Should young adults avoid Astra Zeneca COVID-19 vaccine ?

Probably Yes, because of the reports of rare cases of brain clots following vaccination.

Like everything else in medicine, risks and benefits needs to be assessed in each individual case.

For instance, a doctor won’t give toxic treatments for a self limiting flu. But, on the other hand, a doctor will try toxic chemotherapy to control advanced lung cancer.

It’s always going to be a balance between risks from a disease versus risks and benefits of a particular treatment.

No vaccine or medicine is ever going to be 100% safe.

For that matter, Life is full of risks. Getting out of bed can be risky. Not getting out of bed everyday is also risky.

Older adults who are at high of COVID related death and COVID related complications should have the vaccine during this pandemic and not worry too much about rare serious side effects.

But young adults, who are a low risk, can avoid Astra Zeneca vaccine based on the available data, if alternatives are available.

References

Official UK data. MHRA. Research and analysis. Coronavirus vaccine – weekly summary of Yellow Card reporting. Updated 8 April 2021.

BBC news. Covid-19: Seven UK blood clot deaths after AstraZeneca vaccine. By James Gallagher.
Health and science correspondent.

BBC news. AstraZeneca vaccine: How do you weigh up the risks and benefits? By Robert Cuffe. Head of statistics

BBC news. Covid: Under-30s offered alternative to Oxford-AstraZeneca jab. By Nick Triggle. Health correspondent

BMJ news. AstraZeneca vaccine: Blood clots are “extremely rare” and benefits outweigh risks, regulators conclude. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n931 (Published 08 April 2021). Cite this as: BMJ 2021;373:n931

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Can Vitamins and anti-oxidants increase the risk of breast cancer coming back?

Yes, Dietary supplements can be harmful.

Vitamins and Minerals are absolutely essential nutrients for a Healthy body and a Healthy mind. Anyone not eating a healthy balanced should look what nutrients they might be missing.

But on the other hand, taking too much of vitamins and minerals, when they are not needed, could be harmful to the body.

There is widespread use of dietary supplements during cancer treatment, in the hope they can reduce side effects but many do not think about the disadvantages.

An American study of Breast cancer patients undergoing Chemotherapy looked at the effect of taking dietary supplements such as anti-oxidants, iron, vitamin B12, and omega-3 fatty acids.

Breast cancer patients who took the dietary supplements during chemotherapy were found be harmed by them. They had a higher chance of cancer coming back compared to people who did not take these supplements. The supplements also increased risk of death in those the supplements.

Beware supplements when used improperly, can be harmful.

Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221)

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Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

COVID-19 infection affects brain and mental health

A recent paper published in Lancet Psychiatry reports that at least 1 in 3 patients , who have recovered from severe COVID, have substantial neurological and psychiatric problems during the next six months .

This report is very worrying .

If study findings are confirmed by other studies, this would be yet another substantial reason to consider getting the vaccine as soon as it is offered.

References

Guardian. One in three survivors of severe Covid diagnosed with mental health condition
Study finds 34% developed psychiatric or neurological conditions after six months
.
Sarah Marsh
@sloumarsh
Wed 7 Apr 2021 06.00 BST

BMJ. Covid-19: One in three has neurological or psychiatric condition diagnosed after covid infection, study finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n908 (Published 07 April 2021)
Cite this as: BMJ 2021;373:n908

Taquet M, Geddes JR, Husain M, Luciano S, Harrison PJ. 6-month neurological and psychiatric outcomes in 236379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry 2021 (published online 6 Apr). doi:10.1016/S2215-0366(21)00084-5. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00084-5/fulltext.

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Are COVID-19 vaccines safe in cancer patients having immunotherapy?

Yes, Pfizer vaccine is safe.

A recent study published in the esteemed Lancet Oncology Journal shows that the vaccine is well tolerated in patients having immunotherapy.

Unlike cancer chemotherapy, immunotherapy works differently. It works by releasing the in-built brakes holding down the immune system thereby boosting the body’s immune system against cancer.

There has been some theoretical concerns whether this might lead to COVID vaccine causing more side effects.

Reassuringly, the Vaccine side effects were NO different from those seen in people not having immunotherapy. The Vaccine also did NOT increase the immunotherapy side effects.

Immunotherapy is increasingly used widely in treatment of cancer are often better tolerated than chemotherapy.

So the study is good news for tens of thousands of patients on immunotherapy and any cancer patient who has hesitated before, should seriously consider having the vaccine now

COVID infection could be very nasty in cancer patients and all evidence points to the benefits of vaccine far outweighing any risks from the Vaccine.

References

Short-term safety of the BNT162b2 mRNA COVID-19 vaccine in patients with cancer treated with immune checkpoint inhibitors
The Lancet Oncology. Published: April 1, 2021
Barliz Waissengrin et al. DOI:https://doi.org/10.1016/S1470-2045(21)00155-8

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Are COVID-19 vaccines safe in Children ?

Yes, Israel has vaccinated vulnerable children and there have been NO reports of unusual or unexpected reactions.

Pfizer has just released positive results of a study which looked at safety and efficacy of the Vaccine in 12 to 15 year olds.

Pfizer-BioNTech covid-19 vaccine has shown 100% efficacy against SARS-CoV-2 in 12 to 15 year olds.

The Vaccine reassuringly was well tolerated, and the side effects were no different from those observed in the group aged 16 to 25.

What about much more younger children?

A vaccine trial in the children aged 6 months to 11 years has been started recently and results should be available later this year.

References

SKY news. Wednesday 31 March 2021 14:35, UK

The Guardian. Wed 31 Mar 2021 14.20 BST

BMJ News. Covid-19: Pfizer reports 100% vaccine efficacy in children aged 12 to 15
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n881 (Published 01 April 2021)
Cite this as: BMJ 2021;373:n881

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

How long do the COVID-19 vaccines offer protection?

Many millions of people have now been vaccinated against COVID-19.

The COVID-19 vaccines are highly effective but the next important question is how long would the vaccines continue to protect.

Some vaccines for other viral diseases offer life long protection but others like flu vaccines need annual boosters. COVID-19 Studies are still ongoing.

A recently released Pfizer vaccine study data indicates that protection with Pfizer vaccine lasts for many months as a minimum. To be precise, so far, Pfizer vaccine was found to have 91% efficacy for up to six months. Ongoing studies would clarify whether booster vaccines are needed in future.

Guardian. Pfizer vaccine has 91% efficacy for up to six months, trial shows. Ian Sample Science editor
@iansample
Thu 1 Apr 2021 17.27 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

COVID-19 is risky even after a patient recovers from it initially

COVID-19 is not a self limiting illness particularly if you have been poorly enough to be hospitalised the first time around.

Even after recovering from a COVID-19 infection, many people remain at high risk of death.

A recent UK study published in the BMJ found that “ Nearly a third of people who have been in hospital before were readmitted after discharge for further treatment in the following four months”.

“And worryingly one in ten patients died during the follow up period after hospital discharge”.

The increase in risk was not confined to the elderly. So everyone still needs to be careful as the lockdown is being gradually eased.

References:

1. BMJ. Post-covid syndrome in individuals admitted to hospital with covid-19: retrospective cohort study. BMJ 2021; 372 doi: httpst://doi.org/10.1136/bmj.n693 (Published 31 March 2021)
Cite this as: BMJ 2021;372:n693

2. Guardian. Almost third of UK Covid hospital patients readmitted within four months. Ian Sample Science editor
@iansample
Thu 1 Apr 2021 06.00 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Can Traffic pollution kill you ?

Yes, pollution from cars and lorries can kill.

A recent study published in BMJ shows increase in heart and lung related deaths due to traffic pollution.

Reference:

BMJ. Short term associations of ambient nitrogen dioxide with daily total, cardiovascular, and respiratory mortality: multilocation analysis in 398 cities. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n534 (Published 24 March 2021)
Cite this as: BMJ 2021;372:n534

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Does breast feeding the baby protect the mother from heart diseases in later life ?

Yes, it can.

A Study published in British Medical Journal found that “A longer length of breastfeeding was associated with a reduced risk of cardiovascular disease”

The study also found that women who had certain pregnancy related complications were also at increased risk of heart disease in later life.

In addition, the study also found that taking contraceptive pills (combined pills) in younger age led to increased risk of heart disease and stroke in later life.

Awareness of these risks would help to take steps to reduce the risk from them.

References

Association between the reproductive health of young women and cardiovascular disease in later life: umbrella review. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3502 (Published 07 October 2020). Cite this as: BMJ 2020;371:m3502. https://www.bmj.com/content/371/bmj.m3502

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Is the new variant of COVID-19 Coronavirus more deadly ?

Yes !

