Category: COVID-19

TL:DR – The COVID-19 pandemic is still with us, the January 2023 post summarises some aspects to date.

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It has been a while since I added anything to the site about COVID-19. My periodic monitoring of the stats put out by the ZOE app suggests the disease is currently somewhat on the wane in the UK…for now. During the last few months of 2022, the figures for number of people active cases bounced up and down between around 2.5 million and 3.5 million in a couple of waves.

Today, when I check, the estimate is very much lower, 1.6 million. This figure is based on PCR and LFT tests and symptoms reported by the app’s almost 5 million users and is a statistical extrapolation from that data to the whole UK population. It hasn’t been this low since mid-September 2022. It doubled after that, then dipped again in early to mid-December to 2 million or so. It looks like the numbers have been steadily declining since then. There are, however, still almost 100,000 new cases daily in the UK.

The WHO statistics look a bit more complicated. Globally, there were almost 2.8 million new cases and over 13 000 deaths for the week 9th to 15th January 2023, representing a 0.46% mortality rate, which was down 7% on the previous week. But, if we look at 19th December 2022 to 15th January 2023 there were almost 13 million cases and nearly 53 000 deaths, an increase of 20% on the previous four weeks but a lower average mortality rate 0.41%.

The pandemic is in no way over. It is still advisable to wear a face covering in public places and to avoid high-risk areas and to reduce your risk of spreading the disease to vulnerable people. We should be pushing for governments and organisations to install good air filtering and sterilisation systems, not just to protect us from the SARS-CoV-2 virus that causes COVID-19, but also to be prepared for the next, inevitable, airborne disease, or even just a new variant that is more virulent than omicron. Maybe we could avoid a pandemic wave or an entirely new pandemic .

TL:DR – I disappointingly succumbed to a COVID-19 infection in February 2022.

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So, mid-February 2022 I got a sniffle and a bit of a sore throat, like a common cold coming on. Did a lateral flow test and what do you know – positive for SARS-CoV-2, dammit. Ten days of isolation and an awful sore throat, an unsleepable sore throat, in fact, but thankfully no breathing problems. I’ve managed to take a couple of walks since and a bit of a bike ride, but they’re very stop and start, albeit managing about 3 miles. My lungs aren’t working at full capacity, I must admit, and I feel a bit post-viral.

I feel lucky and privileged to have been doubly vaccinated and also to have had a booster shot*, all of which was free at point of access on the NHS. I don’t know how well I would’ve fared if I hadn’t been vaccinated, but I doubt it would have been well given my underlying conditions. By coincidence, I have a free consultation with the doctor later this week to check lung function and other stuff. Hopefully, the doc will tweak my NHS-subsidised prescriptions a little and I’ll be on my way and good to go.

Thank you NHS.

*Not a jab, a shot, I hate that word “jab”.

Incidentally, despite proclamations by our government to suggest that the pandemic is behind us, I know more people who have the disease right now than the total number I knew who had it in the two years previously.

TL:DR – At the time of writing, people around the world were trying to cope with the COVID-19 pandemic and getting to grips with Greek letters.

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UPDATE: By the way, it’s pronounced “Oh-me-cron” with the emphasis on the “Oh”, it’s not Ommy-Cron or any other variant on that theme. And, this isn’t just me making some random pronouncement, that’s how it was taught throughout science, classicists might beg to differ with their “oh-My-cron”, but that’s the Ancient Greek way, not the scientific way. More to the point, Oxford’s Professor Aris Katzourakis, an expert in SARS-CoV-2 and a Greek speaker, by virtue of his Greek parents had this to say in the Telegraph recently: “English speakers should aim for oh-me-cron, with the emphasis on the o.”

By now, we’ve all heard the phrase “variant of concern” referring to a new form of the coronavirus that causes COVID-19. Technically, these variants have mutations that alter how well the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infects our cells. If the new form of the virus is of concern it is usually because the mutations in the spike protein on the surface of the virus are likely to make it more infectious, faster spreading and/or to worse symptoms or lead to more deaths.

The national and international health organisations assess new variants of which there are known to be hundreds of thousands, if not millions, on the basis of whether they show increased transmissibility, increased morbidity, increased mortality, increased risk of “long COVID”, ability to evade detection by diagnostic tests, decreased susceptibility to antiviral drugs, decreased susceptibility to neutralizing antibodies, ability to cause reinfections, ability to infect people who have been vaccinated, increased risk of multisystem inflammatory syndrome and long-haul COVID, increased impact on particular demographic or clinical groups.

The new variants were initially referred to by the name of the place where they were first identified, although each was given a technical name too to represent their genetic lineage. However, those scientific names, for example, B.1.1.529, are not particularly media friendly nor memorable to non-experts. As such, in May 2021, the World Health Organisation decided that variants of concern would be given a shorthand name using a letter of the Greek alphabet.

Readers will by now be fairly familiar with the first few letters of the Greek alphabet, if they weren’t already as we have already seen the following variants of concern, which used the first four letters of the Greek alphabet:

Alpha – B.1.1.7 (first identified in the UK)
Beta – B.1.351 (South Africa)
Gamma – P.1 (Brazil)
Delta – B.1.617.2 (India)

The current variant of concern that is spreading around the world is Omicron – B.1.1.529 (first identified by scientists in South African).

