Are many NHS staff reluctant to have COVID-19 vaccines?

June 2, 2021June 1, 2021

No !

Vast majority of health care workers already had the COVID vaccine. Only a small minority have vaccine hestitancy.

A recent study found that about 90% of staff had at least one dose of the vaccine within 2 months of vaccine roll out. That is very impressive.

This study ( published in Lancet Journal) found that vaccines are very effective in reducing infections.

But the study also showed what we know already. Vaccination does not give 100% protection.

Everyone, in particular, health care staff need to continue with other COVID precautions such as masks, distancing and regular washing as advised by Government.

Reference: COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): a prospective, multicentre, cohort study. Published:April 23, 2021 DOI: https://doi.org/10.1016/S0140-6736(21)00790-X

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.

Should NHS staff be forced to have COVID-19 vaccines?

June 1, 2021May 30, 2021

U.K. Government vaccine minister announced over weekend that compulsory COVID vaccinations are being considered for NHS staff.

Majority of NHS staff believe in the vaccine and so it is not an issue for most NHS staff. But a small minority of staff are either sceptical or they have some other reasons why they were not able to have the vaccine.

Should those NHS staff be forced to have COVID-19 vaccines?

It is a tough question. Compulsory vaccines have caused huge backlash in past among the general population as well as among some in medical profession.

On the other hand, Vaccination against Hepatitis is already mandatory for NHS surgeons and this is not a new thing.

The vaccination of staff is not only for personal protection but also to prevent NHS staff spreading infection to vulnerable patients.

For instance, many patients recently caught COVID in hospitals. Both Guardian and Daily Mail report that up to 8,700 patients died after catching Covid in English hospitals.

Usually, NHS workers as individuals are allowed to make their own choice particularly with regards to annual flu vaccines.

But during this pandemic, NHS has to balance individual choice against the greater good to the population.

There are no easy answers !

References

Metro. Covid vaccine could become compulsory for NHS staff.

Daily Mail. Jabs for jobs: NHS workers will be legally required to have Covid vaccinations under new plans with up to one in five health staff in some areas still unvaccinated. By William Cole For Mailonline
15:36, 30 May 2021 , updated 17:38, 30 May 2021

RCN. RCN position on mandating vaccination for health and social care staff. 15 April 2021.

BBC news. The anti-vaccination movement that gripped Victorian England
By Greig Watson
BBC News
Published 28 December 2019.

Anti-compulsory vaccination league. Br Med J 1867;1:264–73. doi: https://10.1136/bmj.1.323.264

BMJ. COMPULSORY VACCINATION
Association Medical Journal 1853; s3-1 doi: https://doi.org/10.1136/bmj.s3-1.10.224-a (Published 11 March 1853)
Cite this as: Association Medical Journal 1853;s3-1:224

Guardian. Up to 8,700 patients died after catching Covid in English hospitals.
Denis Campbell and Anna Bawden
Mon 24 May 2021 17.50 BST

Daily Mail. Nearly 9,000 patients died after catching Covid on English hospital wards while being treated for something else. By Connor Boyd Assistant Health Editor For Mailonline
19:00, 24 May 2021 , updated 19:06, 24 May 2021

Have People died after COVID-19 vaccines ?

May 30, 2021May 29, 2021

Yes, people have died after having COVID-19 vaccines.

Recently, a BBC Radio Newcastle presenter, Lisa Shaw was reported to have died after the Astra Zeneca COVID vaccine. Her family is blaming the COVID vaccine for causing clots and ultimately her death.

In India, a Popular Tamil actor and comedian died within 48 hours of receiving a COVID vaccine. His vaccination was broadcast live on TV to encourage public uptake of vaccination but his unfortunate death after vaccination probably ended up causing vaccine hesitancy in some people.

A news article in BMJ reports that the “Pfizer-covid-19 vaccine is “likely” to have been responsible for at least 10 deaths of frail elderly people in nursing homes in Norway”.

But, the most important thing to remember is that deaths are rare after COVID-19 vaccines.

Yes, there are true distressing accounts of vaccine side effects. But what you do not hear is the benefit most people have from vaccines.

Millions of people received vaccines so far with vast majority having no major side effects.

Consider this for context. Think about plane accidents. Millions of people travel by plane without any problems. If People fly safely and reach their destination, it is not headline news. People do not go around saying that they have traveled safely by plane and that they are alive !

