Coronavirus - Part 9 (July
2021)
The
Covid-19 numbers
It is almost impossible to review and summarise the
unprecedented fluctuations of the Covid-19 pandemic during
July. They defy logic and order. That virus is a
desperado.
Remember during most of May, new cases were down to only 2,500
or so each day. But by the end of June and the beginning
of July, the UK was suffering an upward trend of new cases at
around 27,000 per day. By mid-July, that number had
almost doubled to 50,000 yet by the end of July it had settled
back to about 30,000 per day. What volatility! The
third wave was here, but somewhat waveringly. So, do
these decreasing numbers in the last days of July represent a
turning point in the pandemic? Are you an optimist or a
pessimist?
The numbers of hospitalisations, people on ventilators and
deaths have been less erratic, but decidedly upward.
They began July at 400, 300 and 30 per day respectively and
ended the month at 950 and 850 and 80. None of these
trends is welcome or comforting.
Overall, the total numbers of Covid-19 cases and deaths in the
UK have now reached approximately 5.8 million and 129,000
respectively.
The vaccination data are somewhat more heartening. After
eight months of the UK roll-out, a total of 84.7 million doses
have been administered, consisting of 46.8 million first doses
and 37.9 million second doses. Overall, 70% of the UK’s
adult population has now been single jabbed. Analysis by
Public Health England (PHE) reckons that the coronavirus
vaccines have prevented 22 million new infections and 60,000
Covid-related deaths.
The global picture is, as ever, more assorted. There
have now been totals of 196.6 million Covid-19 cases and 4.2
million deaths worldwide. Currently, the USA is the most
infected country (91,000 new cases per day) followed by
Brazil, India, Indonesia, Iran and then the UK in sixth place
(30,000). Countries reporting the most deaths are the
USA (a total of 607,000) followed by Brazil, India, Mexico,
Peru, Russia and the UK (129,000). In terms of deaths
per million population, Peru tops the table (5,949) with the
UK ranked at number 18 (1,909).
The outlook
In mid-July, the UK’s Scientific Advisory Group for
Emergencies (SAGE) released its assessment of the likely
impact of the lifting of restrictions post-19 July. It
reckoned that, at its peak, around 100,000 new cases per day
could occur leading to more than 1,000 people a day being
hospitalised and more than 100 a day dying. Cases are
not expected to peak until mid-August at the earliest.
SAGE is not alone. There are several other
organisations’ estimates, typically less severe, from which to
choose. Such computer modelling is at best sophisticated
guesswork, relying on past trends, weighted statistics and
human hunches. Are their facts and figures any more
accurate than those of your average TV pundit? We shall
see.
Looking further ahead into the year, there are additional
predicted Covid-related setbacks. For instance, the
Academy of Medical Sciences has recently forecast that
outbreaks of respiratory syncytial virus (RSV, the common
virus that causes mild, cold-like symptoms) during this coming
autumn plus flu in the winter could be around twice the
magnitude of a normal year. And they may overlap with
yet another peak of Covid-19 infections. The most
probable outcome will be added pressure on the National Health
Service (NHS).
Finally, what is even more confusing and unpredictable is the
outlook for holiday travel with its vaccine passports,
changeable quarantine regulations, designation of amber-plus
countries, vaccination regulations, and so on. There
will be no attempt in this article to rationalise and comment
on that mess.
And the general outlook? As ever, we will be learning to
live with the virus. And as ever, this Covid-19 pandemic
is far from over.
‘Freedom Day’ and its curious
aftermath
Monday 19 July was that long-awaited day when the UK
government relaxed almost all those Covid-19 restrictions, at
least, in England. Of course, it was a divisive
strategy. A YouGov poll had revealed that the government
was out of step with the public on its decision to reopen,
with just 31% in favour compared with 55% against.
Some politicians, restaurateurs, night clubbers, sports fans
and the like could hardly wait. Others, including
healthcare leaders, raised significant concerns, calling the
action ‘foolish’ and ‘unethical’ at a time when new cases were
continuing to rise to over 50,000 a day and when hospital
admissions were also on the upturn.