The new variant in UK, led to the second National Lockdown. Previously, it was reported that the new UK variant spreads more easily but it was NOT known whether it was more deadly.

Now, new evidence published in BMJ (British Medical Journal) indicates that the new UK variant of Coronavirus is more deadly and causes more deaths.

References for further information.

1.BMJ. Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort study. BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n579 (Published 10 March 2021)
Cite this as: BMJ 2021;372:n579

2. Blog. Is the new variant of Coronavirus more dangerous? 20 Dec 2020

3. Daily Mail. UK’s dominant Kent Covid variant is up to TWICE as deadly as older versions of the virus, study claims. By Stephen Matthews Health Editor and Sam Blanchard Deputy Health Editor For Mailonline 12:11, 10 Mar 2021 , updated 18:34, 10 Mar 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Delays to the 2nd dose of COVID Vaccine can be harmful in cancer patients.

The Pfizer vaccine was tested in clinical trials with two doses given at 3 to 4 week interval.

But during Vaccination of the General population, the UK has taken a pragmatic view and delayed the 2nd Vaccine dose by up to 12 weeks.

A recent study suggests that this delay in administering 2nd Vaccine dose might put cancer patients at risk.

References

1. Guardian. Delaying second Pfizer dose leaves cancer patients at risk, say researchers
Covid vaccination policy review urged after study finds 12-week gap leaves patients vulnerable
.
PA Media
Thu 11 Mar 2021 16.40 GMT

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Should Heath care workers be compelled to have the COVID vaccine ?

The health care workers often deal with the people who are most vulnerable to COVID.

Studies have shown that hospital transmission of COVID played a significant role during first and subsequent wave of the pandemic.

So healthcare workers have a moral and ethical duty to protect their patients by vaccinating themselves.

But this needs to be balanced against the personal choices and beliefs of the healthcare worker.

It is possible that Hospitals and Care homes would make vaccination mandatory for healthcare staff in the near future.

References

Guardian. Healthcare professionals in the UK have a moral duty to get the Covid jab
Frances Ryan.

Daily Mail on Line. Nearly 80% of health care workers in Illinois and half of staff in Texas and North Carolina REFUSE coronavirus vaccines – and it’s holding up the rollout of shots across the US. By Associated Press and Natalie Rahhal U.S. Health Editor 15:37, 08 Jan 2021 , updated 21:21, 08 Jan 2021

Daily Mail. NHS staff could be forced to have Covid jab: Radical plan is being considered for thousands of medical staff who turn down the vaccine… but what if they STILL refuse? By Jason Groves Political Editor For The Daily Mail
22:14, 02 Mar 2021 , updated 22:52, 02 Mar 2021

Gov.UK. SARS-CoV-2 in the hospital environment and risk of COVID-19 nosocomial transmission, 31 May 2020. Paper prepared by the Environmental and Modelling Group (EMG). From:
Scientific Advisory Group for Emergencies
Published: 26 June 2020

Guardian. Fifth of patients with Covid-19 may have caught it in hospital, study finds
This article is more than 9 months old
PHE research chimes with concerns that asymptomatic healthcare workers may have played role in spread Coronavirus

Nicola Davis
@NicolaKSDavis
Tue 19 May 2020 18.56 BST

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Selenium can be harmful for Skin cancer patients

Nutritional supplements are often tried to prevent cancer. But well- designed rigorously conducted clinical trials have NOT shown any benefit in prevention of many cancers.

Selenium was suggested as a preventative supplement for skin cancer.

A clinical trial compared Selenium against placebo in United States. The results were disappointing.

Selenium supplementation was found to be ineffective at preventing Skin cancers.

To make matters worse, Selenium was found to Harmful and increased the the risk of getting some skin cancers such as squamous cell carcinoma.

Selenium Supplementation and Secondary Prevention of Nonmelanoma Skin Cancer in a Randomized Trial. Anna J. Duffield-Lillico, Elizabeth H. Slate, Mary E. Reid, Bruce W. Turnbull, Patricia A. Wilkins, Gerald F. Combs, Jr., H. Kim Park, Earl G. Gross, Gloria F. Graham, M. Suzanne Stratton… Show moreJNCI: Journal of the National Cancer Institute, Volume 95, Issue 19, 1 October 2003, Pages 1477–1481, https://doi.org/10.1093/jnci/djg061

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Which COVID vaccine is the best ?

All vaccines approved by the regulatory authorities are in fact good.

No need to be choosy as there is no head to head comparative data.

Pfizer is new exciting technology. (‘mRNA technology’).

Astra Zeneca is based on tried and tested, old reliable technology. (‘viral vector’ technology).

In fact, ‘anything is better than nothing’ principle applies; any of the approved Vaccines would be helpful during this dreadful pandemic .

Israel easing restrictions following vaccination proves vaccines are our way of this horrible pandemic.

References

BBC news. Coronavirus doctor’s diary: Don’t ask me which vaccine is best, please.

Daily Mail: So which Covid vaccines is Britain getting – and which one is the best? How two companies’ jabs are already being used, another is coming in March and two more could be approved within weeks. By Connor Boyd Assistant Health Editor For Mailonline
11:58, 29 Jan 2021 , updated 02:00, 30 Jan 2021

BBC news. Israel eases restrictions following vaccine success.

Blog. Where can I find official detailed information about the three COVID vaccines (Pfizer, Astra Zeneca and Moderna).

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Can companies force you to have the COVID vaccine and say ‘no jab, no job’ ?

Possibly yes, if it is important for your job.

A BBC report discusses the legality of it .

Vast majority of people are desperate to have vaccination and some people are even queue jumping. So this issue is of relevance to some people only and that too when vaccines are freely available to all.

If you are a plumber, who may be visiting the homes of Vulnerable people or a Care Home worker looking after very elderly people, it may be justifiable to say ‘no jab, no job’.

Balancing individual Liberty versus the benefit of others would be a legal minefield particularly when existing workers are concerned.

Furthermore, there are still lot of things we do not know how vaccines. We do not know how long they will protect somebody. We do not know whether all vaccines have similar efficacy. We do not know about the extent to which vaccines would be effective against any variants.

So “Vaccine passport” for ALL types of jobs is a unlikely now.

BBC News. Coronavirus: ‘No jab, no job’ policies may be legal for new staff. 18 Feb 2021.

BBC news. Covid vaccine passports could discriminate, experts warn
By Rachel Schraer
Health reporter

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

How long does it take for taste sensation to recover after Radiotherpy to Head and Neck region ?

Curative Radiotherpy to Tongue, Mouth , Throat and other parts of head and Neck can lead to dry mouth, sticky saliva, difficulty in swallowing solid foods, and loss of taste sensation.

Loss of taste sensation affects food intake and affects quality of life.

A group from Tel Aviv studied the effect of radiotherapy on taste sensation in head and neck cancer patients.

They found that “taste recovery started to occur 1 month after treatment completion

References:

The effect of radiotherapy on taste sensation in head and neck cancer patients – a prospective study. Michal Asif et al. Radiat Oncol. 2020. Radiat Oncol. 2020 Jun 5;15(1):144. doi: 10.1186/s13014-020-01578-4. Authors: Michal Asif, Assaf Moore, Noam Yarom, Aron Popovtzer.

Oral complications at 6 months after radiation therapy for head and neck cancer. R V Lalla et al. Oral Dis. 2017 Nov. Oral Dis. 2017 Nov;23(8):1134-1143. doi: 10.1111/odi.12710. Epub 2017 Aug 3.

Prospective assessment of taste impairment and nausea during radiotherapy for head and neck cancer. Stefania Martini et al. Med Oncol. 2019 Apr 9;36(5):44. doi: 10.1007/s12032-019-1269-x.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Does Hand Washing help to prevent COVID-19 ?

Yes,

But the extent to which Hand washing helps is uncertain.

Masks, Social distancing and Vaccination seem to be more highly important than Hand Washing.

Read the very good Guardian newspaper piece on the topic of hand washing.

References

Guardian: Q&A: Does handwashing stem the transmission of Covid-19?
James Tapper
Sun 14 Feb 2021 10.00 GMT

Daily Mail: So which Covid vaccines is Britain getting – and which one is the best? How two companies’ jabs are already being used, another is coming in March and two more could be approved within weeks. By Connor Boyd Assistant Health Editor For Mailonline
11:58, 29 Jan 2021 , updated 02:00, 30 Jan 2021

Daily Mail. Pfizer’s Covid vaccine COULD stop people spreading the virus as well as preventing serious illness, Israeli doctor claims after finding antibody levels surged after second dose. By Emily Webber and Sam Blanchard Deputy Health Editor For Mailonline
12:05, 19 Jan 2021 , updated 14:06, 19 Jan 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Vitamin D reduces risk of advanced cancer in normal-weight individuals.

