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.

March 28, 2021

Today it is raining in New York and the weather fits the coronavirus situation. There are now 127 million SARS-CoV-2 infections officially registered, 2,792,000 people have officially died from COVID-19. Meanwhile, cases per day are again increasing relatively rapidly worldwide, and 528 million doses of vaccine have now been administered worldwide.

A Depressing Situation in Europe

In Europe, the situation is relatively depressing. Many countries are in the midst of a wave (France, Germany, Italy, Poland, Ukraine, Czech Republic, Netherlands, Romania, Sweden, Hungary, Serbia, Austria, Bulgaria, Greece, etc.). In some (Poland, Ukraine, Hungary, etc.) the situation looks worse than in previous pandemic waves. In a few others (Italy, Czech Republic, Slovakia, etc.) the situation seems to be stabilizing somewhat.

In Denmark, Croatia, Spain, Belgium, Slovenia, Switzerland etc. the case numbers are also rising, but they are still at the beginning of a wave. Finland and Norway are also in the middle of the third wave (and possibly already over the hill), but the number of cases is still quite low – although Finland has quickly taken drastic measures. And Portugal and Great Britain are holding up extremely well. In Portugal, the numbers are almost at the same level as last summer.

A New Wave in the US?

In the US, there was a very small increase last week. I suspect that a new wave is brewing here as well as in Europe. However, you can probably stop that with the vaccination campaign. We will see, it will probably be a neck-and-neck race between the virus and the vaccine, but I would bet on the vaccine at the moment because the vaccination campaign is really moving very quickly.

In Canada the next wave seems to have already started. South of the US border it looks very mixed. In Mexico, the number of cases continues to go down. Central America looks very stable. But in South America the situation is worrying. Brazil is setting new records almost weekly in terms of deaths per day, they now have almost 100,000 cases per day. But everywhere else – except Peru – the numbers are rising, although not as drastically as in Brazil.

Sharp Increases in South Asia

In Asia, the number of cases is rising sharply in India, Pakistan and Bangladesh, but also in the Philippines. But most of the region is stable and quiet.

In the Middle East, case numbers are going up in Turkey, Iraq, Kuwait, Oman and Bahrain, and they are also very high in Jordan. The Maghreb looks largely stable. Israel’s case numbers are at a low despite openings. I’m guessing those will stabilize at a very very low level. In Africa, Kenya and Ethiopia are currently experiencing problems. South Africa is doing very well.

What You Need to Know About Variants

Now I would like to discuss a little bit the variants.

In Austria, the variant B.1.1.7 (the variant first detected in the UK) is largely dominating infections now. According to the AGES, outside Vorarlberg and Tyrol, about 65-95% of all cases are caused by this variant.

What is known about this variant?

It is about 50% more infectious than normal SARS-CoV-2. In the meantime, it has been shown that B.1.1.7 also leads to an increased number of severe diseases or deaths, about 50% more. Exact numbers are difficult to elicit because the numbers vary in different countries and different age groups, and the confidence intervals are often very wide.

This is worrying, but to call it a “pandemic within the pandemic” as I have heard a couple of times now is I think exaggerated, for two reasons:

  1. The vaccinations (including AstraZeneca) work excellently against this variant.
  2. You can control the variant just like “normal” SARS-CoV-2. The last wave in the UK was caused by B.1.1.7 – and broken with a good package of measures.

In Denmark, this variant is prevalent, and the Danes are also controlling it quite well so far. South Africa has done the same with the B.1.351 variant, which is also more contagious.

You have to take measures instead of opening up.

We hear all over the world that variants are to blame for the increase in case numbers. It seems to me that this is often used by politicians simply as a reason for failure. We are now hearing that again from India and the Philippines, and of course from Brazil.

An Overview Over Variants

Here is an overview over variants that are less known, but which we will probably hear about more often in the media in the future (in addition to B.1.1.7, B.1.351 and P.1):

B.1.1.7 + E484K (unpleasant combination of B.1.1.7 and the E484K mutation, escapes partially neutralizing antibodies)
P.2 (E484K, Brazil)
B.1.525 (E484K)
B.1.526 (partially E484K) – New York variant
B.1.427/B.1.429 – California variants (probably not a problem)
P.3 (E484K and N501Y) – Philippines
Indian double mutant (E484Q and L452R)

While some of these variants carry the E484K mutation (easy to remember: ERIK) which is problematic for neutralizing antibodies, it is not yet clear if they will really cause a problem. I will keep you posted on this in any case.

At the moment we know that some variants (but not B.1.1.7) can reduce the efficiency of the vaccines, but the efficiency is not lost in most cases. For example, the J&J vaccine has an efficiency of 72% against normal SARS-CoV-2 and 64% against the problematic variant B.1.351. And it protects 100% against severe courses of normal SARS-CoV-2 and the variant.

That’s it for this week.

Stay healthy, stay at home if you can and get vaccinated if you can.

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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.