The libertarians responded by asking, ‘If not now,
when?’ Summer was here, schools were out, holidays were
round the corner, so less personal contacts and less risky
outdoor activities were more likely. Besides, should the
population wait until the autumn to reopen amid the start of
the additionally dangerous cold and flu seasons? In its
defence the government said it had already planned to
vaccinate 35 million people against flu this year. Yet
this move has reportedly left GP practices facing a ‘planning
nightmare’ that could leave many healthcare staff unable to
opt in to deliver the proposed Covid-19 booster jabs.
Then despite Professor Neil Ferguson, the erstwhile government
coronavirus advisor, warning that the UK may have 200,000 new
coronavirus cases a day by mid-August, Boris Johnson on the
night before ‘Freedom Day’, urged the public to, ‘please,
please be cautious.’ The upshot was that Monday 19 July
came and went. And nothing drastic occurred – at least,
not yet. The expectation was that if cases of Covid-19
were to flourish, as a result of more mass gatherings, less
social distancing, less face coverings, and so on, it would
take a week or two before the wretched bug was seen to be
taking a hold.
Nevertheless, here is the unexpected oddity. From 1
July, new cases in the UK started to increase slowly to around
27,000 and then they took off to peak at around 50,000 by 15
July. Was this the beginning of the dreaded exponential
growth of a devastating third wave? Seemingly, not
so. Contrary to expectation, the numbers actually began
to fall so that by the end of July they were about 30,000.
And no-one can convincingly explain why these fluctuations
occurred. Questions arise. For example, have
school holidays meant less contact among parents at the school
gate, but also among pupils, who, though not usually seriously
ill with Covid-19, have become more important spreaders as
more adults are protected by vaccinations? Or was the
rise in cases caused by the Euros football tournament with
especially men watching indoors, in close-knit groups, but as
the competition ended, so did the fall in Covid-19
infections? Or has there been less testing because those
with booked holidays are less inclined to get tested with the
prospect of enforced isolation? Or now with about 90% of
UK adults displaying antibodies from either vaccination or
natural infection, does the virus have less opportunity to
spread than in the first and second waves? Or has summer
sun and the recent heatwaves meant more open windows, better
ventilation, less opportunity for the virus?
The truth is no-one knows the causes of these new case
fluctuations. Other pertinent questions remain, such as,
will the fall continue, or is this a false dawn? How
long will people retain immunity? What lies ahead this
winter? Will the NHS cope? Will the estimated two
million people believed to have already developed long Covid
be joined by others? Is there room for optimism yet?
Have you been ‘pinged’?
Apparently the NHS Test and Trace (NHST&T) service has
been working overtime as judged by the boom in the numbers of
people who have been ‘pinged’ and told to self-isolate after
coming into contact with someone with Covid-19. For
example, between 1 and 7 July, a total of 520,194 people in
England had received an alert. A further 9,932 people
received the same alert in Wales. The data from the
following week were up by 17% and reached almost 690,000 in
the week ending 21 July.
This has created a so-called ‘pingdemic’. Such
self-isolation has resulted in massive staff absenteeism
across all business sectors of the UK. For instance,
several supermarkets, including Tesco and Sainsbury’s,
apologised as shortages of delivery drivers strained supply
chains and a lack of shop staff caused empty shelves.
Meanwhile, workforce shortages meant that some businesses,
such as fuel provider BP temporarily closed ‘a handful of
sites’. And dozens of councils were forced to suspend
bin collections. Most temporarily stopped garden waste
pick-ups, but some recycling collections were also hit.
Complaints from businesses pressured the government to
act. Already employers with fully-vaccinated key workers
can request an exemption from isolation for named employees in
industries such as energy, food production and supply, waste
treatment, essential chemicals, medicines and emergency
services. And by 16 August, self-isolation for all
fully-vaccinated people ‘pinged’ by the app is due to be
scrapped. In the meantime, if you are contacted by NHST&T you are
legally obliged to self-isolate until 10 days have passed
since your contact with an infected person.
