COVID-19. A major risk to health, economies & markets. Australian perspective

This page seeks to summarise some of the issues as I see them. Anne de Gheest's clinical updates (see below), which discuss the very latest COVID research, have been extremely valuable in helping me to understand how dangerous COVID variants are and the massive implications of Long-COVID. COVID now seems likely to be with us for many years to come - and current research 20/Apr/21 indicates that it could become far more dangerous over the next year or two.

10/6/21 We have to win every battle in this war against  COVID.  That is, we must beat every new more dangerous variant (before the new variant causes massive loss of life or health)  as they arise. The cost of losing any battle is too high to contemplate.  We have a long way to go before this war is over.

27/Apr/21 The massive explosion of COVID in India https://www.washingtonpost.com/world/interactive/2021/india-covid-cases-surge/ shows what can happen when you become too arrogant and complacent with COVID, like Australia has now become.  Given these new dangerous COVID variants are now flying into Australia every day on planes, it is an now unacceptably high risk to continue to quarantine arrivals in hotels in the centre of our big cities - a disaster waiting to happen. The cost to Australia, if this current system fails would be huge. Australia urgently needs to create a national quarantine station in a far safer area.

​8/May/21 Top epidemiologist says virus outbreak is ‘absolutely inevitable’  https://www.smh.com.au/national/top-epidemiologist-says-virus-outbreak-is-absolutely-inevitable-20210507-p57pth.html   "The risk of a disastrous coronavirus outbreak in Australia is now at its highest level since the pandemic began and continued escapes from quarantine can be expected at least every month. James McCaw, an epidemiologist and mathematical biologist with the University of Melbourne who is leading a research team providing modelling on the pandemic to the federal government, said it was “absolutely inevitable” that the virus would spread within Australia.

4/Jun/21 COVID vaccine Australia: The outbreak Australia had to have (afr.com)    

  •  The renewed risk of COVID-19 infections, from a dangerous and fast-spreading variant, is driving faster take-up of vaccines and helping shake complacency. ...... “The answer is that it is inevitable at some point there will be sustained outbreaks in our community – and not just in Victoria. It’s not a matter of if. It’s a matter of when.” (Paul Kelly  Australia's Chief Medical Officer)

  

  • https://twitter.com/EricTopol/status/1398298896850243584

    • https://www.nytimes.com/2021/05/28/opinion/covid-vaccine-variants.html

      • Covid’s Deadliest Phase May Be Here Soon”  May 28, 2021

        • By Zeynep Tufekci  Dr. Tufekci is a contributing Opinion writer who has extensively examined the Covid-19 pandemic. 

        • “If world leaders don’t act now, the end of the Covid pandemic may come with a horrible form of herd immunity, as more transmissible variants that are taking hold around the world kill millions. There’s troubling new evidence that the B.1.617.2 variant, first identified in India, could be far more transmissible than even the B.1.1.7 variant, first identified in Britain, which contributed to some of the deadliest surges around the world. In countries with widespread vaccination, like the United States and Britain, we can expect that Covid cases, hospitalizations and deaths will continue to decline or stay low, especially because lab tests and real world experience show that vaccines appear to defend recipients well against the severe effects of both variants. For much of the rest of the world, though, this even more transmissible new variant could be catastrophic.”

    • BB comment: Given that at 30/May/21, Australia was ranked a lowly 77th in the world https://ig.ft.com/coronavirus-vaccine-tracker/ from as far as % of population COVID vaccinated, Australia could become one of those countries where the Indian variant might be catastrophic over coming weeks or months - as a result of one of these CBD hotel quarantine "leaks".

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Related pages are here:-

Anne de Gheest updates: 

Other important references:

  • http://puzzlefinancialadvice.com.au/2021/Core/Professor_Osterholm_epidemiologist_COVID_future_depends_entirely_on_variants_210405.pdf   29/3/21

    • Normal Swan asks: “What are you predicting globally, about what will happen with this pandemic over the next 12 months?