“An ounce of prevention better than a pound of cure” is certainly true when it comes to cancer prevention.

Vitamin D, the “sunshine” vitamin has been proven to reduce risk of advanced cancers an large American study.

The study presented at the ASCO ( American Society of Clinical Oncology) virtual scientific symposium in 2020,

“The VITamin D and OmegA-3 TriaL (VITAL) was a high quality study. The study randomly assigned patients to Vitamin D3 supplements and/or omega-3 fatty acid supplements and/or both or placebo in 25,871 men and women.

The study found that “vitamin D supplementation decreased risk of developing advanced cancers by 17% compared with placebo ”

“Omega-3 supplementation did not reduce the incidence of advanced cancer.”

Reference:

Vitamin D Reduces Incidence of Advanced Cancers in Normal-Weight Individuals. ASCO Annual Meeting 2020.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Are breakfast cereals bad for your heart?

Yes.

A large study in BMJ reports that high intake of cereals is associated with higher risk of Blood pressure and Heart diseases.

High intake of white bread, pasta/noodles were also as bad as breakfast cereals because of the refined grains.

Intake of whole grains and whole grain porridges. did not affect the health outcomes.

Interestingly, white rice did not affect the health outcomes either.

Associations of cereal grains intake with cardiovascular disease and mortality across 21 countries in Prospective Urban and Rural Epidemiology study: prospective cohort study
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.m4948 (Published 03 February 2021)
Cite this as: BMJ 2021;372:m4948

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

COVID pandemic: finally, the end is in sight !

The latest good news about Oxford vaccine is hugely encouraging and denotes the end of pandemic is in sight.

The latest positive results show that even a single dose of the vaccine is highly effective.

The vaccine offered 76% effective protection from a single dose for three months”. This validates the UK decision to prioritise first dose of the vaccine and delay the second dose of booster vaccine.

Most importantly the Vaccine was shown to reduce spread of the virus causing the COVID.

It is the first time a vaccine has been shown to reduce transmission of the virus

If all the vaccines now in use continue to be safe and highly effective in real world population, then it is only a matter of months before the pandemic comes to an end and normal life returns in 2021 !

A separate study also reports very positive news. The study reports that 9 out of 10 people who had an actual COVID infection will have protective antibodies for at least six months.

Vaccines work by tricking the body into thinking that there is a real infection and hence the body produces antibodies. So this study indirectly indicates the protection from vaccines will also last longer and yet another reason to be hopeful about the end of pandemic in 2021.

BBC news. Covid-19: Study showing Oxford vaccine slows virus spread ‘superb’ – Hancock.

BBC news: Covid: Antibodies last at least six months in most.
By Rachel Schraer
BBC Health reporter

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Two New Vaccines against COVID-19

More good news on the vaccine front in the fight against the coronavirus.

Two new vaccines have reported positive results.

The NOVAVAX vaccine is first Vaccine to report efficacy against the new variants. It is 95.6% effective against the original strain of coronavirus.

NOVAVAX is 86% effective at protecting against the new UK variant, which is very reassuring. But the Vaccine is only, 60% effective against South African variant of the virus. The efficacy against Brazilian variant is unknown.

The Janssen vaccine, produced by the US giant Johnson & Johnson, is a single-dose vaccine and has proved 66% effective against Covid-19. The vaccine was just 57% effective in the South African part of the trial.

The reduction in efficacy of both vaccines against new variants is a bit worrying and indicates that if further new variants emerge in future, existing vaccines could be less effective and vaccines would need to be updated.

The Janssen vaccine uses a common cold virus and uses a approach similar to the Oxford Astra Zeneca Vaccine.

Novavax vaccine differs from existing vaccines and it uses a artificially produced COVID-19 spike protein, which is then assembled into nanoparticles to make them look like coronavirus.

Bloomberg: Covid Mutations Undercut Optimism Even as More Vaccines Near
By Robert Langreth
30 January 2021, 00:04 GMT
Updated on 30 January 2021, 12:02 GMT

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Spit test for COVID

Anyone who had the COVID test would know that the swab up the nose and throat is unpleasant.

Life would be much more easier if you can just spit in a test tube and the saliva could be tested for COVID.

Early results are promising and tests so far has shown that saliva testing is as good as nose swab testing

References

BBC. Covid-19: No-swab saliva test finds symptomless cases.
By Michelle Roberts
Health editor, BBC News online.

JAMA January 15, 2021. Comparison of Saliva and Nasopharyngeal Swab Nucleic Acid Amplification Testing for Detection of SARS-CoV-2
A Systematic Review and Meta-analysis

Guillaume Butler-Laporte, MD1; Alexander Lawandi, MD, MSc2; Ian Schiller, MSc3; et al. JAMA Intern Med. Published online January 15, 2021. doi:10.1001/jamainternmed.2020.8876

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation the author is associated with. The authors views are not in way intended to be a substitute for professional advice.

Is social media inadvertently responsible for the spread of vaccine misinformation?

Read the excellent article in BMJ and contribute your views through the rapid response section of BMJ

Reference

Too little, too late: social media companies’ failure to tackle vaccine misinformation poses a real threat
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n26 (Published 21 January 2021)
Cite this as: BMJ 2021;372:n26

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Can you get COVID-19 infection just by “Talking” to an infected person for a few minutes?

Yes, you can.

You don’t need to be exposed to an infected person who is coughing, sneezing and spluttering to get the infection.

Merely talking to an infected person can make you catch the coronavirus infection particularly if you are very close to the person with infection and not wearing a mask in an indoor setting with poor ventilation.

Remember, Even Vaccines don’t have 100% protection.

Remember to maintain Space and Wear a Face Mask

References

Guardian. Talking can spread Covid as much as coughing, says research.
Tiny aerosols of the virus emitted when speaking linger in air for longer than larger droplets from a cough.
Nicola Davis Science correspondent
@NicolaKSDavis
Wed 20 Jan 2021 00.01 GMT

Journal Proceedings of the Royal Society A. Evolution of spray and aerosol from respiratory releases: theoretical estimates for insight on viral transmission. P. M. de Oliveira , L. C. C. Mesquita , S. Gkantonas , A. Giusti and E. Mastorakos. Published:20 January 2021. https://doi.org/10.1098/rspa.2020.0584

Guardian. Single Covid vaccine dose in Israel ‘less effective than we thought’.
Peter Beaumont
Tue 19 Jan 2021 16.53 GMT

Telegraph: UK to ‘look carefully’ at claims vaccine efficacy in Israel has dropped to 33 per cent with one dose.
Israel’s vaccine tsar says single Pfizer dose appears ‘less effective than we had thought’ as scientists demand evidence is published
By
Sarah Knapton,
SCIENCE EDITOR
20 January 2021 • 1:46pm

Daily Mail: Israel is STILL waiting for its world-beating vaccination drive to kick in as cases and hospitalisations soar higher than ever despite vaccine stopping 50% of new Covid infections. By Chris Jewers For Mailonline11:20, 14 Jan 2021 , updated 18:04, 14 Jan 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Where can you find official data and statistics on Coronavirus infection?

The official UK Government website for data and insights on Coronavirus (COVID-19).

WHO Dashboard

Worldwide data – John Hopkins university dashboard is perhaps more widely used and quoted.

https://covid19.who.int

https://coronavirus.data.gov.uk

https://coronavirus.jhu.edu/map.html

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Why are some people falsely sceptical of COVID Vaccines?

Disclaimer: A personal view point !

“Vaccines hesitancy” is a problem in some sections of society.

A significant minority of people have an unhealthy scepticism about all vaccines in general fuelled by misinformation on social media. Some people in western world, who haven’t seen the horrors that can be wrecked by infectious diseases, have an ill-informed view about all Vaccines.

Vaccines have played a significant role in protection against various deadly infections diseases in the past century. The infectious diseases of childhood have become less prevalent even in developing countries now. But there is a risk of Vaccine Hesitancy spreading to these third world developing countries .

That is not to say that all vaccines are free of side effects. Lot of people do have mild side effects after any vaccination. But very serious side effects are rare.

The concerns of people with Vaccine Hesitancy particularly relating to COVID Vaccine is genuine. The COVID vaccines have been rapidly developed and there are no long term efficacy or toxicity data. Because it is a global emergency, countries are forced to begin COVID vaccination based on the available excellent short term efficacy and safety data. Only time can tell whether the Governments got it right over long term.

But there is no evidence to suggest secrecy or conspiracy surrounding development of various vaccines including COVID vaccines. For instance, two reports of severe allergies due to COVID vaccine was immediately brought to the attention of everyone by Regulatory authorities in UK.