Questions about the effectiveness of the NHST&T service
persist. Have you seen the government guidance entitled,
‘NHS Test and Trace: what to do if you are contacted’?
There are a full 15 pages of it! Furthermore, it is
reported that because of the inconvenience of the ‘pingdemic’
some 20% of those registered have already deleted the
app. And of those ‘pinged’ not all will always
self-isolate. This approved procedure was not encouraged
by the announcement at 08:00 on ‘Freedom Day’ by Boris Johnson
and Rishi Sunak that they were exempt from self-isolating
after coming into contact with the Covid-19-positive health
secretary, Sajid Javid, because they were taking part in the
pilot scheme involving daily testing. Less than three
hours later, at 10:38, Downing Street announced a U-turn
following a ‘furious backlash’ from the general public – both
senior politicians subsequently self-isolated.
For a service that has been costed at an eye-watering £37
billion, there will need to be robust and searching questions
asked when the Covid-19 public inquiry is convened.
Sputnik V is safe?
Russia’s Covid-19 vaccine, Sputnik V (what else?), has long
been eyed with suspicion. For a start, the Russian
ministry of health approved its use on 11 August 2020, more
than a month before its Phase 1 and 2 human clinical trial
results were published, and before its Phase 3 trial had even
started. Moreover, doubts remained about the incidence
and reporting of its possible rare side effects. But,
based on evidence from Russia and several other countries, it
has now been widely declared to be both safe and effective.
Although Sputnik V, also known as Gam-COVID-Vac, was the first
Covid-19 vaccine to be registered for use in any country, it
has since been approved by 67 countries, including Brazil,
Hungary, India and the Philippines. But the vaccine, and
its one-dose sibling Sputnik Light, has yet to receive
approval for emergency use from either the European Medicines
Agency (EMA), or the World Health Organization (WHO).
Approval by the WHO is crucial for global distribution through
the COVAX initiative, which provides Covid-19 vaccines for
lower-income nations.
This dubious route for the development of Sputnik V by
scientists at the Gamaleya National Center of Epidemiology and
Microbiology in Moscow, is more reminiscent of Russian
roulette rather than orthodox vaccine production. In
this case, the upshot proved to be apparently beneficial
rather than fatal.
The Lambda variant
All viruses change over time, though most such mutations have
little or no impact on a virus’ properties. However,
since January 2020, the World Health Organization (WHO) has
been tracking the genetic modifications and geographical
movements of potentially-hazardous Covid-19 variants (more
strictly known as SARS-CoV-2 variants). The WHO has
classified them as either Variants of Interest (VOIs) or
Variants of Concern (VOCs) depending on their perceived risk
to global public health. The current dangerous VOCs have
been named as Alpha, Beta, Gamma and Delta, but several less
harmful and less widespread VOIs have already been identified,
including Eta, Iota, Kappa and Lambda.
The concern is that these VOIs may develop into VOCs.
The tale of the VOI Lambda is therefore instructive. On
14 June 2021, a variant, assigned to Pango lineage C.37,
GISAID clade GR/452Q.V1, NextStrain clade 20D, was designated
as a global VOI by the WHO and labelled as ‘Lambda’. It
contains several notable mutations, including L452Q and F490S.
This variant, now known as Lambda, was first detected in Peru
in August 2020 and has spread to 29 countries, mainly in Latin
America. Since 20 January 2021, 668 Lambda infections
have been reported in the United States. In Peru, Lambda
is now responsible for more than 90% of new Covid-19 cases, a
rise from less than 0.5% in December 2020. The country
has already suffered the world’s worst mortality rate
(currently 5,949 deaths per million population) due to
Covid-19.
In neighbouring Chile, where the primary vaccine is China’s
Sinovac (also known as CoronaVac), the Lambda variant has
accounted for 31% of cases during the last two months.
These are despite the relatively high proportion of 59% of
Chile’s population having been doubly vaccinated, though with
this vaccine with a poor efficacy of 56%.
So far only eight cases of Lambda have been confirmed in the
UK, most of which have been linked to overseas travel.