But a aeroplane accident which happens rarely is front page news. It would be all over the 24 hour TV news channels across the world. Plane accidents are utterly and unimaginably devastating for those individuals and families involved. But the rare plane accidents do not make most other people avoid flying. The accidents do not mean that no one should travel by plane. The travel by planes has far more benefits than risks for majority of population.

Same with COVID vaccines. Serous Side effects are headline news even if they are very uncommon and rare. The available data indicate benefits are much greater than risks.

So think carefully before you refuse a vaccine.

References

Guardian. Lisa Shaw death: BBC presenter had blood clots after AstraZeneca jab, family says
(Radio Newcastle broadcaster had severe headaches a week after vaccine and fell seriously ill days later, relatives say).
Lisa Shaw
Lucy Campbell
Thu 27 May 2021 18.36 BST

BMJ. News. Covid-19: Pfizer-BioNTech vaccine is “likely” responsible for deaths of some elderly patients, Norwegian review finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1372 (Published 27 May 2021)
Cite this as: BMJ 2021;373:n1372

BMJ. Research. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1088 (Published 13 May 2021)
Cite this as: BMJ 2021;373:n1088

BMJ. News. Covid-19: Risk of cerebral blood clots from disease is 10 times that from vaccination, study finds
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1005 (Published 16 April 2021)
Cite this as: BMJ 2021;373:n1005

Vaccine Hesitancy

May 29, 2021May 29, 2021

Worries about vaccines are nothing new. Anti_vaccination groups were formed in 1860s when small pox vaccination was made compulsory. Even when small pox was causing untold devastation, some people were opposed to it.

The Vaccine hesitancy of 19th century is somewhat excusable. Some of the worries were real, and not much was known about the safety of small pox vaccine at that time. Lot of people were ill-informed and did not have access to good sources of information. They didn’t know the immense potential of the vaccination to eliminate distressing diseases.

Vaccines have now successfully eradicated small pox. Many other devastating infectious diseases such as polio have been controlled in many countries across the globe due to the vaccines.

Some of the vaccine hesitancy in west is because western people are not fully aware of the devastating power of infectious diseases (at least until COVID-19 came to the world in 2020).

Vaccine hesitancy is also sustained by “confirmation bias” . Confirmation bias is the tendency of human beings to seek information that confirms what they believe in. If you distrust vaccines, you go looking for information that confirms you beliefs and you disregard information that proves vaccines are hugely beneficial.

Some people wish for a 100% safe vaccine. But there is no such thing as completely risk free vaccine. It is true Vaccines can cause serious side effects. It is true that Vaccines can cause long term side effects. It is true that Vaccines can rarely cause life threatening side effects and even deaths.

It is normal to worry about side effects of vaccines. But the potential for side effects should not be the reason to decline vaccination.

One has to look at benefits as well as risks. Some people focus on everything bad that can happen as a result of vaccines.

COVID-19 vaccines had an unusually short development period. This is because of the pandemic. The available evidence indicate that the benefits of the vaccines are far greater than risks. It is true that there is no long term safety data. But in the middle of a pandemic, which has caused untold misery to millions, waiting for perfect long term data is not an option.

If you are sceptical about vaccines, please do focus on benefits as well as risks. Do not focus on risks only.

References

BMJ. Practice Pointer. Covid-19 vaccination hesitancy. BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1138 (Published 20 May 2021)
Cite this as: BMJ 2021;373:n1138

BMJ. News. Covid-19: Pfizer-BioNTech vaccine is “likely” responsible for deaths of some elderly patients, Norwegian review finds.
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1372 (Published 27 May 2021)
Cite this as: BMJ 2021;373:n1372

Is PTSD over diagnosed?

May 26, 2021September 3, 2021

Some Soldiers from world war one, suffered from what is then known as “shell shock”

“Shell Shock” would have been very devastating when there was less recognition of that condition.

Fast forward a few decades, a committee of wise men and women, relabelled the condition as “Post Traumatic stress disorder” (PTSD)

The criteria for diagnosis of PTSD is much wider and all encompassing, with inclusion of trauma from road accidents and crime as well as indirect exposure to trauma through professional attendance at a crime scene or site of an accident.

There is concern whether PTSD is now over-diagnosed. There is a debate at the BMJ journal. Please do read my views and submit your views through the rapid response section.

References:

BMJ Head To Head.
Is PTSD overdiagnosed?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n787 (Published 05 May 2021)
Cite this as: BMJ 2021;373:n787

S Sundar. Rapid Response: Over diagnosis hurts those most in need.

U.K. approach to vaccination proven to be the right one. Is it Luck or Foresight?

