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.

June 14, 2021

Here again is the bi-weekly COVID-19 update.

Worldwide, about 176 million SARS-CoV-2 infections have been officially registered so far, 3.8 million people have officially died from COVID-19 (estimates suggest the number of unreported cases is 2 to 4 times higher). 2.33 billion doses of vaccine have been administered so far. The number of cases per day is going down globally, but it does not look good everywhere.

Very Good Situation in Europe

In Europe, the situation is very good. With very few exceptions, case numbers are low and stable or falling.

One exception is the UK, where there has been a sharp increase in cases recently, caused by the B.1.617.2 variant from India (which is now called “delta” by the WHO). I hope that this is not a real wave, but rather a brief interlude. More on this below.

Russia is not looking good either, they still have high case numbers that are just rising again and unfortunately also a very low vaccination coverage rate.

Americas: Stable in the North, Difficult in the South

The US and Canada are both doing quite well – few cases and lots of vaccinations. Mexico is also doing well.

In Central and South America, unfortunately, the situation looks less good and is partly dramatic. Some countries are doing OK but many – like Argentina, Colombia, Uruguay, Paraguay, and Venezuela – are in the midst of the worst wave since the pandemic began. The situation in Brazil also remains very tense, with case numbers simply not going down.

Relaxation in Asia

The situation in India and Nepal is calming down somewhat, and Malaysia also seems to have passed the peak of the wave. China is struggling with a handful of B.1.617.2 (“delta”) cases.

In some countries that have actually had no cases for a long time – such as Vietnam, Cambodia, and Taiwan – case numbers are rising. In Mongolia, case numbers are also going up. In Thailand, the number of cases also went up (to about 2,000-3,000 per day), but seems to be stagnating at the level. In Japan, cases are declining quite rapidly, and South Korea has been holding steady at about 500-700 cases per day.

Stable Middle East & North Africa

The Middle East and Maghreb are basically stable, with a few exceptions. Case numbers in Israel are extremely low (10-15 per day). Northern Africa also seems OK, but cases are increasing by leaps and bounds in the south.

South Africa is at the beginning of a strong fall wave (largely unvaccinated). There are also increases in Zambia, Namibia, Uganda, Botswana, DRC, Rwanda, and Zimbabwe. Angola is just coming down from a wave. IÆm starting to worry about Africa now. It basically looked pretty good there with exceptions, but there are now increases and unfortunately little access to vaccines.

The Delta Variant

And that brings me to a couple of points that I would like to address.

The first point is the B.1.617.2/Delta variant. We know that vaccines work well against the variant (88% efficiency for Pfizer, 60% for AstraZeneca, Moderna probably behaves similarly to Pfizer). But we also know that the variant is more infectious. That means it can spread faster.

A few months ago, I think I explained the concept of the reproductive number (R0). R0 is the number that indicates how many unprotected people an infected person will infect. For influenza, R0 is about 1.5, which means that one infected person infects on average 1.5 other people – this is not very infectious. When the number falls below 1, the virus dies out on its own.

For measles, the number is 18, which is very high. Here is a link to a graphic that shows what happens with SARS-CoV-2, especially with B.1.617.2/Delta (Alpha is the B.1.1.7 variant – don’t ask me why the WHO had to rename everything).

That’s why you have to take some of these new variants very seriously and really try to get the vaccination coverage rate as high as possible. B.1.617.2 could cause a wave in the fall if there are still enough people who are not vaccinated.

It’s a good thing that Europe is now moving ahead quickly with vaccinations.

Mixing Vaccines

This brings me to the next topic, namely the question of “vaccinating on top” or mixing different vaccinations (for example, first dose with AstraZeneca and second dose with mRNA). There are now some results on this.

A British study has recently published results on side effects and found slightly increased side effects with AstraZeneca followed by mRNA – but it does not seem to be a real concern. The immunological results of the British study should also be available soon. A study from Germany already has immunological results on this, and as suspected:

The immune response is better when giving AstraZeneca followed by mRNA compared to 2x mRNA.

So, if at some point it becomes necessary to get another dose of vaccine, it doesn’t seem to be a problem if that is a different vaccine than the initial vaccination. By the way, I am pretty sure that a third vaccination in the fall will not be necessary and I don’t understand why this is already seen as a fact by the politicians.

Vaccinating Children

The last topic here is vaccinating children.

The Pfizer vaccine can be used from the age of 12, the one from Moderna probably soon. Vaccines for younger children are currently in clinical trials and are based on lower doses of the vaccine.

The question now is: Should we vaccinate children or not?

Children and adolescents can become infected with SARS-CoV-2 just like adults. In a study we did recently, the infection rates of 10-18-year-olds were identical to adults; those of under-10-year-olds were slightly lower. So children and adolescents do get infected with the virus, but they quite rarely get COVID-19 or have very mild courses, although rare complications like MIS-C can occur. And, of course, children and adolescents can pass on the virus.

But vaccination also brings risks. According to the U.S. Food and Drug Administration (FDA), about 16 out of every million children and adolescents vaccinated experience (mostly mild) myocarditis. This rate is very low, but you should still know about it. In my opinion, vaccination for children and adolescents makes sense, especially because it prevents the spread of the virus.

That’s it for this week. Stay healthy, enjoy the summer, and get vaccinated!

See you in two weeks.

PS: Congratulations to Austria for the victory against North Macedonia at the European Championship.

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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.