There is currently no evidence that Lambda is more
transmissible, or that it causes more severe disease, or
renders the vaccines currently used in the UK any less
effective. As yet, no-one knows for certain, so Lambda
remains as a VOI. Groups like the WHO and Public Health
England (PHE) are monitoring the situation.
Needle, nose or mouth?
Will the vaccinating needle become redundant? Two
additional systems for delivering vaccines are on the horizon
– maybe.
First, there is news of a spritz coronavirus vaccine being
developed by Rokote Laboratories Finland Ltd. The
company has recently secured funding of 9 million euros to
create the treatment to be administered as a nasal spray,
known as FINCoVac. The new funding will also underwrite
Phase 1 and Phase 2 human clinical trials.
The vaccine is based on novel gene-transfer technology, which
has already been successfully used in several clinical trials
using gene therapy to treat cardiovascular diseases and
cancers. According to Seppo Ylä-Herttuala, from the
University of Eastern Finland, one of the lead scientists
behind the project, ‘The vaccine uses a safe adenovirus
carrier that contains a cloned DNA strand of the SARS-Cov-2
virus’s S protein. This can be used to program
nasopharyngeal cells to produce the surface protein of the
SARS-CoV-2 virus which, in turn, produces a response to the
vaccine. There are no other parts of the virus in the
vaccine.’ It is envisaged that in the future such a
vaccine could serve as an easy-to-administer booster for those
who have already received traditional vaccines.
Second, there is a Covid-19 vaccine as a pill. A human
clinical trial of a prospective oral pill is set to start in
Israel. Oramed Pharmaceuticals, based in Jerusalem, has
created a single-dose oral version of a vaccine being
developed by the Indian company, Premas Biotech. In
March 2021, the Israeli company announced that doses of the
pill had resulted in the successful generation of Covid-19
antibodies in pigs.
If effective in human clinical trials this oral medication
will not need to be stored at low temperatures, it will
eliminate the need for administration by professional
healthcare workers, and it will help vaccinate populations in
countries with limited financial resources and
infrastructure. In other words, such a pill could be a
‘game-changer’ for many.
Should children be vaccinated?
This has been a recurring question, but as the adult
population becomes largely vaccinated, it has inevitably
shifted up to the vaccine policy frontline.
It is already known that severe Covid-19 illness, deaths and
even long Covid are rare among healthy youngsters. Yet
children, and particularly adolescents, can play a significant
part in coronavirus transmission and there are additional
concerns as new variants emerge. Moreover, only a few
vaccines have been tested in young people over the age of 12,
including the mRNA vaccines made by Moderna and
Pfizer–BioNTech, and the two Chinese vaccines made by Sinovac
and Sinopharm. So far, these appear to be safe in
adolescents, yet rare adverse reactions have occurred, for
example, with an association between the Pfizer–BioNTech
vaccine and heart inflammation disorders known as myocarditis
and pericarditis. And there is that thorny question, is
it ethical to vaccinate ‘low-risk’ children when ‘high-risk’
adults, including key healthcare workers, in other countries
remain unvaccinated? So, on balance, should children be
vaccinated, do they even need to be vaccinated?
On 19 July, the UK’s Joint Committee on Vaccination and
Immunisation (JCVI) issued guidelines and the vaccines
minister, Nadhim Zahawi, confirmed that children over 12, who
are at higher risk of getting ill if they catch Covid-19,
namely those with severe neurodisabilities, or at risk of
immunosuppression, are to be offered Pfizer-BioNTech
vaccinations. In addition, some healthy children over
12, who live with vulnerable people, can also have vaccines,
as well as those on the cusp of turning 18. This means
that overall, around 370,000 children will be eligible.
However, the vast majority of children in the UK, who are low
risk, will not be offered any vaccines, at least, not for
now. This puts the UK in marked contrast with numerous
other countries, such as the USA, Canada, Israel, Singapore
and Japan, which already have implemented policies for mass
vaccinating their children aged 12 and over.
