Effectiveness Over Time & Delta

On Sunday, Metropole brings you a COVID-19 update from Prof. Dr. Florian Krammer, an Austrian virologist who works and teaches at the Icahn School of Medicine at Mount Sinai, New York City.

April 11, 2021

Here is again my weekly coronavirus update.

Worldwide, 136 million officially infected people have been registered to date, and 2,941,000 people have officially died from COVID-19. The international trend in infections per day is still upward. 768 million doses of vaccine have been administered so far.

Improvements in Europe

In Europe, things are looking a little better. The UK and Portugal are holding up very well at very low levels – Denmark is actually looking pretty good in this regard as well.

In many other countries the peak is either flattening out (Austria, Germany, Poland, Ukraine, Netherlands, Sweden, Belgium and hopefully also France and Greece), or numbers are already coming down from their peak (Italy, Czechia, Romania, Hungary, Serbia, Slovakia etc.).

In Spain, Slovenia, Croatia and Switzerland, unfortunately, we are seeing a rise in cases. Of course, the Easter weekend distorts the data in many countries a little. But I think, in Europe, the situation is getting better now. My speculation is that we are largely out of the woods. I hope I’m right.

Slight Upward Trend in the US, Rising Cases in South America

In the U.S., the numbers are going up very slightly, and that’s mainly caused by individual states like Michigan. The cases in many states are stable or trending slightly downwards (also ew York). Canada is unfortunately in the middle of quite a strong wave, they are also struggling with quite a strong spread of the P.1 variant from Brazil.

Cases in Mexico continue to be on a downward trend. The rest of Latin America doesn’t look so great. Central America is mostly stable, but cases in South America are going up everywhere (it’s fall there now, by the way). Cases in Brazil, the problem child, have leveled off at a very high level, with more than 4,000 official deaths per day.

Trouble in South Asia, Increases in the Middle East, Mixed Picture in Africa

In Asia, India, Pakistan, Bangladesh and the Philippines are currently the big problem areas. In Japan, we are also seeing an increase of cases, but not very drastically. Thailand is also recording an accumulation of cases (no, you can’t call it a wave). The rest of Asia is either stable or has no problems with the virus at all.

The Maghreb seems to be quite stable (though there is a slight increase in cases in Tunisia). But in the Middle East, we are seeing sharp increases in cases in Turkey, Iraq, Iran (the most severe wave so far, they are back in lockdown), etc.. Jordan seems to be out of the woods. Egypt looks stable according to the numbers, but I keep hearing stories from Egyptian friends that make me doubt the official numbers.

In Israel, the number of cases continues to drop, but they are already at less than 300 cases per day (in the last two days they were under 200 cases per day). By the way, Israel has about as many inhabitants as Austria and has basically opened up the country again – just with a vaccination rate of about 55%.

In Africa, Cameroon, Kenya, Ethiopia, Gabon and Angola seem to be in waves. The big ones (Nigeria, South Africa) seem to be stable. But the overall situation here is hard to gauge.

More Variant News

Some news on the variants: On the whole, B.1.1.7 (the variant from the UK) seems to dominate wherever it shows up. Variants with E484K (i.e., the ones we’re a bit more worried about because of vaccines) often seem to “lose out” to B.1.1.7, although there are of course instances of worrying spreads with these variants, too. I am much less worried about the variants than I was in January, though, partly because of the good data with many of the vaccines.

Vaccines on the March

In other news, Pfizer has applied for approval in 12-16 year olds in the U.S. I assume that Moderna will follow suit quite soon. Clinical trials in the 6 months to 11 years age group are also ongoing.

One more thing about AstraZeneca: There is now a better assessment from the EMA. So far, according to the EMA, 62 cases of sinus vein thrombosis and 24 cases of splenic vein thrombosis have occurred in Europe in 25 million vaccinated individuals, mostly in women under 60.

So particularly for women under 60, the EMA now sees a link, though the risk to the individual is very small. Austria continues to use the vaccine in all age groups, and I think that is a good decision – the benefits far outweigh the risks.

Meanwhile, some cases have also been found after vaccination with the Johnson & Johnson vaccine, so it could be a general side effect with adenovirus vector vaccines. It is therefore reasonable to assume that Sputnik V and CanSino can also cause such rare side effects.