    • Prof Michael Osterholm (epidemiologist) response:

      • in early November did we start to understand that

        • Some variants can cause much more severe disease.

        • They are also much more infectious.

        • They can actually evade the immune protection from vaccine or from natural immunity.

        • And once we realised that, and we labelled these variants of concern, we began to understand that this was a whole new ballgame

      • But now you are asking where we are going with this? I don't know

        • We have to be very very leery of assuming that just because we have the vaccines that we do now, that we are done. We may not be at all.

  • You might also note Eric Topol co-authored article in Nature Magazine ( https://science.sciencemag.org/content/371/6531/759/tab-pdf , https://twitter.com/EricTopol/status/1379159370471153666 6/Apr/21) where Eric explains that while the initial COVID virus was “evasion-light”, thus enabling vaccines to be developed very quickly, there is a very real risk that a COVID variant that is “evasion-strong” may emerge, so that COVID may develop what is known as “immune escape” – very serious. One of the real risks is “Laboratory studies suggest the potential for immune escape with at least one of these (UK, South African, Brazilian) variants”.

  • Eric Topol interviews Prof Michael Osterholm (epidemiologist)  14/May/2021

    • https://www.medscape.com/viewarticle/951101#vp_7  

    • Dr Michael Osterholm, who is ....  one of the leading lights in the pandemic.

    • You have helped multiple administrations, both Republican and Democrat, in guiding the management of infectious diseases, most recently on the Biden COVID-19 advisory board.

    • The more I learn about pandemics, the less I understand them. That's a point of honesty that would serve many of us well. We need a real dose of humility.

    • One thing that has come up recently has been the idea of a pan-coronavirus vaccine, a betacoronavirus family vaccine that would knock them all out and basically protect us from future pandemics — no less this idea of a variant-by-variant approach, which is kind of a bivalent, put in the South African spike protein, mRNA, or whatever. Can you comment on that?

      • First of all, the issue of vaccines and what they can do in terms of life- and economy-saving measures has not really been appreciated until this pandemic.

      • At CIDRAP we have been heading up an international effort with support from the Wellcome Trust, the WHO, and a number of different partners, including the Gates Foundation, to look at and develop a comprehensive roadmap for influenza vaccines that would be more of a universal or game-changing flu vaccine that would deal with both seasonal and pandemic influenza, and also address the issue of the timeliness of the availability of these vaccines for a pandemic. We are publishing our roadmap in the next month;

      • It serves as a model for the coronaviruses. We now realize the importance of these viruses and what they might do — and God knows what the next coronavirus might be that might emerge. We no longer can count on it being a SARS- or MERS-like model where, when it emerges, it can sure do damage

      • This is a very important topic area. And having talked to many economists, including Nobel Prize–winning laureates, they have all said that if it takes us billions of dollars to make and deliver these vaccines, they're worth every penny because they will save lives and trillions of dollars.  ....    It's our job to capitalize on that and do whatever we can to move big-picture vaccines forward, and not just take it one antigen at a time.

      • The mRNA vaccine technology, and how it was brought forward, was nothing short of a modern public health Manhattan Project success. Now what we need, however, is a second Manhattan Project with a Marshall Plan attached to it.  The second Manhattan Project is, how are we going to manufacture enough vaccine for the world?

      • what's the next variant to come down the pike? We need to stop transmission globally — not just for humanitarian reasons, but to protect the integrity and the functionality of these current vaccines.

Royal Australian College of General Practitioners

  • "Current COVID vaccines could be ineffective by next year: epidemiologists"

    • https://www1.racgp.org.au/newsgp/clinical/current-covid-vaccines-could-be-ineffective-by-nex  31March2021

      • "Two-thirds of epidemiologists who took part in a recent global survey have predicted it will be less than a year before SARS-CoV-2 mutates to such an extent that the majority of first generation COVID vaccines are rendered ineffective and new or modified candidates are required."

      • "Variants of concern have already emerged in South Africa, the US, India and Brazil, and Yale University’s Associate Professor Gregg Gonsalves said the fact that millions of people around the world are still contracting the disease means new mutations will arise every day."