It is now reported that Norway is investigating deaths after coronavirus vaccination in very frail elderly people. Any adverse report on vaccines will be investigated and made public.

Rare individual stories of serious side effects is understandably shocking. It is human nature not to risk when one personally feels well at a particular point in time.

It is very important to remember that life is full of risks. People make decisions every day based on benefits versus risks ( eg driving a car). People need to understand that the benefits from most vaccines against infections diseases significantly outweighs the risks of various vaccine side effects. While a handful have serious side effects, many millions do benefit from the all vaccines.

“Vaccines hesitancy” is also not helped Historic mistrust of government in sections of population which regrettably can make things difficult in terms of achieving good vaccine coverage at population level.

If you have concerns about vaccines –

“Do read information about Vaccines with an open mind and pay attention to high quality population level studies assessing risks versus benefits and ignore individual unsubstantiated stories”.

“Do speak to your doctor about your concerns with an open mind”.

“Do NOT always seek information that affirms your views and Worries. Do seek reliable information that challenges your views on vaccines before you make your choice”.

References

JAMA Insights Clinical Update
January 21, 2021
Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine
Tom Shimabukuro, MD, MPH, MBA1; Narayan Nair, MD2
Author Affiliations
JAMA. Published online January 21, 2021. doi:10.1001/jama.2021.0600

BMJ. Covid-19: Norway investigates 23 deaths in frail elderly patients after vaccination
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n149 (Published 15 January 2021)
Cite this as: BMJ 2021;372:n149.

Guillain-Barré syndrome after vaccination in United States: data from the Centers for Disease Control and Prevention/Food and Drug Administration Vaccine Adverse Event Reporting System (1990-2005)
Nizar Souayah et al. J Clin Neuromuscul Dis. 2009 Sep.

The Atlantic. Anti-vaxxers Think This Is Their Moment. Society’s well-being depends on how well public-health officials and average internet users combat misinformation. DECEMBER 20, 2020
Renée DiResta.
Technical research manager at the Stanford Internet Observatory.

Countering Vaccine Hesitancy. Kathryn M. Edwards, Jesse M. Hackell and THE COMMITTEE ON INFECTIOUS DISEASES, THE COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE
Pediatrics September 2016, 138 (3) e20162146; DOI: https://doi.org/10.1542/peds.2016-2146

Guardian. Covid vaccine: 72% of black people unlikely to have jab, UK survey finds.
Linda Geddes
Sat 16 Jan 2021 07.00 GMT

Lazarus JV, Ratzan SC, Palayew A, et al. A global survey of potential acceptance of a COVID-19 vaccine. Nat Med 2020 doi: 10.1038/s41591-020-1124-9

BBC. Royal Marsden’s leading cancer expert Martin Gore dies.
Published 11 January 2019

Times. Cancer pioneer Martin Gore’s sudden death from routine jab.
David Brown
Friday January 11 2019, 12.01am, The Times

The benefit of the doubt or doubts over benefits? A systematic literature review of perceived risks of vaccines in European populations
Emilie Karafillakis et al. Vaccine. 2017.

BMJ. The rush to create a covid-19 vaccine may do more harm than good. BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3209 (Published 18 August 2020)Cite this as: BMJ 2020;370:m3209

MHRA: Confirmation of guidance to vaccination centres on managing allergic reactions following COVID-19 vaccination with the Pfizer/BioNTech vaccine

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Can Vaccines get us back to normal life again during autumn?

Possibly Yes, but not sooner than that.

Perhaps in later part of 2021, life can just approach some sort of normality in western countries with high uptake of vaccination.

There are many hurdles along the way.

The first problem is supply of Vaccines. There are limited initial supplies globally. It will take many months even for richer countries to get their full supply.

Secondly, Vaccines take many weeks to become very effective. In clinical trials, more than 90% effectiveness was noted for some Vaccines a few weeks after the second dose.

Millions in the UK are yet to receive the first dose. Lots of people would not get the second dose until 10-12 weeks after first dose. A UK minister predicts a September vaccination target for all adults.

So it will take time for the full Vaccine effect to kick in at both individual as well as society level.

Thirdly, there is a potential problem of “Vaccines hesitancy” in sections of the society. A significant minority of people have a unhealthy scepticism about Vaccines fuelled by misinformation on social media.

Fourthly, it has to be pointed out that “No Vaccine works perfectly”. A Vaccine does not offer 100% protection. The high efficacy rates noted in young healthy volunteers participating in various trials might not be observed in real world population, and efficacy rates might be lower in elderly people.

Finally, the most serious potential risk and hurdle would be loss of Vaccine efficacy if new variants of Coronavirus are not protected by existing Vaccines.

Keep the mask; a Vaccine won’t end the COVID-19 crisis right away !

References.

BBC. Will a vaccine give us our old lives back?
By the Visual Journalism Team.
14 January 2021

WSJ. Vaccines Are Coming but They Won’t End Covid-19 Anytime Soon. By Feliz Solomon
Dec. 13, 2020 8:00 am ET

Guardian. All adults in UK will be offered coronavirus vaccine by September.
Dominic Raab sets timescale and says ministers hope to ease lockdown restrictions in March.
Heather Stewart
Sun 17 Jan 2021 13.17 GMT

Guillain-Barré syndrome after vaccination in United States: data from the Centers for Disease Control and Prevention/Food and Drug Administration Vaccine Adverse Event Reporting System (1990-2005)
Nizar Souayah et al. J Clin Neuromuscul Dis. 2009 Sep.

Countering Vaccine Hesitancy. Kathryn M. Edwards, Jesse M. Hackell and THE COMMITTEE ON INFECTIOUS DISEASES, THE COMMITTEE ON PRACTICE AND AMBULATORY MEDICINE
Pediatrics September 2016, 138 (3) e20162146; DOI: https://doi.org/10.1542/peds.2016-2146

Guardian. Covid vaccine: 72% of black people unlikely to have jab, UK survey finds.
Linda Geddes
Sat 16 Jan 2021 07.00 GMT

CDC. New COVID-19 Variants.
Updated Jan. 15, 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Low Carb diet for Diabetes: what is the scientific evidence?

Low Carb diet is often used for weight loss.

A recent “Study of Studies” published in BMJ shows that Low-Carb-diet is beneficial for diabetes control and remission.

The beneficial effects seem quite remarkable in the first six months but there is uncertainty about the long term effect.

Before you consider the Low-Carb-diet option, do discuss it with your doctor.

What replaces the Low-Carb-Diet is also important. Long term Low-Carb-Diet with animal protein seems to be bad for health.

Do consider plant based proteins instead .

References: Efficacy and safety of low and very low carbohydrate diets for type 2 diabetes remission: systematic review and meta-analysis of published and unpublished randomized trial data.
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.m4743 (Published 13 January 2021)
Cite this as: BMJ 2021;372:m4743

Seidelmann SB, Claggett B, Cheng S, et al. Dietary carbohydrate intake and mortality: a prospective cohort study and meta-analysis. Lancet Public Health2018;3:e419-28. doi:10.1016/S2468-2667(18)30135-X pmid:30122560

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are NOT in way intended to be a substitute for professional advice.

Covid-19: Can you catch the coronavirus while exercising outdoors?

Yes, you can.

But the risk depends on how long and how close you have been in touch with an infected person.

Momentarily passing someone while jogging is extremely unlikely to lead to an infection.

But face to face contact lasting many minutes with a friend or someone who is infected can lead to an infection.

There is a good article on how BBC website.

References:

BBC. Covid-19: Can you catch the virus outside?https://www.bbc.com/news/explainers-55680305
By David Shukman. Science editor.

Mayo Clinic. Safe outdoor activities during the COVID-19 pandemic. By Mayo Clinic Staff.

Imperial. Airborne transmission of COVID-19 carrier particles during exercise.

UK. Ministry of Housing, Communities &
Local Government. Guidance. COVID-19: Guidance for managing playgrounds and outdoor gyms. Updated 6 January 2021

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Should you avoid the Hospitals during this third wave of COVID pandemic?

Yes and No. It depends on how important your hospital visit is.

Recent news reports say that a significant number of patients acquired COVID during their hospital stay. Hospital acquired infections are a serious concern.

Yes, avoid, if you are trying to visit a family member admitted for a routine or elective medical procedure and is doing well.

Yes, avoid, if you can have a satisfactory phone or video consultation with medical team.

No, you should NOT avoid if you have any serious illness like heart attacks, stroke or cancer.

Everything in medicine depends on an assessment of risks versus benefits. For many patients with serious illness, on the whole, the benefits of proper treatment are likely to outweigh the risks of serious problems from COVID and risks can be managed.

