions skyrocketed during that first COVID wave, as you would expect. It is plausible that in some cases strained medics turned to 'making the patient as comfortable as possible' without exploring all other options or battling for longer. It seems far more plausible that thousands of people were gravely ill and suffering terribly from the effects of severe COVID, and Midazolam was an appropriate treatment.
Midazolam is now being discussed in UK Parliament after MP Andrew Bridgen raised it this week. 

You can only ever do the best you can at the time. Looking back and seeing a better way is hindsight, and knowing you'd do a better job now, doesn't mean you could have at the time. Often the most we can do is learn and take that with us as we go forward.
Never beat yourself up if you did your best. You didn't have better than that available to you. 

240223 COVID Actuaries ONS age standardised all cause death

Matt Hancock, ex UK Health Secretary, who broke the law during lockdown by  partying his days away, looks like his dalliance with the law won't end any time soon. He's already been found guilty in court of a couple of crimes, and now people are attempting to get the Metropolitan Police to investigate whether or not he broke more laws by starting an affair with his family friend, who he had employed as an advisor. He's also being looked into because handily his sister owned a company called Topwood who, like many others, suddenly branched into PPE sales in Spring 2020. It was awarded £300,000 in contracts. Guess who owned 15% of that company? Yes, it was Matt! 
Oh yeah, and he has a book out. 
How the other half live eh... 

Mpox (I can't help but sing that in a 'Hanson' voice) has not gone away, and World Pride is coming up. Vaccine efficacy is being discussed, and they're all pretty good, especially for saying they were designed years back for Smallpox. 
Preliminary results from a multi-jurisdictional case control study found: "Among those without immunocompromising conditions, vaccine effectiveness was 90% for full vaccination". 
Independent advisers to the US CDC have voted unanimously to offer the two-dose Jynneos mpox vaccine to adults at risk of catching the disease during any future outbreak. Currently the mortality rate is steady around 1 in 1,000, but it can also leave you with scarring and other longer term problems.
Get vaccinated if you are in doubt - lots of 'pop ups' over the next month (including London and Brighton). 

Monkeypox did you spot any symptoms.jpg

Avian Flu Update:
Two people from the same family in Cambodia have been confirmed to have H5N1 Bird Flu. Although this has set everyone on edge, it is too early to say if human to human transmission took place, or they simply caught it from the same local source. The family kept birds who had already succumbed to Avian Flu. This story has only just broken, so hopefully by next week we'll all know more.
As of yet, no known human to human transmission has ever occurred, despite hundreds of people becoming infected by birds and their droppings, but in the last 4 months it's suspected mammal to mammal transmission may have occurred for the first time in farmed mink, and wild sea lions and seals. 

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

The death of dog-walker Nicola Bulley is an utter tragedy. One of the things it has highlighted is how hard menopause can be for a lot of people. From 1st April in England you can get HRT with a special annual prescription (request it online or by phone), which costs the same as 2 ordinary prescriptions.
There are different types of HRT available, and if one doesn't suit you, or the person you live with, go back to the doctor. The understanding of menopause is changing, medicine is no longer exclusively by men for men, and you really are not on your own. 

UK supermarkets have announced rationing to 3 products each of several salad veg, berries and brassica (veg in the cauliflower and broccoli family). 
Drought and flooding, late frosts and war have affected availability of many crops, including wheat and animal feed.
We are told climate is to blame, and in part it is. However there is no rationing or any clear shortages in shops in Europe. 
High energy bills mean UK farmers can't afford to heat glasshouses without passing on large price increases - something supermarkets are very reluctant to sign up to. Dare I mention Brexit? Rumour is queues to get into the UK are reported to be up to 77 hours (lorryload of tomatoes). Few lorry drivers want to do that to themselves. It also appears we are buying our food from Morocco for example, via West Africa, and some temporary export bans are in place (ironically to preserve promised stocks for Europe lolz). 
Ex-Health Secretary and current UK Environment Secretary Thérèse Coffey has suggested we "cherish" turnips instead. Someone call Baldrick, we've gone full Blackadder. I love turnips Thérèse, but they're not really a direct swap for cucumber or tomatoes. 
Unless you want to cater a salad-based party, you should still have plenty of food available to you. For goodness sake don't panic buy salad - the brown bins would be full next week. If you want to be proactive, contact your local MP to ask for a reduction in the energy price caps now that wholesale prices have dropped, and support for domestic farming... and get a window box and some lettuce seed.