May 25, 2021May 23, 2021

UK government wanted as many people have “some” degree of protection against the COVID-19 rather a only few people having “full” protection against COVID-19.

A recent paper published in BMJ validates the U.K. approach even though it was initially criticised by WHO ( world health organisation)..

Is it Luck or Foresight that U.K. Govt got it right? Probably both but more foresight than luck. Perhaps a cappuccino cup of foresight sprinkled with chocolate of luck.

Guardian. No data to support UK delay of vaccines’ second dose, says WHO.
Sarah Boseley Health editor
Tue 5 Jan 2021 19.48 GMT

Daily Mail. UK should feel ‘vindicated’ over its ‘brave’ decision to delay second doses of Covid vaccines, World Health Organization official says. By Sam Blanchard Deputy Health Editor For Mailonline. 13:29, 08 Feb 2021 , updated 15:03, 08 Feb 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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Should chemotherapy be used before radiotherpy for bladder cancer?

May 24, 2021May 23, 2021

Yes, chemotherapy given before surgery or radiotherapy for invasive bladder cancer improves cure rates and survival rates.

But there is also strong U.K. data to show that Chemotherapy given along with Radiotherapy is useful because it makes radiotherapy work better .

Should chemotherapy be given before radiotherapy and then followed by more chemotherapy along with radiotherapy ?

There is lot of scientific debate on this question and well known U.K. experts are favouring this “double chemo” approach in-spite of inconclusive new data published in the European Urology journal.

The NICE guidelines on bladder cancer also favours this approach of “double” chemotherapy ( before as well as along radiotherapy).

It is a question that ideally needs to addressed in clinical trials .

Read my views expressed in a letter published in the Journal European Urology

Reference: Re: Syed A. Hussain,
Nuria Porta, Emma Hall, et al. Outcomes in Patients with Muscle-invasive Bladder Cancer Treated with Neoadjuvant Chemotherapy
Followed by (Chemo)radiotherapy in the BC2001 Trial. Eur Urol 2021;79:307–15

How effective are the COVID vaccines against the new Indian variant?

May 23, 2021May 23, 2021

Everyone in U.K. hoped that we have turned the corner with this pandemic after the recent spike in infection from the Kent Variant,

But now comes the Variant from India. (the scientific name is B1.617.2 variant of concern).

The Indian variant appears to be more transmissible but no evidence yet that the Indian variant is inherently more deadly than the Kent variant.

Naturally, we are in a better place now than last year because of the vaccination.

But there is some evidence that spontaneous changes (mutations) in the B.1.617.2 variant virus may make it partially resistant to antibodies produced by vaccines.

So how effective are the current vaccines against this Variant from India?

Lab testing shows that the current vaccines can be still effective against the Indian variant but may not be highly effective as it is against the Kent/U.K. variant.

PHE data shows that after two doses, Pfizer vaccine is 88% effective against Indian variant compared to 93% effectiveness against the Kent strain.

After two doses, AstraZeneca jab is 60% effective against Indian variant compared to 66% effectiveness against the Kent variant.

But after the first dose, both vaccines were only 33% effective against Indian variant compared to around 50% efficacy against the Kent strain.

The vaccine protection is better with two doses of vaccine and that’s why the Govt is speeding up second vaccine dose in affected areas.

Fingers crossed, hope this strategy works !

References

BMJ. Covid-19: Caution urged while lockdown eases in England because of vaccine success
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1203 (Published 11 May 2021)
Cite this as: BMJ 2021;373:n1203

BMJ News Covid-19: UK cases of variant from India rise by 160% in a week
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1315 (Published 21 May 2021)
Cite this as: BMJ 2021;373:n1315

U.K. Govt. Most vulnerable offered second dose of COVID-19 vaccine earlier to help protect against variants. From: Department of Health and Social Care. Published 14 May 2021

Telegraph: Two doses of AstraZeneca vaccine provide over 80 per cent protection against Indian variant, PHE study finds.