Let’s Talk About Sputnik V

This brings me to the last topic: Sputnik V.

Austria is negotiating the purchase of the vaccine, which I consider positive in principle. However, I would like to see them wait for EMA approval before using it (the process is underway).

Sputnik V uses two different viral vectors, an adenovirus 26 vector (same as the Johnson & Johnson vaccine) and an adenovirus 5 vector (same as Chinese company Cansino). In principle, the vaccine could be quite good, however, the handling of the approval and marketing soured me a lot.

The vaccine was approved in Russia after a small phase II trial (less than 80 people) and declared efficient and safe – and that destroyed a lot of trust. Phase III looks quite OK in principle and there, the efficiency was high. However, there are some problems now.

Slovakia has not approved the vaccine so far because the vaccine supplied is apparently not identical to the vaccine used in phase III. Brazil has not approved the vaccine yet either (the approval process is dragging on and on). The production facilities have yet to be inspected and approved by the EMA (this has not happened yet). Furthermore, I find the behavior of the company marketing the vaccine – the Russian Direct Investment Fund – very irresponsible. As soon as criticism of one aspect comes up, they immediately write about fake news and scream that these are all evil political actions against Russia.

A colleague of mine recently analyzed sera from Sputnik V vaccinees from Argentina and found that the neutralizing activity against the B.1.352 variant was minimal (as with some other vaccines). He then published this and was massively attacked for it, by internet trolls but also by the official Sputnik V account on Twitter (which is run by the Russian Direct Investment Fund).

So, in principle, I think Sputnik V could help to overcome the vaccine shortage, but I wonder how, for example, problems with the vaccine would be reacted to.

Austria’s Vaccine Records

So now, for the end, something positive: Austria is starting to set vaccination records. On Friday, April 9, for the first time, more than 70,000 people were vaccinated in one day.

Keep it up! I think we are soon over the hill!

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Prof. Dr. Florian Krammer
Prof. Krammer is the Principal Investigator of the Sinai-Emory Multi-Institutional Collaborative Influenza Vaccine Innovation Center (SEM-CIVIC). Currently Prof. Krammer holds a position as a Professor of Vaccinology at the Department of Microbiology at the Icahn School of Medicine at Mount Sinai. He has published more than 100 papers, is member of the editorial boards of the Journal of Virology, Plos One and Heliyon and is a peer reviewer for more than 30 journals.

Current Status

If you live in Vienna, make sure to register for getting a vaccine against COVID-19 under impfservice.wien.  Here you can book your vaccination appointment.

The City of Vienna offers free vaccinations without an appointment to everyone – regardless of citizenship, residency or insurance status – at multiple locations across the city. 

Vienna has reinstated a number of coronavirus restrictions for the fall. The Austrian government has presented a plan for schools and universities.  

Here’s an overview of where you can get tested for COVID-19 in Vienna and how the free PCR “gargle” tests at home work. 

If everything is a bit much for you or you experience domestic violence of any kind, here is our mental health resource article.

Numbers

For current coronavirus numbers, check the website of Ministry of Health and the AGES dashboard.

The Austrian Ministry of Health also publishes daily vaccination statistics and a preview of scheduled deliveries.

Resources

The City of Vienna has compiled comprehensive information on questions and answers regarding coronavirus and the COVID-19 disease in English.

The Austrian Ministry of Health has put together FAQs on the coronavirus and also provides material to download on how to protect yourself and others from the disease, also in English.

Furthermore, the ministry will constantly update its German-language website with information on the number of people tested and cases of COVID-19 in Austria.

Hotlines

Health advice by telephone1450

If you show symptoms (fever, cough, shortness of breath, breathing difficulties) or fear that you are ill, stay at home and dial health number 1450 for further procedures (diagnostic clarification).

Coronavirus hotline AGES+43 0800 555 621

The Austrian Agency for Health and Food Safety (AGES) answers questions about the coronavirus (general information on transmission, symptoms, prevention) 24 hours a day at +43 0800 555 621.

VKI hotline for travel law questions+43 0800 201 211

For legal questions concerning trips that have already been booked (e.g. whether a trip can be cancelled free of charge), the experts of the Association for Consumer Information (VKI) provide advice free of charge from Monday to Sunday between 09:00 and 15:00 at +43 0800 201 211.