If in doubt, ask your doctors or nurse about it. Do not take any action without discussing your concerns with your medical team.

References

Telegraph. Exclusive: Almost as many caught Covid in hospital in past month as in previous four. More than 11,000 people who went into England’s hospitals with unrelated issues contracted virus in December and early January
By Katherine Rushton and Sophie Barnes
14 January 2021 • 9:54pm

BMJ: Views And Reviews. Acute Perspective.
David Oliver: Could we do better on hospital acquired covid-19 in a future wave?
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n70 (Published 13 January 2021)
Cite this as: BMJ 2021;372:n70. davidoliver372@googlemail.com
Follow David on Twitter @mancunianmedic

JAMA: Richterman A, Meyerowitz EA, Cevik M. Hospital-acquired SARS-CoV-2 infection: lessons for public health. JAMA2020;324:2155-6. doi:10.1001/jama.2020.21399. https://jamanetwork.com/journals/jama/fullarticle/2773128. pmid:33185657

JAMA: Rhee C, Baker M, Vaidya V, et al., CDC Prevention Epicenters Program. CDC Prevention Epicenters Program. Incidence of nosocomial covid-19 in patients hospitalized at a large US academic medical center. JAMA Netw Open2020;3:e2020498. doi:10.1001/jamanetworkopen.2020.20498. pmid:32902653

HSJ. Hospital acquired covid infections hit record high. By Matt Discombe11 December 2020

Healthcare Safety Investigation Branch. National report charts challenges of managing COVID-19 transmission in hospitals. 29 Oct 2020. https://www.hsib.org.uk/news/national-report-charts-challenges-managing-covid-19-transmission-hospitals/.

David Oliver: Heed HSIB on covid transmission in hospital. BMJ2020;371:m4306. doi:10.1136/bmj.m4306. pmid:33177046

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice

Anything potentially good from this COVID-19 pandemic?

It might seem foolish to ask the question “Anything good from this COVID-19 pandemic?” when so many people across the world has been so badly affected by the coronavirus pandemic.

There is some truth in the proverb that “every dark cloud has a silver lining” and no matter how bad the current pandemic is now, human spirit and endeavour would get something positive out of it.

One possible good thing that has come out of the pandemic is the “mRNA technology”.

Of the three vaccines so far, two of them the Pfizer vaccine and the Moderna vaccine are based on RNA technology.

The successful use of RNA technology for Coronavirus Vaccines would hopefully enable the versatile RNA technology to be further developed and successfully used a cancer treatment in near future.

Further clinical trials in cancer patients would be done to provide proof of their potential.

References:

Bloomberg. Technology & Ideas. mRNA Vaccines Could Vanquish Covid Today, Cancer Tomorrow.
The best news about the mRNA shots from BioNTech and Moderna is that the same technique could also defeat many other diseases.

MSKCC. In a Twist, Scientists Find Cancer Drivers Hiding in RNA, Not DNA.

Jerusalem Post Health & Science. Israeli scientists use mRNA COVID-19 vaccine technology to fight cancer. By MAAYAN JAFFE-HOFFMAN NOVEMBER 24, 2020 20:08

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

A first COVID infection can make the body resistant to second infection for atleast five months

If someone had a COVID-19 Coronavirus infection and has recovered from it, then their body develops resistance to a further second infection

The protection is similar to that provided by vaccination. The UK study found that the protection lasts for atleast five months.

Caveats: It is not known how long the protection will last and the study is ongoing.

While a previously infected is protected against 2nd infection, that person can still carry and transmit virus to others. PHE reports that “early evidence from the next stage of the study suggests that some of these individuals carry high levels of virus and could continue to transmit the virus to others”. So the usual COVID-19 precautions are still needed.

The study involved healthcare workers from hospitals across the UK. The study recruited mainly Young and Middle age people ; it is not known whether the study findings would apply to older age people who are the most vulnerable.

The protection is not 100%. The protective effect was noted for only 83% . So there is still a chance someone who has recovered from the 1st infection might still get a 2nd infection.

The other big concern is “the risk of reinfection from the new Covid variants spotted in the UK, South Africa and Brazil”.

The study continues and more information would be available later this year ”

References:

PHE. Press release. Past COVID-19 infection provides some immunity but people may still carry and transmit virus
Study finds past coronavirus (COVID-19) infection provides some immunity for at least 5 months, but people may still carry and transmit the virus. Published 14 January 2021. Public Health England

Guardian Newspaper. Recovering from Covid gives similar level of protection to vaccine
PHE found immunity from earlier infection provided 83% protection against reinfection for at least 20 weeks.
Ian Sample Science editor. @iansample
Thu 14 Jan 2021 06.00

Daily Mail. Previous coronavirus infection gives people immunity for five months – MORE than the Oxford vaccine, PHE study finds. By Joe Pinkstone For Mailonline
00:01, 14 Jan 2021 , updated 11:54, 14 Jan 2021

Telegraph: Brazilian Covid variant may infect people who have recovered from virus
Scientists find new coronavirus strain has mutated to be more infectious and has changes that help it evade immune system
By Sarah Knapton,
SCIENCE EDITOR
14 January 2021 • 3:00pm

SIREN – SARS-COV2 immunity and reinfection evaluation; The impact of detectable anti SARS-COV2 antibody on the incidence of COVID-19 in healthcare workers.

SIREN protocol: Impact of detectable anti-SARS-CoV-2 on the subsequent incidence of COVID-19 in 100,000 healthcare workers: do antibody positive healthcare workers have less reinfection than antibody negative healthcare workers?

BMJ: Covid-19: Past infection provides 83% protection for five months but may not stop transmission, study finds.
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n124 (Published 14 January 2021)
Cite this as: BMJ 2021;372:n124

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Are spirits and beers more risky than wine?

Yes, according to a recent UK biobank study.

A large study of 309,123 participants found that Spirit drinking was associated with higher risk of early death compared to red wine drinking.

Beer/cider drinkers were also found to be at a higher risk of early death.

Alcohol consumption without food was associated with higher risk of early death compared to consumption with food.

Binge drinking with Alcohol consumption over 1–2 times/week was more risky compared to drinking spread out over 3–4 times/week.

But the study doesn’t seem to have looked at teetotallers. The study specifically excluded Abstainers and infrequent alcohol consumers. It is quite possible that avoiding alcohol altogether may be more beneficial but that might not be acceptable to many people !

As usual most of studies relating to food and drink need to be taken with a dose of healthy scepticism.

References:

Daily Mail. I Drinking wine instead of beer or spirits is healthier and could cut risk of death, study suggests. By Xantha Leatham For The Daily Mail 01:49, 12 Jan 2021 , updated 01:59, 12 Jan 2021

Association between patterns of alcohol consumption (beverage type, frequency and consumption with food) and risk of adverse health outcomes: a prospective cohort study. Bhautesh Dinesh Jani1* , Ross McQueenie1, Barbara I. Nicholl1, Ryan Field2, Peter Hanlon1, Katie I. Gallacher1, Frances S. Mair1 and Jim Lewsey2. Jani et al. BMC Medicine (2021) 19:8 https://doi.org/10.1186/s12916-020-01878-2

BBC. No alcohol safe to drink, global study confirms. By Laurel Ives. BBC Health. Published24 August 2018

Guardian. Study finds one small alcoholic drink a day raises risk of irregular heartbeat. Researchers examined heart health and drinking habits of 108,000 people aged 24 to 97 over 14 years
The report found people who consumed equivalent to a 330ml beer, a 120ml glass of wine, or 40mls of spirits were 16% more likely than teetotallers to develop atrial fibrillation.
Ian Sample Science editor
@iansample
Wed 13 Jan 2021 06.00 GMT

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Where can I find official detailed information about the three COVID vaccines (Pfizer, Astra Zeneca and Moderna)

You might have read information about the COVID vaccines on various news outlets and social media messages.

If you want complete summary information about vaccines approved by the regulatory authorities, click on the links below.

Two types of information leaflets accompany all licensed medicines.
– One is meant for health professionals and has lot of clinical information. (called SPC)
– The other is meant for patients and public and provides a summary of facts using lay terms.(called PIL).

The leaflets provide information about all common side effects observed in the trials.

Oxford Astra Zeneca: Professionals Version .

Oxford Astra Zeneca: Patient Version

Pfizer. Professionals Version

Pfizer. Patient Version

Moderna. Professionals Version

Moderna. Patient Version

FDA USA: Pfizer-BioNTech COVID-19 vaccine prescribing informationexternal

FDA USA: Moderna COVID-19 vaccine prescribing informationexternal

The above links reproduced below with longer titles and date of publication.

