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

Possibly Yes, but not sooner than that.

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

There are many hurdles along the way.

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

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

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

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

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

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

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

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

References.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

References:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Is this the beginning of the end for COVID-19 ?

The superstitious might say “don’t jinx it by calling the end early”……..

So the answer is “may be”.

The good news from two Vaccine trials indicates that this might be “beginning of the end” for COVID-19.

Two recent press reports give rise to lot of optimism to the population that is getting weary with the lockdown. It is good to have a ray of hope among all the doom and gloom.

The covid-19 vaccine (mRNA-1273) from US biotech company Moderna was found to be 94.5% effective.

Another mRNA vaccine developed by Pfizer and BioNTech was reported to be 90% effective.

Now the caveats…. these are interim trial results and the trial results have not been subject to scrutiny by the wider scientific community as the full results are yet to be published.

Clinical Trials usually recruit motivated people without too many other medical problems. So one has to hope that these interim trial results can be replicated in the wider elderly population with lot of medical problems.

Update: Now a third Vaccine, the “Oxford Vaccine” has been found to be 90% effective when given as “a half and then full” schedule.

Update: summary so far at BMJ website.

Let’s hope that all the vaccines are very safe and highly effective when used in the real world population.

References: (1). Covid-19: Vaccine candidate may be more than 90% effective, interim results indicate. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4347 (Published 09 November 2020). Cite this as: BMJ 2020;371:m4347.

(2). Covid-19: Moderna vaccine is nearly 95% effective, trial involving high risk and elderly people shows. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4471 (Published 17 November 2020). Cite this as: BMJ 2020;371:m4471

(3). Covid-19: Oxford vaccine is up to 90% effective, interim analysis indicates
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4564 (Published 23 November 2020)
Cite this as: BMJ 2020;371:m4564

Covid-19: What do we know about the late stage vaccine candidates?. BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4576 (Published 24 November 2020)
Cite this as: BMJ 2020;371:m4576

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.

Coronavirus re-infection and immunity

Many Viral infections give some sort of immunity to the person infected. For example, if a child has chicken pox, then the child develops immunity to further chicken pox. This immunity can even be life long for many children.

But some viral infections don’t result in significant immunity to further infection. For example, Flu and Common Cold viruses infections do not result in effective long immunity. That’s why flu vaccines are given yearly to vulnerable people.

It was hoped that a Coronavirus infection could result in at least some sort of long immunity to further infections.

A recent report of man who developed Coronavirus/ COVID-19 for the second time is worrying. If this is a widespread phenomenon and not an isolated case, then it has significant implications for the current pandemic.

Herd immunity, whereby many people are immune to further Coronavirus infection either through previous infection or Vaccination, was suggested as the way of ending the current pandemic.

This report, if confirmed to be true across significant sections of population, would indicate a much more longer duration of COVID-19 pandemic.

References:

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

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

3. Lancet Infectious diseases. What reinfections mean for COVID-19. Akiko Iwasaki
Published:October 12, 2020. DOI:https://doi.org/10.1016/S1473-3099(20)30783-0Edridge AWD

4. Edridge AWD, Kaczorowska et al.Seasonal coronavirus protective immunity is short-lasting.Nat Med. 2020; (published online Sept 14.)https://doi.org/10.1038/s41591-020-1083-1View in Article

5. Tillett RL et al. Genomic evidence for reinfection with SARS-CoV-2: a case study.Lancet Infect Dis. 2020; (published online Oct 12.)https://doi.org/10.1016/S1473-3099(20)30764-7View in Article

6. To KK-W et al. COVID-19 re-infection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole genome sequencing.Clin Infect Dis. 2020; (published online Aug 25.)https://doi.org/10.1093/cid/ciaa1275View in Article

7. Van Elslande J et al.Symptomatic SARS-CoV-2 reinfection by a phylogenetically distinct strain.Clin Infect Dis. 2020; (published online Sept 5.)https://doi.org/10.1093/cid/ciaa1330View in Article

8. Prado-Vivar B et al.COVID-19 re-infection by a phylogenetically distinct SARS-CoV-2 variant, first confirmed event in South America.SSRN. 2020; (published online Sept 8.) (preprint)https://doi.org/10.2139/ssrn.3686174View in Article

9. Dearlove B et al. A SARS-CoV-2 vaccine candidate would likely match all currently circulating variants.Proc Natl Acad Sci USA. 2020; 117: 23652-23662View in Article

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

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

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

Yes, you can get infection again.

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

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

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

References

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

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

3. Clinical Infectious Diseases : report on twitter.

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

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

Is Honey a better treatment for coughs and colds ?

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

The paper has been widely quoted in various newspapers today.

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

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

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

References

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

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

2. Guardian Newspaper:

3. Daily Mail.

4. BBC paper review .

5. Evening Express

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

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

Can you get Coronavirus infection more than once?

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

Unfortunately, the answer is a YES.

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

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

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

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

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

References

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

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

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