Abuse during vaccinations
Just what is happening here? This is deeply
shocking. A survey published at the end of June revealed
that over half (52%) of GP practice staff have received
threats of physical abuse while working on the Covid-19
vaccination programme.
The poll of 222 GP practice staff by the Medical Protection
Society (MPS) also found that over half (53%) of staff said
that their surgery or vaccination centres had been defaced by
anti-vaccination material. The survey included GPs,
nurses and practice managers at surgeries in the UK.
And it is apparently getting worse. By mid-July,
Covid-19 vaccinators were reporting abuse, threats and
aggression from people demanding their second jab early, that
is, before the recommended eight weeks, so they can go on
holiday this summer. Police have had to be called to
some incidents and other GP-led vaccination centres have had
to hire security guards to protect themselves.
Two thirds of respondents (60%) said that abuse and complaints
relating to the Covid-19 vaccination programme had impacted on
their own or their team’s mental well-being. A spokesman
for the MPS said, ‘Well-being support must be provided to all
GP surgery staff who are feeling overwhelmed and demoralised,
and a zero tolerance policy of abuse must be enforced across
the NHS so healthcare workers feel their safety is a
priority.’ Come on, these people are trying to help you
- 'Let your gentleness be evident to all' [Philippians 4:5].
Dr Joseph Mercola
No, me neither. But The New York Times (24 July)
called 67-year-old Joseph Mercola, ‘the most influential
spreader of coronavirus misinformation online.’ He is an
osteopathic physician and a proponent of alternative medicine,
from Cape Coral, Florida, who has become rich and famous by
selling natural health products and by making misleading
claims about Covid-19 vaccines.
Since the pandemic started, Mercola has posted more than 600
articles on Facebook spreading doubts about vaccines. He
employs dozens of staff to create fake news and spread it to
millions of Facebook and additional social platform
users. In other words, he has become an arch-manipulator
of both facts and people.
For example, one of his articles, published online on 9
February, declared that coronavirus vaccines were ‘a medical
fraud’ and that they did not prevent infections, provide
immunity, or stop transmission of Covid-19. The article
further claimed that the vaccines, ‘alter your genetic coding,
turning you into a viral protein factory that has no
off-switch.’
In mid-July, President Biden referred to a claim that 65% of
anti-vaccine messaging on social media could be traced to 12
people – the so-called ‘Disinformation Dozen’, of which
Mercola is a key figure. Biden further stated that such
bogus messaging is one of the chief obstacles to improving
vaccination rates as new cases, hospitalisations and deaths
from Covid-19 increase across the US.
By mid-July, every US state was reporting increased cases and
30 states had yet to reach 50% vaccine coverage. As
Anthony Fauci, the chief medical adviser to the President,
said vaccine reluctance had put the US in an ‘unnecessary
predicament’ and that, ‘We’re going in the wrong
direction.’ Anti-vaxxers, charlatans and conspiracy
theorists like Joseph Mercola are largely to blame.
Eat your way to immunity?
Natto beans are one of Japan’s most traditional, distinctive,
pungent and sticky, not to mention, weird, culinary delights
made from soybeans fermented with Bacillus subtilis var.
natto. Recently a team from the Tokyo University
of Agriculture and Technology (TUAT) reported that extracts
from natto can breakdown spike proteins on the coronavirus’s
surface, preventing it from infecting other cells.
The study was published as, ‘Natto extract, a Japanese
fermented soybean food, directly inhibits viral infections
including SARS-CoV-2in vitro’ by Mami Obi et al., in Biochemical
and Biophysical Research Communications (2021, 570:
21-25).
The Japanese researchers believe that more than one of natto’s
enzymes may be involved in this antiviral property.
These preliminary results were obtained with in vitro
natto components rather than in vivo ingestion of the
fermented beans. So in the future, could you eat your
way to immunity? A fascinating concept, but one on which
the jury is still out.
[On a personal note: for several weeks in 1989, to the
consternation, yet admiration, of my Japanese hosts at the
University of Miyazaki, I found natto beans surprisingly
appetising.]