Please note when new significant information comes to light, the company and regulatory authorities are likely to update the information leaflets.

Oxford Vaccine : Information for Healthcare Professionals on COVID-19 Vaccine AstraZeneca
Updated 7 January 2021.

Oxford Vaccine: MHRA. Information for UK recipients on COVID 19 Vaccine AstraZeneca
Updated 7 January 2021.

Pfizer Vaccine. MHRA. Information for Healthcare Professionals on Pfizer/BioNTech COVID-19 vaccine
Updated 31 December 2020

Pfizer Vaccine. MHRA. Information for UK recipients on Pfizer/BioNTech COVID-19 vaccine
Updated 31 December 2020

Moderna. MHRA. Information for Healthcare Professionals on COVID-19 Vaccine Moderna
Updated 8 January 2021.

Moderna. MHRA. Information for UK recipients on COVID-19 Vaccine Moderna
Updated 8 January 2021.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Some Good news for those who have recovered from a COVID-19 infection !

People who have recovered from a COVID-19 infection are expected to have some protection against another repeat infection by the COVID-19 Coronavirus.

The protection comes from patients own antibodies present in their blood.

Previously, there was a concern that this protection might not last very long and that the levels of protective antibody may drop off quickly and this in turn can lead to repeat infections.

Now a study from Oxford indicates that protection against repeat infection (re-infection) can last atleast 6 months.

This news indirectly might also be good news for COVID-19 vaccines .

Vaccines work by tricking the body into thinking that there is a virus infection and the body then produces the protective antibodies and cells.

Based on this study, one can logically hope that the protection by vaccines can be long lasting as well. Of course, nothing is certain and further vaccine data is awaited to confirm this.

References: (1) Lumley SF, O’Donnell D, Stoesser NE, et al., Oxford University Hospitals Staff Testing Group. Antibody status and incidence of SARS-CoV-2 infection in health care workers. N Engl J Med2020. doi:10.1056/NEJMoa2034545. pmid:33369366

(2) BMJ news: Covid-19: Antibodies protect against reinfection for at least six months, study finds. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4961 (Published 30 December 2020)
Cite this as: BMJ 2020;371:m4961

(3). BBC news: Covid reinfection: Man gets Covid twice and second hit ‘more severe’
By James Gallagher
Health and science correspondent

(4). Lancet Infectious diseases. Genomic evidence for reinfection with SARS-CoV-2: a case study. Richard L Tillett, PhD, Joel R Sevinsky, PhD, Paul D Hartley, PhD, Heather Kerwin, MPH, Natalie Crawford, MD, Andrew Gorzalski, PhD, et al. Published:October 12, 2020. DOI: https://doi.org/10.1016/S1473-3099(20)30764-7

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

A third Vaccine approved for protection against COVID-19 Coronavirus infection

Pfizer Vaccine and Astra Zeneca/Oxford Vaccine were approved last month by the UK regulatory authorities.

Now the regulatory authorities have approved a third vaccine. The third vaccine from Moderna along with two other vaccines should help to bring the pandemic to an end.

The Moderna vaccine is a new technology like the Pfizer Vaccine. (based on mRNA technology).

Like the two vaccines, the short term data for Moderna vaccine is very encouraging.

Over long term, one hopes that the protective effect of all the three vaccines is long lasting and that they remain effective against any new variants of coronavirus that might emerge in the coming months.

Overall, there is certainly ‘light at end of the tunnel’ and the world can emerge out of this horrific pandemic in a short period.

BBC. Moderna becomes third Covid vaccine approved in the UK
By Michelle Roberts
Health editor, BBC News online

BBC.Covid-19: Pfizer/BioNTech vaccine judged safe for use in UK
By Michelle Roberts
Health editor, BBC News online
Published2 December 2020

BBC. Covid-19: Oxford-AstraZeneca vaccine approved for use in UK
By James Gallagher and Nick Triggle
BBC News
Published30 December 2020

MHRA. Oxford University/AstraZeneca COVID-19 vaccine approved.

MHRA. Moderna vaccine becomes third COVID-19 vaccine approved by UK regulator.

MHRA. UK medicines regulator gives approval for first UK COVID-19 vaccine.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Are takeaway deliveries risky during Coronavirus pandemic?

Possibly yes, if food is not properly handled during preparation, packaging and delivery.

It is likely the risks from properly prepared food and food packaging itself are minimal. There is more risk from interaction with the delivery person.

If you are shielding or a very old person, there is a chance the food delivery person might pass on the infection to you. Stay at safe distance, use gloves and masks, and advice the delivery to be left at door for collection. Wipe Clean outside packaging and transfer contents to your own containers.

But for young adults the risk is likely to be very small.

Most importantly, it has to pointed out that everything in life has some risks. If you are not buying a takeaway, you might have to go shops or supermarkets to buy food for cooking and eating. There is a risk of catching cornovirus from other people while shopping !

There is a good article in BBC titled “ Coronavirus: How safe are takeaways and supermarket deliveries?

A previous blog post also gives information about survival of coronavirus in artificial surfaces

References: Can you catch Coronavirus infection from Soft drink cans, Sandwich wrapper and Amazon Parcels?

Coronavirus: How safe are takeaways and supermarket deliveries? By Victoria Gill
Science correspondent, BBC News

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

New drug treatments for COVID-19

More good news in fight against COVID-19 pandemic !

Steroids were previously proven to be effective against severe Coronavirus (COVID-19) infection. The steroids are believed to work by dampening the inflammation caused by coronavirus.

Dexamethasone and Prednisolone are the commonly used steroids.

Now two other drugs have been reported to work in COVID-19 infection. (yet to be published).

Both the anti-inflammatory drugs are not entirely new drugs as they are already routinely used for treatment of various arthritis.

The BBC reports: “The anti-inflammatory medications, given via a drip, save an extra life for every 12 treated, say researchers who have carried out a trial in NHS intensive care units”.

The two drugs “tocilizumab and sarilumab” may become available for treatment of severe COVID-19 shortly.

All these additional drug treatments are needed ONLY for severe Coronavirus (COVID-19) infection. Mild COVID-19 infections do NOT need these drug treatments.

References . BBC news. Two more life-saving Covid drugs discovered. By Michelle Roberts. Health editor, BBC News online. Published 7 Jan 2021.

BBC news. Coronavirus: Dexamethasone proves first life-saving drug. By Michelle Roberts. Health editor, BBC News online. Published 16 June 2020

BBC News. Tocilizumab: Arthritis drug may treat severe Covid. By James Gallagher. Health and science correspondent. Published 19 November 2020

BMJ. Dexamethasone in management of covid -19. BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2648 (Published 03 July 2020)
Cite this as: BMJ 2020;370:m2648

BMJ. Rapid Recommendations. A living WHO guideline on drugs for covid-19. BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379 (Published 04 September 2020). Cite this as: BMJ 2020;370:m3379

BMJ. Covid-19: Arthritis drugs improve survival in intensive care patients, shows study
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n61 (Published 08 January 2021)
Cite this as: BMJ 2021;372:n61

eMC. Sarilumab is a human monoclonal antibody selective for the interleukin-6 (IL-6) receptor, produced in Chinese Hamster Ovary cells by recombinant DNA technology. (Sarilumab, administered as a subcutaneous injection is routinely used for treatment of arthritis and is not an entirely new drug).

eMC. Tocilizumab is a recombinant humanized, anti-human monoclonal antibody of the immunoglobulin G1 (IgG1) sub-class directed against soluble and membrane-bound interleukin 6 receptors. (Tocilizumab, as a intravenous or subcutaneous formulation, is routinely used for treatment of various arthritis and is also not an entirely new drug).

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Can you get Coronavirus infection even after getting the Vaccine ?

Yes, you can get the COVID-19 infection even after the vaccines.

This is because no vaccine is 100% effective. ( Eg Pfizer 95%, Oxford 70%)

The distressing story of a Nurse in Wales getting the infection after vaccination is an example.

There is also a theoretical chance that protective effect of vaccine is affected by new variants of Coronavirus.

But it is reassuring to learn that the Pfizer vaccine could be effective against UK and South Africa coronavirus strains (but the study is unpublished study and yet to be not peer reviewed ).

Be safe. Be aware !

References: BBC news. Covid: Nurse ‘angry’ over positive test despite vaccination. By Rachael Garside. BBC Wales News.

