Pfizer COVID Vaccine: How much efficacy is lost every month?

COVID vaccines lose some efficacy over time.

How much ?

Pfizer vaccine has been reported to lose, on average, about 3% efficacy every month.

An updated trial report of the Pfizer vaccine says that “ Pfizer vaccine efficacy decreased from 96% to about 84% over 4 months.

The results of this study certainly indicates that booster vaccines are needed for the winter months to prevent another wave of deaths.

References

BMJ News. Covid-19: Pfizer vaccine’s efficacy declined from 96% to 84% four months after second dose, company reports
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1920 (Published 30 July 2021)Cite this as: BMJ 2021;374:n1920

BMJ News. Covid-19: Millions could be offered booster vaccinations from September
BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1686 (Published 02 July 2021)
Cite this as: BMJ 2021;374:n1686

Thomas SJ, Moreira ED Jr., Kitchin N, et al. Six month safety and efficacy of the BNT162b2 mRNA covid-19 vaccine.medRxiv2021 [Preprint].

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 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 personal 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 that the author is associated with. The views expressed in this blog are NOT, in way whatsoever, intended to be a substitute for professional advice.

Do face masks prevent COVID illness ?

Yes, good masks may help to reduce infections that are spread by airborne particles.

But not all masks are the same.

Cloth masks were promoted during 2020 when the proper surgical masks were in short supply . The effectiveness of cloth masks are not well studied and they are of varying quality depending who made them and how well they were made.

Properly manufactured surgical masks are better than home made cloth masks. But how much protection they can offer is a matter of scientific debate. Surgical masks have been found to give some protection against other respiratory viruses in past. But a recent Danish study found no significant benefit against COVID among the general public.

The high quality FFP3 masks which filter most of the inhaled air is superior to normal surgical masks. A recent study from Cambridge found that Heath care workers who used FFP3 masks had better protection from COVID compared to normal surgical masks in the Hospital.

Overall, clean, well manufactured masks are likely to of some benefit to the public rather than wearing no masks at all. In the hospital setting, FFP3 masks seem to provide superior protection to Health care staff working with COVID patients.

And most importantly people have to understand that masks are not to be used alone. Masks got to be used along with protective measures such as social distancing and Hand-washing.

References

CLOTH MASKS

BMJ. Covid-19: What is the evidence for cloth masks? BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1422 (Published 07 April 2020)
Cite this as: BMJ 2020;369:m1422

DANISH STUDY- SURGICAL MASKS

Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers : A Randomized Controlled Trial
Henning Bundgaard et al. Ann Intern Med. 2021 Mar.

BMJ. Danish mask study: masks, media, fact checkers, and the interpretation of scientific evidence. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4919 (Published 23 December 2020)
Cite this as: BMJ 2020;371:m4919

BMJ. The curious case of the Danish mask study
BMJ 2020; 371
doi: https://doi.org/10.1136/bmj.m4586 (Published 26 November 2020)
Cite this as: BMJ 2020;371:m4586

Daily Mail. Face masks do NOT protect the wearer from coronavirus, but will stop them from infecting other people, Danish study finds. By Mary Kekatos Senior Health Reporter For Dailymail.com and Reuters
15:26, 18 Nov 2020 , updated 18:02, 20 Nov 2020

Spectator (magazine) https://www.spectator.co.uk/article/do-masks-stop-the-spread-of-covid-19-

Full fact.org. Danish study on mask efficacy only tells us half the story. 24 NOVEMBER 2020

Forbes. Lead Researcher Behind Controversial Danish Study Says You Should Still Wear A Mask
Leah Rosenbaum. Forbes Staff 18 Nov 2020. Critics of mask-wearing policies used a Danishstudy on mask-wearing to bolster their claims such policies are ineffective, but scientists, including those involved with the study, disagree.

JAMA Insights
February 10, 2021
Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2
John T. Brooks, MD1; Jay C. Butler, MD1
Author Affiliations
JAMA. 2021;325(10):998-999. doi:10.1001/jama.2021.1505

CAMBRIDGE REPORT ON HIGH QUALITY MASKS

BMJ. Covid-19: Upgrading to FFP3 respirators cuts infection risk, research finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1663 (Published 29 June 2021)
Cite this as: BMJ 2021;373:n1663. https://www.bmj.com/content/373/bmj.n1663

BBC news. Covid: Masks upgrade cuts infection risk, research finds
By David Shukman
Science editor

Guardian. Cambridge hospital’s mask upgrade appears to eliminate Covid risk to staff
Hospital infection study shows use of FFP3 respirators at Addenbrooke’s ‘may have cut ward-based infection to zero’
Nicola Davis and Denis Campbell
Tue 29 Jun 2021 10.49 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 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 that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

Some good news amid the doom and gloom: People have Longer immunity to Coronavirus infection after recovering from it.