Guardian. India Covid variant: is it a threat to the UK’s reopening plans?
Ian Sample Science editor
@iansample
Fri 14 May 2021 11.19 BST

Daily Mail. UK is in a ‘very good position’ against Covid variants as Pfizer says there is NO proof current jab needs updating to fight mutant strains. By Luke Andrews Health Reporter For Mailonline
16:30, 10 May 2021 , updated 18:12, 10 May 2021

Daily Mail. How deadly is India’s Covid variant and is it REALLY behind explosion of cases? Scientists say ‘perfect storm’ fuelled nation’s crisis and mutant strain just had a ‘head-start’ – as study shows vaccines DO work against it. By Connor Boyd Assistant Health Editor For Mailonline
16:26, 27 Apr 2021 , updated 08:17, 28 Apr 2021

Collier, DA et al. SARS-CoV-2 B.1.1.7 sensitivity to mRNA vaccine-elicited antibodies. Nature; 11 March 2021; DOI: 10.1038/s41586-021-03412-7

BBC. What is the India Covid variant and will vaccines work?
Soutik Biswas
India correspondent

BBC. Covid: Increasing confidence jabs work against Indian variant
By Doug Faulkner
BBC News

ONS. Coronavirus (COVID-19) Infection Survey, UK: 21 May 2021 (“early signs of a potential increase in the week ending 15 May 2021”)

BBC. Covid: Pfizer and AstraZeneca jabs effective against Indian variant – study
By Dulcie Lee
BBC News

How effective is a single dose of Pfizer and AstraZeneca vaccine?

May 22, 2021May 22, 2021

UK government wanted as many people have “some” degree of protection against the COVID-19 rather a only few people having “full” protection against COVID-19.

So the U.K. government delayed the second dose of Covid vaccine for 12 weeks.

Some people have now been offered two vaccines but still there are many people who were yet to have the second dose. They would be wondering how effective a single dose of the vaccine is. How much protection they have now.

A recent paper published in BMJ provides very encouraging news .

With Pfizer vaccine, vaccine effectiveness reached 61% after 4 to 5 weeks of the first dose.

With AstraZeneca vaccine, vaccine effectiveness reached 73% after 5 weeks of first dose.

This data is very reassuring

But the data also stresses the importance of having the second dose for further protection.

Please do make a note that (a) vaccines do take a few weeks to be become effective after the first dose (b) no vaccine is 100% effective and (c) we also do not know how long this protection from vaccine will last.

BMJ. Effectiveness of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on covid-19 related symptoms, hospital admissions, and mortality in older adults in England: test negative case-control study
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1088 (Published 13 May 2021)
Cite this as: BMJ 2021;373:n1088

BMJ. Public health impact of delaying second dose of BNT162b2 or mRNA-1273 covid-19 vaccine: simulation agent based modeling study
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1087 (Published 12 May 2021)
Cite this as: BMJ 2021;373:n1087

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 the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

Can Mistletoe control cancer?

May 17, 2021May 1, 2021

Photo by Pixabay on Pexels.com

No, there is no good clinical evidence to show that Mistletoe therapy improves life expectancy or quality of life of cancer patients.

Laboratory studies have indicated that Mistletoe might have some clinical activity. But activity seen in lab setting is not good enough for using it in actual patients.

The popularity of mistletoe extracts continues unabated despite their unproven efficacy in oncology.

The clinical evidence does not support use of Mistletoe as a standard therapy for cancer.

Mistletoe is best used as Christmas decoration only !

References:

1. Mistletoe and cancer: controversies and perspectives. Patrick J Mansky. Semin Oncol. 2002 Dec.

2. Is Mistletoe Treatment Beneficial in Invasive Breast Cancer? A New Approach to an Unresolved Problem. Peter Fritz et al. Anticancer Res. 2018 Mar.

3. Molecular mechanisms of mistletoe plant extract-induced apoptosis in acute lymphoblastic leukemia in vivo and in vitro. Georg Seifert et al. Cancer Lett. 2008.

4. From ill-defined extracts to the immunomodulatory lectin: will there be a reason for oncological application of mistletoe?H J Gabius et al. Planta Med. 1994 Feb.

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.

New treatment for Cervical cancer

May 15, 2021May 16, 2021

Advanced Cervical cancer which has come back after surgery or radiotherpy is usually treated with chemotherapy.

There is a new immunotherapy treatment option for all advanced cervical cancer patients now .

At the European Society of Medical Oncology (ESMO 2021) virtual conference, an international team of investigators, presented trial data regarding this new immunotherapy drug called cemiplimab.

One group of patients in the trial received the immunotherapy drug cemiplimab every 3 wks and another group of patients received intravenous chemo (pemetrexed, vinorelbine, gemcitabine, irinotecan or topotecan).

Cemiplimab significantly improved survival of patients and was better than chemotherapy.

This new immunotherapy drug cemiplimab is already being used for skin cancers and vulval skin cancers. Very soon, it would be used in cervical cancer patients.

