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 21, 2021

And again, the weekly update from today’s very spring-like New York (15 degrees Celsius and sunny). 123 million people have been officially diagnosed with a SARS-CoV-2 infection, 2,723,000 have officially died from COVID-19. Globally, unfortunately, the case numbers are going up again. 430 million doses of vaccine have now been administered.

A Third Wave in Europe

In Europe it looks like third waves almost everywhere. Exceptions that are currently holding up well are Portugal, Spain, the UK, Switzerland, Denmark and Portugal (although the last two are also showing a small upward trend). All other countries are either at the beginning of a new wave (e.g. Austria, Germany, Croatia) or already in the middle of it (e.g. Czech Republic, France, Italy, Poland, Ukraine, Serbia, Romania, Netherlands, Sweden) and in some countries the magnitude of this wave exceeds that of previous ones (e.g. Hungary). Finland and Norway are also now experiencing serious problems with a new wave.

Stabilization at High Levels in the Americas

In the U.S., case numbers have continued to go down slightly, but seem to be stabilizing – we are now at the level of last October. Not bad, but could be better. We expect a race between vaccinations and a possible further wave. The current targeted goal of the US government is to have 70% of the population fully vaccinated by July (we are now at 18% with about 2-3 million vaccines administered per day). Cases in Canada have leveled off at a high level. Let’s see how things will continue there.

Cases in Mexico continue to go down. South of there, it unfortunately looks worse. Unfortunately, Brazil is again setting records for deaths per day, but in Peru, Chile, Paraguay, Uruguay and Venezuela, too, the number of cases is rising sharply or is very high.

Mixed Situation in Asia, the Middle East & Africa

In Asia, the situation looks rather mixed. In India the number of cases went up last week and I don’t like that at all. The situation is similar in Pakistan and Bangladesh. The Philippines is also seeing a very high increase in infections with record numbers for the country. The rest of Asia and Oceania is relatively quiet.

The situation in the Middle East and Maghreb is mixed, too. Some countries have stable and some have quite low case numbers. But Iraq, Turkey, Jordan, Kuwait, Palestine, etc. are in the middle of strong waves and in other countries like Libya, Iran or Egypt the numbers are relatively stable but very high.

What is interesting is Israel, which is still coming down from a wave and has strongly decreasing case numbers. On the one hand, this has to do with the measures taken during this wave, but probably also with the vaccination rate of now over 50%.

In Africa, Kenya and Ethiopia are currently worrying, we’ve seen a strong increase in cases there. South Africa has managed to gain control of the situation despite the B.1.351 variant, so things are looking pretty good. However, it has to be said that the data situation in many African countries is quite sparse.

Update on AstraZeneca

So, now two vaccine updates.

The incidents around AstraZeneca have now been investigated by the European Medicines Agency (EMA). No link to “normal” thrombosis or pulmonary embolism has been found. What did stand out were sinus vein thromboses. There were 18 cases recorded in 20 million vaccinated people. That’s above the rates expected for sinus vein thrombosis in the general population (typically 4-6 per 1 million per year; sinus vein thromboses, by the way, are much more common in women than in men, presumably because of the use of hormonal contraceptives that increase the risk of thrombosis). While the EMA did not find a causal relationship, it could not be ruled out.

Sinus vein thrombosis will therefore be included in the package insert as a rare serious adverse event and there will be increased monitoring and further investigation. However, since this is a very rare occurrence (about 1 case in 1 million vaccinated according to the EMA), the EMA recommends continued use of the vaccine. The risk seems to be similar to the risk of getting Guillain-Barré syndrome after influenza vaccination or getting polio after oral polio vaccination.

The risk for the individual is vanishingly small, especially when compared to the risk of COVID-19 disease (where, by the way, thrombosis occurs in 10-30% of those who get it) and therefore I think the EMA’s recommendation to continue using the vaccine is very good.

I would get vaccinated with the AstraZeneca vaccine anytime and can only recommend to get vaccinated with it if offered.

A New Vaccine

Another very positive vaccination story.

My colleague Peter Palese started working on a COVID-19 vaccine at the beginning of last year, and my lab is also involved a bit. The vaccine can be produced in chicken eggs like the influenza vaccine, but it is cheaper because you get about 10 doses per egg (for one dose of influenza vaccine, you need 3-4 eggs). Vietnam, Thailand, Brazil and Mexico have their own influenza vaccine production facilities and have started to develop the vaccine.

Of course, this took a little longer because there are no big pharmaceutical companies involved, but last Monday the first people in Vietnam were vaccinated with the vaccine as part of a phase 1 clinical trial. Thailand will be vaccinated next week and Brazil should also start a trial soon. If all goes well, the vaccine will be approved by the end of the year and would then give those countries control over their own vaccine supply or they would also supply that particular region. We are also hopefully starting a clinical trial in the U.S. soon, but it all takes a little bit longer there.

That’s it for this week. Stay healthy, take care of yourselves and please don’t get infected. The numbers are going up, it could get very uncomfortable again. But I am still convinced that the spook will soon come to an end. It would be good if in the EU with the vaccinations soon what would go on. Science has delivered, now it’s up to politics.

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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.