After someone has recovered from a Coronavirus infection, the body remembers how to fight the virus in future. This is called immunity and it is not known how long this immunity will last.

If the immunity is not long lasting, people can get coronavirus infection again during the second and even third wave.

The body’s immunity is made up of two types of cells: B cells and T cells. T cells and B cells are central to the human immune system.

B cells produce antibodies and previously in various studies , they were found to decline rapidly give rise to fear that people would get Coronavirus infection again and again.

Now a study has reported that T cell immunity can last more than 6 months in patients who have recovered from an infection.

This news is also good from a vaccine point of view. It gives us hope that sooner or later an effective vaccine would become available.

BMJ News.
Covid-19: T cell response lasts for at least six months after infection, study shows
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4257 (Published 02 November 2020)
Cite this as: BMJ 2020;371:m4257

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.

If you survive the Coronavirus, Can you get Coronavirus infection again ?

Yes, you can get infection again.

Last month, we had studies reporting that the immunity to Coronavirus fades quickly after recovering from an infection. The scientists have warned that re-infection is a risk.

Now, we have a case in Hong Kong where a patient seem to have been unlucky to get the infection again. It is a worrying report and suggests that coronavirus is going to be with us for a long time.

The only reassuring fact is that patient was free of symptoms during second infection. One has to hope that all re-infections are mild !

References

1. Sundar.blog. CAN YOU GET CORONAVIRUS INFECTION MORE THAN ONCE?

2. BBC. Hong Kong reports ‘first case’ of virus reinfection.

3. Clinical Infectious Diseases : report on twitter.

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 publication 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.

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

Yes. Possible but chances are very small according to reports.

If someone sneezed or coughed near a parcel or food package and you touch it within a few hours, it is possible to get Coronavirus infection from parcels and packages.

But, in practice, most parcels and food packaging seem safe and no conclusive real world evidence has been published so far to indicate that packages spread infection widely.

In experimental conditions, Coronavirus has been shown to survive for upto 72 hours. The virus is “more stable on plastic and stainless steel than on copper and cardboard”.

In laboratory conditions “On copper, no viable SARS-CoV-2 virus was measured after 4 hours . On cardboard, no viable SARS-CoV-2 virus was measured after 24 hours”.

In the artificial conditions of the lab “The longest viability of viruses was on stainless steel and plastic; the estimated median half-life of SARS-CoV-2 virus was approximately 5.6 hours on stainless steel and 6.8 hours on plastic”.

Solution: If you are worried , and if possible, you can try leaving parcels for 24hrs before touching them with bare hands. Alternatively, try wearing disposable gloves to remove packaging.

References

1.NEJM. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. April 16, 2020. N Engl J Med 2020; 382:1564-1567. DOI: 10.1056/NEJMc2004973

2. BBC. Coronavirus: What are the risks of catching it from food packaging?

3. CDC. How It Spreads.

Is Honey a better treatment for coughs and colds ?

Possibly yes, in some cases of viral infections , according to a paper published a BMJ group journal ( BMJ Evidence Based Medicine) .

The paper has been widely quoted in various newspapers today.

The BMJ group journal authors report: “Honey was superior to usual care for the improvement of symptoms of upper respiratory tract infections.

It provides a widely available and cheap alternative to antibiotics…….but further high quality, placebo controlled trials are needed.”

A word of caution: Honey has high sugar content. Diabetics need to be careful. People will allergies need to take care. Of course bacterial infections need antibiotics particularly in old and vulnerable!

References

1. BMJ Evidence Based Medicine. Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis .

Abuelgasim H, Albury C, Lee J Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis BMJ Evidence-Based Medicine Published Online First: 18 August 2020. doi: 10.1136/bmjebm-2020-111336.

2. Guardian Newspaper:

3. Daily Mail.

4. BBC paper review .

5. Evening Express

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 publication 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.

Can you get Coronavirus infection more than once?

If you are one of the unlucky ones to have already been infected with Coronavirus infection but recovered from it, can you become unlucky again and get another Coronavirus infection later this year ?

Unfortunately, the answer is a YES.

Some Viral infections can sometimes lead to life long immunity. For example, most people who had chicken pox as a child tend to have lifelong immunity and it would be uncommon to get chicken pox again. (except in some circumstances).

But infection with ‘Coronavirus causing COVID-19’ doesn’t seem led to long lasting immunity or resistance to a second Coronavirus infection.

A Newspaper report on a study by a team from King’s College London suggests that susceptibility to a second infection may occur as short as 3 months in some patients. This because the level of antibodies produced by the immune system after first infection start to fade away within a few months in some patients.

If confirmed, this is probably one of the most worrying news during this pandemic.