Reference

ESMO 2022 Virtual Plenary Resources:
RANDOMISED PHASE III TRIAL DATA ON THE EFFICACY AND SAFETY OF CEMIPLIMAB AS OPPOSED TO CHEMOTHERAPY IN PATIENTS WITH PROGRESSIVE ADVANCED CERVICAL CANCER. Presenter: Krishnansu S. Tewari, USA; Discussant: Mansoor Mirza, Denmark;

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Delaying second vaccine dose leaves cancer patients vulnerable to coronavirus

May 15, 2021May 15, 2021

How effective is a single dose of Pfizer Vaccine in cancer patients?

Single dose is not very effective in cancer patients.

An UK study has now been peer reviewed and published in the esteemed Lancet oncology journal. The study showed inadequate protection after first dose.

More than half of the cancer patients receiving a single dose of the Pfizer COVID-19 vaccine have been left with little protection against the virus.

Two doses are critical and the second booster ideally need to be given on time at 21days.

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Here we go again – another new variant that can derail the plans to return to normality in U.K.

May 14, 2021May 14, 2021

The UK is coming out of lockdown and the infection rates, hospital admissions and deaths are reassuringly low.

The vaccination rates are rapidly going up and understandably many people are hoping for some sort of normality very soon.

But a new variant has been detected across the country. The scientists are worried about this new variant of coronavirus- called India variant. This variant can derail government plans in UK.

The current vaccines seem to offer somewhat less protection against this new variant . If this variant takes a strong foothold in UK , then we have to wait a bit longer for normality.

References:

Guardian: India Covid variant: is it a threat to the UK’s reopening plans?
Ian Sample Science editor
@iansample
Thu 13 May 2021 15.35 BST

BBC. Covid: Three cases of Indian variant found in Leicester
Published 28 April.

BBC. Covid: Targeted testing in Nottingham after Indian variant rise. 11 May.

BBC. Covid: Boris Johnson ‘anxious’ about Indian variant
By Hazel Shearing & Joseph Lee
BBC News. 13 May.

BBC. Covid vaccine: How many people in the UK have been vaccinated so far?
By The Visual and Data Journalism Team
BBC News

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Can unauthorised treatments cause harm?

May 11, 2021May 10, 2021

Yes, there is a risk of serious harm from “unauthorised” COVID treatments that are not officially authorised by competent regulatory authorities such as MHRA in UK or FDA in USA.

If a treatment is not authorised, it should have at least have good clinical trial evidence.

India is going to a rough patch. People with COVID are desperate for treatment. There is shortage of oxygen which is a commonly used treatment.

Apart from oxygen for respiratory support, only Two treatments have been proven to be of significant help in COVID-19 pneumonia. (1) Steroids (2) An arthritis drug called Tocilizumab

Many antivirals drugs have not shown any meaningful benefit. Various other drugs are still in trials.

It is rapidly evolving area and the BMJ has a COVID guideline which is being frequently updated during this pandemic.

This is significant risk of harm from drugs which are NOT properly assessed in clinical trials.

Anecdotally there has been lot of sudden deaths in India. Lot of unproven treatments such as Azithromycin, ivermectin, antivirals agents, chloroquine, and other agents widely used in india.

Although there is no definitive proof, One cannot help wondering whether poor outcome in at least some Indian patients is related to combinations of unproven drugs that are used widely in unregulated private healthcare sector.

BMJ. Drug treatments for covid-19: living systematic review and network meta-analysis
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2980 (Published 30 July 2020)
Cite this as: BMJ 2020;370:m2980

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

BMJ COVID-19 Treatment algorithm.

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

What has ‘Public health’ ever done for us ?

May 7, 2021May 7, 2021

An apple a day might not keep the doctor away. But a good public health team can keep the doctors away for many people!

Public health is about prevention and promotion of health in the society.

Public health is largely responsible for the significant improvements in life expectancy over the last 150 years.

Providing people with clean drinking water, removal of rubbish from houses and streets, good sewage system, and vaccination has saved many millions of lives over the years.

The recent smoking ban in work-places, public places and indoor venues is a modern example of public health activity.

The one area where public health has not been hugely successful is obesity. It may be because of the reliance on nudging the individual to change rather than dealing with underlying structural problems.

Read my letter in BMJ and make your views known at the BMJ rapid response section.

Sundar S. Public health needs to go back to basics, not rely on nudge theory.

