Is it the beginning of the end ?

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.

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

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 safe in cancer patients having immunotherapy?

Yes, Pfizer vaccine is safe.

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

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

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

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

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

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

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

References

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

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

COVID pandemic: finally, the end is in sight !

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Oxford Astra Zeneca: Professionals Version .

Oxford Astra Zeneca: Patient Version

Pfizer. Professionals Version

Pfizer. Patient Version

Moderna. Professionals Version

Moderna. Patient Version

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

FDA USA: Moderna COVID-19 vaccine prescribing informationexternal

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 : Why Hand hygiene is also important in addition to Face mask ?

The UK government’s slogan for controlling COVID-19 pandemic is “ ‘Hands. Face. Space

The reason hands are emphasised is because the Virus can stay alive on Human skin for many hours. So touching others by hugging or hand shaking can spread the virus.

A recent Japanese study found that Coronavirus can stay alive on skin surfaces for about 9 hours. They also found that alcohol gel can inactivate the virus in about 15 seconds !

References:

1. Survival of SARS-CoV-2 and influenza virus on the human skin: Importance of hand hygiene in COVID-19 Ryohei Hirose, Hiroshi Ikegaya, Yuji Naito, Naoto Watanabe, Takuma Yoshida, Risa Bandou, Tomo Daidoji, Yoshito Itoh, Takaaki NakayaClinical Infectious Diseases, ciaa1517, https://doi.org/10.1093/cid/ciaa1517 Published: 03 October 2020

2. Guardian: Coronavirus outbreakHands. Face. Space’: UK government to relaunch Covid-19 slogan.

3. Fox News: The coronavirus can survive on skin for this many hours, study suggests
Researchers found that SARS-CoV-2 outlived the influenza A virus on human skin
. Madeline Farber By Madeline Farber | Fox News

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please 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.

Cancer and COVID-19

Cancer patients, as expected, did badly during the 1st wave of the COVID-19 pandemic

Data presented at ESMO ( European Society of Medical Oncology) shows that Cancers had – higher rates of Hospitalisation, higher risk of Complications and increased risk of Death.

Elderly cancer patients on the whole did very badly but surprisingly cancer patients under age of 50 did far worse than their peers without cancer.

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.

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

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

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

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

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

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

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

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

References

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

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

3. CDC. How It Spreads.

Can you get Coronavirus infection more than once?

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

Unfortunately, the answer is a YES.

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

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

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

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

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

References

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

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

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

Can Vitamin D prevent respiratory infections such as COVID-19 ?

No conclusive evidence yet.

Some studies suggest a protective effect but two recent “official” reviews in UK has concluded the following.

(1). “The available evidence does not support vitamin D supplementation to prevent acute respiratory tract infections in the general UK population”.

(2). “There is currently no evidence to support vitamin D supplements reducing the risk or severity of covid-19″.

References

NICE. Covid 19 rapid evidence summary: vitamin D for covid-19 evidence summary. 29 June 2020. http://www.nice.org.uk/advice/es28/chapter/Key-messages.

Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017;356:i6583. doi:10.1136/bmj.i6583 pmid:28202713

Evidence does not support vitamin D for reducing respiratory infections, reviews conclude. BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2629 (Published 30 June 2020). Cite this as: BMJ 2020;369:m2629

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 Vitamin K help fight Coronavirus?

Possible but like every other observational study, take it with pinch of salt.

Further evidence from well conducted trials are needed before it can be recommended as a COVID treatment.

In mean time, it’s better to stick to natural sources of vitamin such as those mentioned in the newspaper article ( spinach, broccoli, green vegetables, blueberries, all types of fruit and vegetables).

Guardian Newspaper: Vitamin K could help fight coronavirus, study suggests

Scientists in Netherlands explore possible link between deficiency and Covid-19 deaths

Daniel Boffey. Fri 5 Jun 2020 14.50 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.

Is Chloroquine useful in treatment of Corona Virus?

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

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

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

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

References

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

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

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

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

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