Children. Mariupol Theatre. Ukraine
дети = children

It is the weekend...breathe, and relax. Unless you have to work, in which case thank you. End of half term here too, I forsee less squabbling ahead next week. Whether your kids have bickered all week or not, don't forget to treat yourself to something nice. We all need to feel special, and we all need things to look forward to - and it doesn't have to cost a penny. 

Play Outdoors, Wear A Hat, Save The NHS. 

Some people. They look like numbers here, but they are all people.

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

World 679,340,106 (+130,788) 6,796,150 (+1,106)
Germany 38,090,089 (+21,177) 167,723 (+119)
Japan 33,151,209 (+15,193) 72,051 (+128)
Russia 22,218,663 (+14,721) 395,938 (+37)
Taiwan 9,985,320 (+14,387) 17,709 (+37)
USA 105,161,023 (+12,094) 1,144,368 (+126)
Brazil 37,008,944 (+11,616) 698,834 (+453)
S. Korea 30,469,702 (+10,845) 33,909 (+22)
Austria 5,884,691 (+5,763) 21,853 (+1)
France 39,605,037 (+4,489) 164,848 (+19)
Mexico 7,439,281 (+4,215) 332,913 (+28)
The UK no longer appear in this chart because we simply don't publish this data in a timely fashion - which is why I use ONS and CMI figures. 
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Sources: 

Image. Children. дети = children

https://www.worldometers.info/coronavirus/
https://ourworldindata.org/covid-vaccinations

Ukraine / China Statement
https://kyivindependent.com/national/zelenskys-address-on-1-year-war-anniversary
https://www.dw.com/zh/%E4%B8%AD%E5%9C%8B%E6%8F%90%E7%83%8F%E5%85%8B%E8%98%AD%E5%92%8C%E5%B9%B3%E8%A8%88%E5%8A%83%E5%B0%88%E5%AE%B6%E7%BC%BA%E4%B9%8F%E8%AA%98%E5%9B%A0%E4%BD%BF%E4%BF%84%E6%94%B9%E8%AE%8A/a-64805782

Healthcare and strikes:
https://twitter.com/BBCHughPym/status/1629080947239821312?t=KOZV1Xgr7DvfbCDaGNxiJA&s=19
Sky News: https://news.sky.com/story/strikes-set-for-february-heres-who-is-taking-action-when-and-why-12778841
https://www.nationalrail.co.uk/service_disruptions/industrialaction.aspx
https://commonslibrary.parliament.uk/research-briefings/cbp-9715/

CMI report and Images
https://t.co/tsO291GvD9
Images
https://twitter.com/COVID19actuary/status/1628007500623540224?t=JDh68ZqyjOwwqQFgo66U3g&s=19

Long COVID

Moderna bivalent updated booster
https://edition.cnn.com/2023/01/11/health/moderna-bivalent-transparency/index.html

Variants
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1138007/variant-technical-briefing-50-10-february-2023.pdf

ONS

Jeremy Farrar WHO

Midazolam
https://twitter.com/MaajidNawaz/status/1625510327239540736?t=ODe5zyD1kEgMWKsM37rDzQ&s=19

Matt Hancock. 
https://twitter.com/kennyarnold1997/status/1627925442236928003?t=7r_d-jq0ykNVNXS600ianA&s=19
https://twitter.com/BladeoftheS/status/1625026922399862788?t=iRs6t5SQ8amit80DaSawCQ&s=19
https://twitter.com/JolyonMaugham/status/1627647413799337990

Avian Flu
https://news.sky.com/story/bird-flu-infections-in-humans-still-rare-despite-cambodian-girls-death-12818731

Mpox
https://edition.cnn.com/2023/02/22/health/cdc-mpox-vaccine-vote/index.html

HRT England
https://twitter.com/mariacaulfield/status/1628104006827487234?t=zM-9pueEFzyBvxbe8ecGYw&s=19

UK Food Shortages:
https://news.sky.com/story/asda-limits-purchase-of-some-fruits-and-vegetables-due-to-supply-challenges-12816521
https://twitter.com/bobrmitchell/status/1626997852625928192?t=M5VyCWuqzObmJjk_jaUcKA&s=19
https://twitter.com/LBC/status/1628947355104956417?t=hw98S1rRIJjj-2nSVVD1yg&s=19

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