Toll-free link:
http://bmj.com/cgi/content/full/bmj.n1153?ijkey=CUQNozGH9yJeK57&keytype=ref

References:

BMJ. Lifestyle and socioeconomic group on health
Public health needs to go back to basics, not rely on nudge theory
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1153 (Published 06 May 2021)
Cite this as: BMJ 2021;373:n1153

BMJ. Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction
BMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2161 (Published 08 June 2010)
Cite this as: BMJ 2010;340:c2161

BMJ. Associations of healthy lifestyle and socioeconomic status with mortality and incident cardiovascular disease: two prospective cohort studies
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n604 (Published 14 April 2021)
Cite this as: BMJ 2021;373:n604

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Would COVID-19 vaccination be made compulsory for people in some jobs !

May 6, 2021May 5, 2021

New Zealand recently fired customs and border officials after they refused vaccines.

Compulsory COVID vaccination -for people in some jobs- is not official policy in UK or USA yet.

“Italy has become the first country in Europe to make COVID vaccination compulsory for healthcare workers”

It does look like that COVID-19 vaccination would be made compulsory for people in some jobs !

Any third wave, later year, in UK may push the government in making COVID vaccination mandatory for health workers and some other key workers.

References

Guardian. New Zealand fires nine border workers who refused Covid vaccine.
Tess McClure in Christchurch
@tessairini
Mon 3 May 2021 02.32 BST

BMJ. News Analysis. Covid-19: Is the UK heading towards mandatory vaccination of healthcare workers?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1056 (Published 21 April 2021)
Cite this as: BMJ 2021;373:n1056

BMJ News. Covid-19: Italy makes vaccination mandatory for healthcare workers
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n905 (Published 06 April 2021)
Cite this as: BMJ 2021;373:n905

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Is it the beginning of the end ?

May 5, 2021May 5, 2021

COVID-19 is still raging like wild fire in various parts of world particularly in India now.

But, in U.K, it does look like the “beginning of the end” for the COVID pandemic. Vaccines seem to have greatly aided this end.

On Tuesday, UK reported 1,946 new infections and only four deaths within 28 days of a positive test.

So unless there is a new variant which overcomes the protective shield of the Vaccines, there may be no more lockdowns and life may go back to some sort of normality.

References

BBC news. Another Covid lockdown unlikely, says scientist. By Hazel Shearing
BBC News

The official UK government website for data and insights on coronavirus (COVID-19).

BBC news. What is the India Covid variant and will vaccines work?
Soutik Biswas
India correspondent
Published22 April

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Outdoor face masks: is it helpful or an hindrance?

May 4, 2021May 3, 2021

In the indoor settings, wearing masks can help to reduce the risk of getting COVID-19 infection.

But in the outdoor setting, masks may not be very helpful as the risk of getting COVID-19 infection from others, in outdoor settings, is considerably smaller.

Two teams discuss the pros and cons of outdoor mask wearing in a BMJ debate.

Apart from infection prevention, I can see some additional benefits for voluntarily wearing masks in the streets.

The streets of major cities have significant air-pollution. So facial masks can help to reduce inhalation of toxic chemicals.

More and more surveillance street-cameras are now deploying facial-recognition software to deter criminals. But the cameras may also track movements of ordinary law-abiding people for marketing and advertising reasons. So face-masks may also be helpful to those with privacy concerns.

Read the article and submit your views through BMJ rapid response section.

BMJ . Coronavirus Transmission
Should masks be worn outdoors?
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1036 (Published 28 April 2021)
Cite this as: BMJ 2021;373:n1036

Sundar S. Voluntary outdoor mask-wearing can have incidental benefits in cities. BMJ rapid response. 2nd May 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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Should hormone therapy be used before or after prostate radiotherpy?

May 3, 2021May 1, 2021

Combination therapy with Hormone therapy and Radiotherapy is used with curative intent for treatment of prostate cancer.

There is some debate which treatment should be started first. At present, the hormone therapy is started first and radiotherpy is started second at a later date.

This is because many previous clinical trials, which found beneficial effects for the combination therapy, involved starting hormones first.

One advantage of starting hormone therapy immediately and delaying the start date of radiotherpy is that hormone therapy shrinks the size of prostate before radiotherpy . This greatly helps when image-guided Radiotherpy is planned later on.

A group of high Calibre researchers and authors from Canada and USA have published paper arguing in favour of radiotherpy starting first and starting hormones afterwards.

Some of the authors behind this paper in Journal of Clinical oncology have previously published seminal, practice changing, papers in field of prostate cancer.

My personal view, is that we have to wait for confirmatory evidence before changing the current practice.