I’ve been asked several times by people who have some familiarity with the Greek alphabet as to why the WHO made a leap from Delta to Omicron. Well, there wasn’t a “leap” as such, there were variants that were labelled with some of the intermediate letters that didn’t turn out to be as problematic as anticipated and were not highlighted in the mainstream media. So, we did have the following variants: Epsilon (lineages B.1.429, B.1.427, CAL.20C), Zeta (P.2), Eta (B.1.525), Theta (P.3), Iota, (B.1.526), Kappa (B.1.617.1). Lambda (C.37), and Mu (B.1.621)

Nu and Xi have been skipped deliberately, the former because English speakers may pronounce it like the word “new” (it’s actually pronounced “nih” or “nee” and Xi because it resembles a common surname).

The next variant would likely be Pi, although that is a rather familiar symbol to many people and so they may well skip that one too. The last letter of the Greek alphabet is Omega (“big O” compare that to Omicron “little o”.

But, let us hope that we stifle this virus long before we run out of Greek letters…

TL:DR – Concerns about a connection between Guillain-Barre syndrome and COVID-19 infection and/or vaccination, put to rest.

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The rare and potentially lethal neurological disorder, Guillain-Barre syndrome, is not triggered by Covid nor by vaccination against Covid, recent research suggests.

There was concern during the early months of the Covid pandemic based on anecdotal evidence that there had been an increase in the incidence of a potentially lethal neurological disorder known as Guillain-Barre syndrome (GBS). In this disease, the body’s own immune system attacks peripheral nerves causing numbness, pain, and paralysis. It can be fatal if not treated promptly.

Pain and numbness often spread upwards from the soles of the feet or the hands but can also begin in the scalp and spread downwards. Damage to the nerves involved in breathing can lead to suffocation.

In December, Stephen Keddie* and colleagues published evidence that shows there is no obvious link between infection with the coronavirus (SARS-CoV-2) that causes Covid. Indeed, their evidence (published in the journal Brain) suggests that GBS incidence has been lower than usual during the pandemic.

Lockdown measures, social distancing, face coverings, and hand-washing have been a common feature of the pandemic for the majority of people in the UK. This, Keddie and his colleagues suggest has also led to a decline in the incidence of gastrointestinal infection, such as Campylobacter jejuni and infection with other respiratory viruses. There is evidence that GBS is sometimes a reaction to infection with C. jejuni where the immune system mistakenly attacks nerve cells instead of the bacterium. Far rarer is the incidence of GBS following vaccination against influenza.

Supplementary work from Keddie and his colleagues has also shown that there is no risk of GBS associated with Covid vaccination.

I think if anything, like the flu vaccine, that risk would be about one in a million, Keddie told Sciencebase. We know the risks of COVID are far higher. I have spent time recently working on neurology wards and visiting the intensive care departments and the risks of not getting the vaccine are very clear to see, he adds.

I’ve been talking about this for years…since I first wrote about pandemics in New Scientist in 1997 and then in more depth for the Royal Society of London in the wake of SARS, in January 2004, in fact. It’s worrying…we are always on the verge of a new pandemic. Until Covid-19, we’d managed to get on top of them largely. But, the next emergent pathogen could be far more virulent and far more deadly than SARS-CoV2, the virus that causes Covid-19.

Now, an international team of researchers has shown for the first time where people consistently interact with wildlife and where this overlaps with poor human health outcomes and highly globalised cities. 40% of the world’s most connected cities are close to areas of impactful spillover, say the researchers. The presence of such hotspots will almost inevitably give rise to a major pandemic unless preventative measures are taken urgently.

Details are published in the journal One Health.

I mentioned elsewhere that MIT is offering a free online course for anyone interested in learning more about Covid-19 and SARS-CoV-2. You can watch them live or grab the Youtube clips each week. The first lecture offers and excellent summary of our knowledge regarding this emergent pandemic disease as well as looking back briefly at previous viruses, such as previous coronavirus threats SARS and MERS, as well as the retrovirus HIV.

The lecture also cautions that we must remain vigilant about future viruses, which are a significant existential threat for the human race (as I wrote in New Scientist in 1997). A virus with the high mortality rate of MERS and the high transmissibility of Covid-19 would lead to a far more devastating pandemic.

You can watch the first lecture below from Bruce Walker of the Ragon Institute of MGH, MIT and Harvard, but please do sign up for the course on the MIT website linked from the video page

Here’s my basic summary of Walker’s points:

• The virus emerged at the end of 2019 in Wuhan, China, it most likely was a virus from bats that passed to pangolins and back to bats and then became infectious to humans.
• Unlike previous coronavirus threats, the Covid-19 virus is highly infectious several days before symptoms appear
• Wearing a mask should be obligatory in most indoor and some outdoor settings, along with social distancing and regular handwashing. Adhering to these measures even if they “infringe” on one’s personal liberties can slow the spread of the disease
• Research is advancing faster than with any earlier disease, but we have a lot to learn
• Spot test kits could soon be with us
• People can be reinfected as their antibodies following infection dwindle in numbers as the weeks go by
• Vaccines will give stronger protection than natural immunity
• The most promising of the dozens of vaccines being tested may need three doses over six months to be effective
• Scientists are working on new drugs and repurposing old drugs as treatments for the disease, some have been successful in severe cases
• Getting the world’s billions of people vaccinated is going to be difficult to say the least

COVID-19 lockdown and hospital surges

A new study suggests that for major cities it would help avoid catastrophoic overloading of hospitals, if local lockdown measures are reinstated when the seven-day average of hospital admissions goes above a certain number. The lockdown would be eased when the admission rate falls of when the hospitals are below 60% of capacity.

This would minimize economic and social disruption but at the same time protect health services.

One proviso is that high-risk populations must be shielded adequately during the times when the city is not in lockdown.

“Timing social distancing to avert unmanageable COVID-19 hospital surges” – Proc Natl Acad Sci