Covid-19: Pfizer/BioNTech vaccine judged safe for use in UK. By Michelle Roberts. Health editor, BBC News online. Published2 December 2020

Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. List of authors.
Fernando P. Polack, M.D., Stephen J. Thomas, M.D., Nicholas Kitchin, M.D., Judith Absalon, M.D., et al., for the C4591001 Clinical Trial Group*
December 31, 2020
N Engl J Med 2020; 383:2603-2615
DOI: 10.1056/NEJMoa2034577

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. Merryn Voysey, DPhil *Sue Ann Costa Clemens, PhD *Shabir A Madhi, PhD *Lily Y Weckx, PhD *Pedro M Folegatti, MD *Parvinder K Aley, PhD
et al.
Published:December 08, 2020DOI:https://doi.org/10.1016/S0140-6736(20)32661-1

CNN. Genetics experts worry coronavirus vaccines might not work quite as well against UK variant. By Elizabeth Cohen, CNN Senior Medical Correspondent. Updated 0328 GMT (1128 HKT) December 24, 2020

Telegraph: Coronavirus latest news: Pfizer vaccine could be effective against UK and South Africa strains, study says. Gareth Davies, breaking news editor. 8 JANUARY 2021 • 9:41AM (“Pfizer Inc and BioNTech’s Covid-19 vaccine appeared to work against a key mutation in the highly transmissible new variants of the coronavirus discovered in the UK and South Africa, according to a laboratory study conducted by the US drugmaker. The not-yet peer reviewed study by Pfizer and scientists from the University of Texas Medical Branch indicated the vaccine was effective in neutralizing virus with the so-called N501Y mutation of the spike protein.”)

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

What is evidence for delaying the 2nd dose of COVID-19 ?

The UK has made a pragmatic decision based on limited available evidence to delay the second dose so that more people can get the vaccine.

While there is some evidence for the Oxford vaccine, there is scant public evidence in support of delaying the Pfizer vaccine.

A BMJ news article provides an excellent summary of the current evidence.

Only time will whether there are any major risks to this approach.

Reference: Covid-19 vaccination: What’s the evidence for extending the dosing interval? BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n18 (Published 06 January 2021). Cite this as: BMJ 2021;372:n18

Covid-19: Order to reschedule and delay second vaccine dose is “totally unfair,” says BMA
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4978 (Published 31 December 2020)
Cite this as: BMJ 2020;371:m4978

NHS. Letter to chief executives of all NHS trusts and foundation trusts. 30 Dec 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/12/C0994-System-letter-COVID-19-vaccination-deployment-planning-30-December-2020.pdf.

NHS. Coronavirus (COVID-19) vaccine. When the 2nd dose will be given.

Daily Mail. Pfizer warns there is NO proof its Covid jab works when doses are taken 12 weeks apart as UK regulator scraps 21-day rule in desperate attempt to get millions more vaccinated. By Connor Boyd Assistant Health Editor For Mailonline
14:52, 30 Dec 2020 , updated 16:58, 30 Dec 2020

Statement from the UK Chief Medical Officers on the prioritisation of first doses of COVID-19 vaccines. Joint clinical advice from the 4 UK Chief Medical Officers on the prioritisation of first doses of the coronavirus (COVID-19) vaccines. Published 30 December 2020.

Priority groups for coronavirus (COVID-19) vaccination: advice from the JCVI, 30 December 2020. Advice from the Joint Committee on Vaccination and Immunisation (JCVI) on the groups that should be prioritised for vaccination.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Why do some people falsely believe COVID-19 is a hoax ?

It is quite difficult to give a single reason why some people believe COVID-19 is a hoax.

Since the coronavirus pandemic started, there has been so much anxiety, stress and severe disruption to the everyday life.

Most people like certainty with everyday life. Most people do not wake up and think that there is very very tiny chance I might die today (even though that’s true).

Thinking about bad things all the time can make you feel very stressed and exhausted . In a way, it is healthy NOT to focus on all the bad things that can happen everyday.

The daily bad news about Coronavirus pandemic can be very upsetting to some people, particularly if you cannot mentally switch off.

So some people mentally cope by believing the COVID-19 is fake news. Believing COVID-19 is a hoax helps some people to get on with their lives without being very fearful and worried everyday. It is a coping mechanism.

Unfortunately social media doesn’t help and lot of fake news sites tell people that it is no worse than a simple flu. (which is not true, COVID-19 is certainly much worse than simple flu).

It is true that only about 1% of people with COVID-19 die due to the disease. But if ten million people get infected in a country that means an extra 100,000 deaths. If the whole population of UK were to get the infection, theoretically it could mean at least an extra 500,000 deaths.

COVID-19 is particularly bad for old people . The risk of death is <1 per 10 000 for someone aged less than 30 but the risk is much higher for older age groups. For example, in men aged 80 or older, the risk of dying from COVID-19 is just over 1 in 10.

Be safe. Be aware.

Do trust the NHS website rather than a “friend of a friend” on social media.

References:

Guardian Newspaper. Doctors are our frontline against Covid. Now they lead the fight against its deniers, too
Gaby Hinsliff. Mon 4 Jan 2021 14.36 GMT

Newspaper headlines: ‘Lockdown 3′ and ‘race to vaccinate vulnerable’
By BBC News. 5 Jan 2021.

“Normal” risk and dangers of covid-19
Awareness of normal risk is not normal
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4121 (Published 29 October 2020)
Cite this as: BMJ 2020;371:m4121 https://www.bmj.com/content/bmj/371/bmj.m4121.full.pdf

Spiegelhalter D. Use of “normal” risk to improve understanding of dangers of covid-19. BMJ2020;370:m3259. doi:10.1136/bmj.m3259. pmid:32907857

Comparative evaluation of clinical manifestations and risk of death in patients admitted to hospital with covid-19 and seasonal influenza: cohort study. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4677 (Published 15 December 2020)
Cite this as: BMJ 2020;371:m4677

Infection fatality risk for SARS-CoV-2 in community dwelling population of Spain: nationwide seroepidemiological study
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4509 (Published 27 November 2020)
Cite this as: BMJ 2020;371:m4509. https://www.bmj.com/content/371/bmj.m4509

Office for National statistics. Population estimates for the UK, England and Wales, Scotland and Northern Ireland: mid-2019.

NHS Coronavirus (COVID-19). Get the latest NHS information and advice about coronavirus (COVID-19).

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and the authors views are not in way intended to be a substitute for professional advice.

Obesity kills but is losing weight in old age also risky ?

Losing weight is a New year resolution for many people. There is no doubt that having a normal weight is healthy overall.

But there is always some degree of uncertainty with any health advice and this BMJ paper certainly gives “food for thought”.

Before you read further , you have understand that there are varying degrees of being overweight. BMI ( Body mass index) is the scientific way of looking at body weight issues and it is calculated using height and weight.

Based on BMI, people are usually classified into three groups:

(a) underweight and normal weight (BMI<25)

b) overweight (BMI 25.0-29.9)

(c) obese (BMI ≥30.0)

There is no doubt that obesity is bad for health. The BMJ paper not supringly found obesity in adulthood increased the risk death.

But, intriguingly, just being overweight only without being obese does NOT seem to have MAJOR impact on risk of death in adults.

Paradoxically, the study found that “weight loss from middle to late adulthood was associated with increased risk of death”

It is large well designed study but nevertheless results of observational studies need to be interpreted with caution.

The message from this study is “do not gain excessive weight during early adulthood“. Losing the excessive weight later on might not undo the damage already done to the body.

References:

(1) Weight change across adulthood in relation to all cause and cause specific mortality: prospective cohort study.

BMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l5584 (Published 16 October 2019) Cite this as: BMJ 2019;367:l5584

(2) Free NHS calculator for BMI ( Body mass index calculation) and advice regarding Body mass index.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Does smoking cause Body pain ?

Yes. Smoking can cause body pain and make you miserable.

Smoking is bad for various obvious reasons including the risk of developing of cancer. As smoking can make you miserable with pain, it’s time to make a new year resolution to stop smoking.

A large study done in UK shows that current and ex-smokers have a higher degree of bodily pain.

The study involved 223,537 people who were surveyed between 2009 and 2013 by the British Broadcasting Corporation (BBC) Lab UK Study.

As it is such a big study, the conclusions do need to be taken seriously.

Definitely another reason for quitting smoking this new year !

Reference:

Associations between smoking status and bodily pain in a cross-sectional survey of UK respondents. Addictive Behaviors 102:106229 · December 2019. DOI: 10.1016/j.addbeh.2019.106229

Smokers past and present ‘live in more pain’ – BBC News

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Can a Vegan diet help weight loss?

Yes, Vegan diet can help weight loss.

Lot of diets promoted by Magazines, Social Media Influencers and Celebrities do not have strong scientific evidence in favour of them.

A scientifically sound trial published by the medical journal JAMA ( Journal of American Medical Association) recently, found the Vegan Diet helped weight loss and promoted Good metabolism.