I have to resort to the megaphone of a provocative headline grabbing title so that oncologists won’t uncritically accept the conclusion of the paper

Read the original paper and my published response .

Adjuvant Hormone Therapy After Prostate Radiation: Is This Data Torture?

Santhanam Sundar , MD and Micheal Ocathail, MD. Nottingham University Hospital NHS Trust, Nottingham, United Kingdom

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Medical Resuscitation: the unnecessary distress due to misconception

May 1, 2021May 1, 2021

CPR or cardiopulmonary resuscitation is a medical procedure that is often misunderstood. It causes lot of anguish and distress to patients and family unnecessarily.

It is sometimes colloquially known as “kiss of life” as “mouth to mouth resuscitation” was previously used in pre-COVID era along with “chest compressions”.

CPR may involve “electric shocks to heart” when needed if machines are available. CPR in hospital may involve “tubes pushed down the throat” to enable air get into lungs. CPR almost always involves someone “pressing hard on the chest repeatedly with both hands” so as to help air get into lungs.

Overall, it can appear a bit brutal but it can be a life saver. That’s why the work places, train stations, airports and some public parks have the automatic defibrillators.

CPR is a wonderful medical first aid, which, delivered promptly, can save lives. It is highly successful in previously fit people with a sudden cardio respiratory arrest due to a “reversible or treatable” illness.

Television serials and Hollywood movies often portray CPR as a highly successful procedure.

But, unfortunately, in routine hospital practice, the success rates are low.

In particular, success rates are very low in “terminally ill” cancer patients and in frail patients with “multiple irreversible medical conditions”.

Because many people believe CPR is hugely successful in “everyone”, patients and families understandably get very upset when the medical team talk about “do not attempt resuscitation (DNAR)“.

When CPR is NOT used appropriately, it prevents peaceful death and stops terminally ill patients from gently fading away surrounded by their loved ones.

In cancer patients, when cancer treatments are not working, death occurs after the body has been overwhelmed by cancer. Trying to re-start the heart and lungs after the organs have stopped working due to cancer is often futile. More importantly, CPR can make death more traumatic for patients and family.

Other than educating people about benefits and limitations of CPR, there is no easy way to make this misconception about resuscitation go away.

Read my BMJ letter on this topic and contribute your views on the rapid response section of BMJ.

BMJ. Misconceptions about CPR distress patients at the end of life and bereaved people.

Toll-free link:
http://bmj.com/cgi/content/full/bmj.n1060?ijkey=YhH9UQOseeXaJzT&keytype=ref

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 views expressed in this blog are not in way intended to be a substitute for professional advice.

COVID-19 pandemic: India vs Israel

April 24, 2021April 24, 2021

The contrast between India and Israel over this weekend is astonishing. (Gloom vs Cheer).

Israel reports “no new daily Covid-19 deaths for the first time in 10 months”.

India, on the other hand, reports, a record 2,624 deaths in the 24 hours and about one million infections in last three days alone.

The new wave in India seems to have been caused by emergence of new variants, as well as mass gatherings.

It maybe that the mass rapid vaccination drive in Israel helped.

Let’s hope that UK, Europe and USA are firmly on the path towards normality in the summer as the vaccination rates go up.

References

BBC news. Covid-19: Israel records no daily deaths for the first time in 10 months.

BBC news. India Covid surge: Hospitals send SOS as record deaths registered.

Guardian. CoronavirusWhat do we know about the Indian coronavirus variant?
Ian Sample Science editor
@iansample. Mon 19 Apr 2021 16.50 BST

BBC news. Covid vaccine: How many people in the UK have been vaccinated so far?
By The Visual and Data Journalism Team
BBC News

New York Times. Tracking Coronavirus Vaccinations Around the World.
By Josh HolderUpdated April 23, 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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Can someone die due to COVID-19 infection even after having the full course of protective vaccination?

April 24, 2021April 24, 2021

Yes, rarely it can happen.

COVID vaccines are very highly effective in preventing serious infections that would result in hospitalisation. Even a single dose of the vaccine has very good efficacy.

But vaccines are not 100% effective.

So until the pandemic is under full control, older adults, particularly those over 60 years, should be cautious even after full vaccination.

It also has to be said that the risk is dramatically small after full vaccination. Only a tiny minority of people get serious COVID-19 infection after full vaccination.

In USA, about 5800 “breakthrough” COVID-19 infections has been reported so far among the roughly 77 million people who had been fully vaccinated. That’s less than 0.008% cases.