This study result could also affect Vaccine development and how frequently it may need to be administered.

References

Guardian Newspaper: Coronavirus outbreak. Immunity to Covid-19 could be lost in months, UK study suggests. Ian Sample. Science editor. @iansample. Sun 12 Jul 2020 17.31 BST

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 publication 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.

Can Coronavirus linger in air, and cause COVID-19 by spreading through air ?

Normally many flu-like viruses spread by direct or close contact.

Because Virus containing droplets are heavier than air, scientifically it is thought that when someone coughs or sneezes, virus particles quickly fall to ground or surrounding objects.(“like a brick or stone falling to ground“).

But a group of scientists and WHO have raised the possibility that coronavirus can stay in air for longer periods, float around and cause more infections. (“float like a balloon“). This is called air-borne transmission.

What does it mean?

If confirmed– this means “closed spaces” are high risk even if you maintain 2 metre distance from an infected person. AVOID CLOSED SPACES.

As many people in UK do not wear masks in public places, there is a high chance of second wave of infections in the coming weeks as lock down is eased. WEAR A MASK.

It also means avoiding non-essential visitors to hospitals so that visitors cannot catch the infection or pass the infection to vulnerable patients. AVOID NON-ESSENTIAL VISITORS AT HOSPITALS.

If air borne transmission is confirmed, it is also bad news for the coming winter.

If Coronavirus is still in community and not eliminated by winter, air-borne transmission is likely to result in further wave of infections.

This is because Winter means more closed spaces and more chance of infection !!!!!!

STAY SAFE

References

1. Daily Mail Newspaper. Group of 239 scientists demand that WHO admit coronavirus is AIRBORNE -meaning the public should wear masks indoors and AC units should be fitted with filters .By Ariel Zilber For Dailymail.com and Reuters and Associated Press. 17:44, 05 Jul 2020 , updated 08:14, 06 Jul 2020

2. Guardian Newspaper. WHO underplaying risk of airborne spread of Covid-19, say scientists. Open letter says there is emerging evidence of potential for aerosol transmission. Hannah Devlin. Science correspondent. @hannahdev

3. Guardian Newspaper. Coronavirus outbreak Global report: WHO says ‘evidence emerging’ of airborne coronavirus spread. Martin Farrer and agencies.

4. BBC News. Coronavirus: WHO rethinking how Covid-19 spreads in air.

5. It is Time to Address Airborne Transmission of COVID-19. Lidia Morawska, Donald K Milton. Clinical Infectious Diseases, ciaa939, https://doi.org/10.1093/cid/ciaa939. Published: 06 July 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 publication 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.

Health effects of vitamin and mineral supplements

In Western countries, upto two thirds of people take vitamin and mineral supplements regularly.

Many people think it’s common sense to take supplements. Many people don’t realise mega doses of vitamins can cause harm. Paradoxically the people who don’t have a healthy diet are less likely to supplements than those who have a well balanced diet.

A recent article in BMJ reviews the evidence regarding “Health effects of vitamin and mineral supplements” and concludes that “Randomised trial evidence does not support use of vitamin, mineral, and fish oil supplements to reduce the risk of non-communicable diseases”.

This article is certainly a “food for thought”

Reference

Food for Thought 2020. Health effects of vitamin and mineral supplements. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2511 (Published 29 June 2020). Cite this as: BMJ 2020;369:m2511

Skeie G, Braaten T, Hjartåker A, et al. Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study. Eur J Clin Nutr2009;63(Suppl 4):S226-38. doi:10.1038/ejcn.2009.83 pmid:19888276

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 publication 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 Chloroquine useful in treatment of Corona Virus?

Chloroquine and the related drug Hydroxy-Chloroquine are drugs commonly used to prevent and treat Malaria infections; and treat some Joint conditions.

During the initial stages of COVID-19 pandemic, there were some reports of Chloroquine being useful in treating Corona Virus.

A Chinese trial published in British Medical Journal BMJ now reports that ” Administration of hydroxychloroquine did not result in …. any meaningful antiviral benefits… compared to standard of care alone in patients admitted to hospital with mainly persistent mild to moderate covid-19

Chloroquine was not only useless but it had significant side effects in a minority. So Chloroquine or Hydroxy-Chloroquine should not be used routinely outside a clinical trial setting.

References

1. Hydroxychloroquine (HCQ). Wiki. https://en.m.wikipedia.org/wiki/Hydroxychloroquine

2. BMJ. Chloroquine and hydroxychloroquine in covid-19. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1432 (Published 08 April 2020)

3. Hydroxychloroquine in patients with mainly mild to moderate coronavirus disease 2019: open label, randomised controlled trial. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1849 (Published 14 May 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 publication 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.