The trial involving 244 participants found that over 16 weeks, body weight decreased on average by 5.9 kg in those having a Vegan Diet. That’s very impressive!

References: Effect of a Low-Fat Vegan Diet on Body Weight, Insulin Sensitivity, Postprandial Metabolism, and Intramyocellular and Hepatocellular Lipid Levels in Overweight Adults: A Randomized Clinical Trial
Hana Kahleova et al. JAMA Netw Open. 2020.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

New oral medication approved for Prostate Cancer

Advanced Prostate cancer can be successfully controlled for many years by hormone therapy.

Until now, the hormone therapy, which is widely used widely used, involved either hormone injections or hormone implants.

The FDA in USA has recently approved a new novel oral medication for prostate cancer. It acts quickly and has been proven to be highly active. It is taken as a daily oral medication. It is reasonably well tolerated.

It is not known when the medication would be approved in UK and Europe.

References

(1) NEJM. Oral Relugolix for Androgen-Deprivation Therapy in Advanced Prostate Cancer

(2) FDA approval. FDA approves relugolix for advanced prostate cancer.

(3) Information about Relugolix. FDA: HIGHLIGHTS OF PRESCRIBING INFORMATION. and FULL PRESCRIBING INFORMATION.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Will the existing COVID vaccines work against the new Coronavirus variant spreading in England ?

A new variant of Corona virus is spreading fast in England.

Some Hospitals in England are reportedly being swamped with COVID patients.

The whole world is placing their bets on vaccines to defeat the Coronavirus and emerge out of this dreadful pandemic.

Studies are ongoing about the effectiveness of vaccines against this new variant coronavirus. There is a risk that changes seen in the variant virus (mutations) might make it evade the vaccine shield.

So far, there has been no conclusive evidence that the variant virus will definitely escape the vaccines. Even if they do, the good news is that current vaccines can be adapted to deal with the changes in the virus.

Reference

(1) BBC News. New coronavirus variant: What do we know?. By James Gallagher
Health and science correspondent. Published 20 December 2020.

(2) BBC News. Newspaper headlines: ‘Vacc to the future’ and village hall jabs.

(3) Preliminary genomic characterisation of an emergent SARS-CoV-2 lineage in the UK defined by a novel set of spike mutations.

(4) Neutralising antibodies drive Spike mediated SARS-CoV-2 evasion.

(5). Covid-19: New coronavirus variant is identified in UK. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4857 (Published 16 December 2020)
Cite this as: BMJ 2020;371:m4857

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Is the COVID-19 Coronavirus Vaccine mandatory for everyone?

NO, it is not mandatory. The Government is NOT making it compulsory for everyone to have the vaccination. You have to give voluntary consent for Vaccination.

No one is being forced to have the COVID-19 vaccines.

In fact, there is a huge queue of people waiting to have the vaccine. The NHS capacity is limited at present and the NHS is trying the best to give vaccination to those people who are very keen to have it.

So, if you don’t want to have it, no one will force you to have it.

Once the waiting list for vaccination is cleared in early 2021, there might be some changes . If clinical trials show that vaccinated people do not carry virus and pass it to others, then the Government might change its guidelines.

For instance, health professionals working with sick and vulnerable people might be asked to have the vaccine so that they don’t pass the virus to vulnerable people under their care.

But it’s very unlikely vaccination would be made mandatory for General Public.

References

(1). Guidance. COVID-19: the green book, chapter 14a. Coronavirus (COVID-19) vaccination information for public health professionals.

(2). Guidance. COVID-19 vaccination: guide for healthcare workers. Updated 15 December 2020

(3) Form. COVID-19 vaccination: consent form and letter for adults

(4). Coronavirus (COVID-19) vaccination consent forms.

(5). Guardian Newspaper. NHS doctors ‘scrabbling’ to get vaccine amid alarm at Covid variant. Many medics ‘frustrated’ about low priority given to frontline staff at high risk of infection. Denis Campbell Health policy editor
Sun 27 Dec 2020 20.46 GMT

(6). PHE. Guidance. Why you have to wait for your COVID-19 vaccine. Published 7 December 2020

(7). Guardian. Coronavirus. Spain will register people who refuse Covid vaccine, says health minister. Ashifa Kassam in Madrid. Tue 29 Dec 2020 14.33 GMT

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Is the COVID-19 Coronavirus vaccine safe for use in patients having chemotherapy and immunotherapy?

Yes, the available indirect evidence indicates that the anticipated benefits overweigh the potential risks.

Cancer patients, particularly those on chemotherapy have compromised immune systems and hence more vulnerable to COVID-19 Coronavirus complications.

The guidelines indicate that anticipated benefits of vaccine are greater than unknown risks from the Coronavirus vaccines.

The Vaccine trials deliberately included lot of healthy people. Very few people with cancer, particularly cancer patients on active treatment, were included in the COVID-19 trials. So there is not much direct evidence regarding efficacy and safety of Vaccines in cancer patients. But indirect evidence significantly favours Coronavirus vaccination in cancer patients.

Flu vaccines are regularly used in cancer patients without any major side effects specific to cancer patients. No increase in incidence or severity of drug side effects were seen in immunotherapy patients having flu vaccines.

On balance, Vaccination is most likely to be of utmost benefit for most advanced cancer patients on active treatment.

References:

ESMO STATEMENTS FOR VACCINATION AGAINST COVID-19 IN PATIENTS WITH CANCER.

Guidance: COVID-19: the green book, chapter 14a
Coronavirus (COVID-19) vaccination information
for public health professionals. (UK),

Cochrane: Influenza (flu) vaccination for preventing influenza in adults with cancer

Safety of Inactivated Influenza Vaccine in Cancer Patients Receiving Immune Checkpoint Inhibitors
Curtis R Chong et al. Clin Infect Dis. 2020.

ESMO: CANCER PATIENT MANAGEMENT DURING THE COVID-19 PANDEMIC.

Kuderer NM Choueiri TK Shah DP et al.
Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020; 395: 1907-1918

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.
The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Is the new vaccine against COVID-19 causing CoronaVirus safe and effective ?

Yes, the available short term data indicates the vaccine is safe and effective in vast majority of people.

The big unknown is the long term efficacy and side effects.

Normally medicine progresses slowly and carefully like a big train turning slowly on sharp uphill bend .

But due to pandemic emergency, the vaccines are being introduced to the the general public more more earlier than it would have done, well before availability of more mature data.

Long term, there are some uncertainties. For instance, there is a possibility of loss of efficacy if vaccine effect is not long lasting. But there is no evidence to suggest at present this would happen. As regards long term side effects, once more data is collected and more patients are followed up after vaccination, there will more mature data on side effects.

The available data suggests that very high groups who are a high risk of death from COVID , have good odds of benefitting from vaccine.

The trial data published so far, UK Medicine regulator conclusions , Pfizer data sheet and UK govt Guidelines has been positive so far.

It may be that low risk groups such as people in 20s, who have less chance of dying from COVID, may opt for more long term data before having the vaccination.

References:

NHS Coronavirus (COVID-19) vaccine

MHRA Regulatory approval of Pfizer / BioNTech vaccine for COVID-19

Information for UK recipients on Pfizer/BioNTech COVID-19 vaccine. Updated 16 December 2020.

Information for Healthcare Professionals on Pfizer/BioNTech COVID-19 vaccine. Updated 16 December 2020.

Public Health England. COVID-19 vaccination programme. Information for healthcare practitioners. Published December 2020. Version 2.1

The Green book chapter 14a COVID-19-SARS-Cov-2.

PHE. Confirmation of guidance to vaccination centres on managing allergic reactions following COVID-19 vaccination with the Pfizer/BioNTech vaccine. 9/12/2020.

British Society for Rheumatology. Guidance for COVID-19 vaccinations.

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.


The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.

Is the new variant of Coronavirus more dangerous?

Yes and No

The new mutant is more dangerous because it is more easily transmissible from person to person. The new variant is now spreading very rapidly in London and South East of England.

But, so far, the new variant has NOT been found to be more deadly than the original version. The new variant does NOT seem to have substantially increased the risk of hospitalisation and death anymore than the original version of coronavirus.

Emergence of this new mutant (called variant VUI-202012/01 fall) is a certainly a worrying development in this pandemic.

The mutations has made the new strain 70 per cent more transmissible but scientists do not expect these mutations to reduce the effectiveness of vaccines.

Tests are being carried out to confirm that the existing vaccines would still have a high degree of protective affect.

It is an evolving area and we have to hope that the new variant doesn’t make things worse than they are now !

Covid-19: New coronavirus variant is identified in UK. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4857 (Published 16 December 2020)
Cite this as: BMJ 2020;371:m4857

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The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.