A much more smaller minority among this minority group had serious infections. Among the 5800 cases, 396 patients were admitted to hospital and 74 patients died from COVID-19. That’s less than 0.0001% deaths.

So unless new viral mutations dramatically reduce vaccine efficacy, it looks very promising.

References:

1. BMJ News. Covid-19: Infections fell by 65% after first dose of AstraZeneca or Pfizer vaccine, data show BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1068 (Published 23 April 2021)
Cite this as: BMJ 2021;373:n1068

2. BMJ news. Covid-19: US reports low rate of new infections in people already vaccinated
BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1000 (Published 16 April 2021)
Cite this as: BMJ 2021;373:n1000

3. Sun News. DOUBLE TROUBLE ‘Concerning’ Indian Covid variant now in UK has two ‘escape mutations’ that could dodge antibodies
Vanessa Chalmers, Digital Health Reporter
12:22, 16 Apr 2021Updated: 12:25, 16 Apr 2021

4. BBC news. Coronavirus: ‘Double mutant’ Covid variant found in India. Published 25 March

5. Daily Mail. Could the Indian ‘double mutant’ coronavirus derail Britain’s roadmap out of lockdown? Experts warn variant could ‘scupper our escape plan’ and urge Boris to put country on red list. By James Robinson for MailOnline
01:49, 17 Apr 2021 , updated 11:08, 17 Apr 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 views expressed in this blog are not in way intended to be a substitute for professional advice.

Are COVID-19 vaccines necessary for someone who has recovered from a COVID-19 infection ?

April 19, 2021April 18, 2021

Yes !

If someone has recovered from a COVID-19 infection, they would have some protection against getting another COVID-19 infection.

But, even if someone has recovered very well from a previous infection, vaccination is necessary because there is still a significant risk of getting COVID-19 infection again.

A recent study published in the medical journal Lancet reports that people who had a previous infection have about one-fifth risk of getting an infection again compared to those without a previous infection.

So while there is some protection against future infections, there is still a risk and hence it is prudent get the Vaccine when it is offered.

Reference:

Lancet. SARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study. DOI: https://doi.org/10.1016/S2213-2600(21)00158-2

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 young adults avoid Astra Zeneca COVID-19 vaccine ?

April 10, 2021April 10, 2021

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?

April 9, 2021April 1, 2021

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)

Christine B. Ambrosone, PhD¹; Gary R. Zirpoli, PhD²; Alan D. Hutson, PhD¹; William E. McCann¹; Susan E. McCann, PhD, RD¹; William E. Barlow, PhD³; Kara M. Kelly, MD¹; Rikki Cannioto, PhD, EdD¹; Lara E. Sucheston-Campbell, PhD⁴; Dawn L. Hershman, MD⁵; Joseph M. Unger, PhD³; Halle C.F. Moore, MD⁶; James A. Stewart, MD⁷; Claudine Isaacs, MD⁸; Timothy J. Hobday, MD⁹; Muhammad Salim, MD¹⁰; Gabriel N. Hortobagyi, MD¹¹; Julie R. Gralow, MD¹²; George T. Budd, MD⁶; and Kathy S. Albain, MD¹³

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

April 7, 2021April 7, 2021

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?

April 4, 2021April 4, 2021

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 ?

April 4, 2021April 4, 2021

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?

April 2, 2021April 1, 2021

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

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

April 1, 2021April 1, 2021

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

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 ?

March 28, 2021March 27, 2021

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 ?

March 15, 2021January 4, 2021

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

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

March 14, 2021March 13, 2021

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.

March 12, 2021May 3, 2021

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

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 ?

March 3, 2021March 2, 2021

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

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

March 1, 2021January 4, 2021

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

Which COVID vaccine is the best ?

February 21, 2021February 21, 2021

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).

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’ ?

February 20, 2021February 19, 2021

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

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 ?

February 15, 2021January 4, 2021

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.

Does Hand Washing help to prevent COVID-19 ?

February 14, 2021February 14, 2021

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. 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

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.

February 8, 2021January 29, 2021

“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.

Are breakfast cereals bad for your heart?

February 6, 2021February 12, 2021

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

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 !

February 3, 2021February 3, 2021

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

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

January 30, 2021January 30, 2021

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

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

January 29, 2021January 29, 2021

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

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?

January 22, 2021January 22, 2021

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

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

January 21, 2021January 20, 2021

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

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

January 21, 2021January 21, 2021

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

Why are some people falsely sceptical of COVID Vaccines?

January 20, 2021January 23, 2021

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

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

January 19, 2021January 17, 2021

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

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