February 14, 2021
Here again is the weekly SARS-CoV-2 update. We stand at 109 million officially registered cases worldwide and 2.4 million official deaths. 172 million doses of vaccine have been given so far, 52 million of them in the U.S. Now for the positive news: Globally, cases per day are going down.
Downward Trends in Europe
In Europe, there is also some good news: Spain and Portugal are over the peak and seeing a downward trend in cases. And while in many countries the cases have settled at levels that are much too high (also in Austria), there are a few, such as Germany, Croatia and Denmark, where we see further downward trends.
In Hungary and Slovakia, however, there seems to be a slight upward trend in cases again. The other positive story is Great Britain. Infection activity there is dominated by variant B.1.1.7, which has little impact on vaccine efficacy but is more infectious. Nonetheless, the UK has brought the case numbers down quickly. I know when you turn up the TV, it’s all a bit depressing, but it’s not all gray at the moment.
… in the Americas
In Canada and the USA, the trend in new cases is also heading downwards. Of course, the U.S. is still very high up in terms of cases per day, but it’s going down pretty fast. We’ve had a couple of days now with less than 100,000 new infections per day. The trend is the same in almost all states.
In many Latin American countries, the situation also getting better. Mexico is over the peak, Brazil too, but cases are only going down very moderately there. In many other countries like Argentina, Colombia, Bolivia etc. cases are trending downwards. In countries like Chile, Peru etc., case numbers seem to stagnate, even if they do not go down yet. So, not rosy, but not bad either.
Stable Outlook in Asia
Asia looks good. The Indian subcontinent has pretty much everything under control, falling numbers in India, Pakistan and Bangladesh. The Philippines, Malaysia and Indonesia are stable, or over peaks. Japan and South Korea have brought their small waves down in a controlled manner. Vietnam and Thailand see falling case numbers (you could talk about waves, but the absolute number of cases relative to population is laughable).
There is not much to say about Singapore, Taiwan, Hong Kong, Australia and New Zealand. Except, maybe, how to deal well with such a virus. New Zealand found three cases in Auckland and put the city into a local lockdown, probably for a very short time. Australia is similarly radical in dealing with cases that pop up. And the strategy has worked quite well so far.
… and in Africa and the Middle East
The Middle East and North Africa are relatively stable. In a few countries the number of cases is going down (Israel for example), in others a little bit up (Iraq). Africa also seems to be quite stable, on the whole. In some West African countries there seem to be rising waves, Mozambique in the south is also experiencing one.
But the big positive story here is South Africa. In South Africa, the variant B.1.351 had completely taken over the infection pattern, but the country has pushed the case numbers way down. Again, an example that you can control variants that are a little more infectious.
So, now a little bit about vaccines and variants.
There are two new vaccines coming out, one from Johnson & Johnson (J&J) based on an Ad26 vector (only needs to be given once) and a recombinant protein vaccine from Novavax (quite a classical method, used for some influenza vaccines, hepatitis B and HPV vaccines).
The rolling review of Novavax by the European Medicines Agency has started (and the EU is negotiating deliveries), the approval of the J&J vaccine in the EU is expected in March (there are already contracts with the EU). The good thing is, we already know that both vaccines are effective against the B.1.351 variant from South Africa (although less so than against conventional variants).
This now brings me to AstraZeneca.
This week, data was published showing that the AstraZeneca vaccine is not effective against the South African variant in mild and moderate cases. No conclusions can be made about severe infections because there were none in the study (but it can be assumed that there is protection).
South Africa then decided not to use the 1 million doses of AstraZeneca vaccine they had because in principle only this variant is circulating in South Africa. Because of the low number of cases and the variant, they are now waiting for the J&J vaccine.
Now people in Austria are of course unsettled.
But, the AstraZeneca vaccine has a good efficiency (less good than Pfizer and Moderna, but still good) against “normal” SARS-CoV-2 viruses and the B.1.1.7 variant from the UK. So it works very well against most of the viruses circulating in Austria. This is also true for Tyrol.
So far, the B.1.351 variant from South Africa accounts for less than 10% of the infections in Tyrol, so the AstraZeneca vaccine protects against most of the circulating viruses there as well. But perhaps it is now understandable why many virologists and also I have sounded the alarm about the spread of B.1.351 in Tyrol. The variant must be eliminated there if it is still possible.