      • There is some concern that the AstraZeneca vaccine shows much less protection against the South African strain [B.1.351], but it was quite a small study that did not examine whether there was still protection against severe disease.'

Establishment of a COVID-19 mRNA vaccine technology transfer hub to scale up global manufacturing

  • https://www.who.int/news-room/articles-detail/establishment-of-a-covid-19-mrna-vaccine-technology-transfer-hub-to-scale-up-global-manufacturing

    • "WHO and its partners are seeking to expand the capacity of low- and middle-income countries (LMICs) to produce COVID-19 vaccines and scale up manufacturing to increase global access to these critical tools to bring the pandemic under control.   WHO will facilitate the establishment of one (or more, as appropriate) technology transfer1 hub(s) that will  use a hub and spoke model (REF) to transfer a comprehensive technology package and provide appropriate training to interested manufacturers in LMICs. This initiative will initially prioritize the mRNA-vaccine technology but could expand to other technologies in the future."

    • The reasons why WHO decided to advance immediately on mRNA vaccines are as follows:

      • They have proven extremely efficacious in protecting against COVID-19, and protection is maintained to a large degree against variants;

      • This technology is very flexible and allows relatively rapid adaptation of the vaccine to variants, if needed;

      • They can be produced by manufacturers of medicines and medical active substances in addition to vaccines;

      • Many technical features are free of Intellectual Property Rights in many countries of the world.

  • https://twitter.com/normanswan/status/1383599744136609798

    • "We could have started something like this here last year. Too rigid in our thinking. Establishment of a COVID-19 mRNA vaccine technology transfer hub to scale up global manufacturing"

New COVID variants can quickly overwhelm a country.

Indian_new_COVID_infections_210421.PNG

Asia is losing vaccine race, as West streaks ahead  20/May/21

  • https://www.afr.com/world/asia/asia-is-losing-vaccine-race-as-west-streaks-ahead-20210520-p57tkl   

    • What worked last year in keeping infections at bay is not working now and while the United States and Europe are opening up, much of Asia is locking down. Economists haven’t given up on the Asian-led recovery yet but say vaccination rates need to increase.

    • Without vaccines, and with new variants coming in, there’s a greater risk of us going in and out of restrictions. That will hit business and consumer confidence and have a longer term impact as well,” said Oxford Economics’ lead Asia economist Sian Fenner in Singapore.

Some older Australians are holding off on getting a COVID-19 vaccine  21/May/21

  • https://www.abc.net.au/news/2021-05-21/covid-vaccine-interest-lags-as-australians-choose-to-wait/100147894 

  • The federal government has ordered 33 million more doses than it needs to vaccinate Australia's entire adult population — although many of the shots aren't arriving until later this year.

  • Initially, the AstraZeneca vaccine was supposed to be the backbone of Australia's strategy as it was the only one that could be manufactured locally, but after last week's federal budget, Health Minister Greg Hunt confirmed plans to fund an mRNA facility, which could produce the Moderna vaccine, in Adelaide, for late 2022.

https://twitter.com/EricTopol/status/1399059271644450818  31/May/21

  • A simplified summary table of the key features for the major variants.  One and the most important common feature: vaccines work

Variants_Transmission_etc_Topol_210531.j

28/May/21 Anne de Gheest COVID Clinical update https://www.youtube.com/watch?v=8bI7V4lkKs4  

AnneDG_vaccine_effectiveness_210528.png
AnneDG_vaccine_effectiveness__vs_UK_Indi

Electronic nose inches closer to sniffing out COVID-19 (afr.com)  4/June/21

  • If Israeli researchers are correct, testing for COVID-19 could be radically changed. Rather than rolling down their windows to confront a nurse with a swab, drivers at testing stations could come face-to-face with a plastic electronic nose. Just as dogs sniff each other, so the e-nose would sniff their nose. Unlike the swab test, this would be non-invasive and the result would be instant.