New Coronavirus News from 18 Mar 2022

Ukraine: disease control is a casualty of war – so a surge in COVID cases is likely [The Conversation United Kingdom, 18 Mar 2022]

by Michael Head

Russia’s invasion of Ukraine has already – and will continue to have – extraordinary health and socioeconomic consequences for the Ukrainian people. One of those consequences will almost certainly be an increased COVID burden.

Ukraine reported 37,000 new COVID cases on February 10, 2022 – the country’s highest daily total since the beginning of the pandemic. Since COVID emerged, Ukraine has had more than 5 million confirmed cases and more than 100,000 deaths. Over a million of those cases have occurred since the beginning of 2022, and with infections climbing sharply in February, deaths were rising too.

However, following the invasion, Ukraine’s data reporting initially slowed down before stopping altogether. There’s now no record of how COVID is progressing in the country; from here onwards all case and death statistics will be an under-count. What is clear is that the war started at a time when COVID was plainly on the rise.

Compounding this problem is the fact that the country’s COVID vaccine coverage is low, with just 36% of the population having received one or more vaccine doses. So a high proportion of Ukrainians remain susceptible not only to catching COVID, but also to the potential consequences of hospitalisation and death, which are far more likely in the unvaccinated.

Thus, even in peaceful times, there would be cause for concern about how the relatively fragile health systems in Ukraine might manage further waves of COVID infections. Providing healthcare in a conflict situation is even more difficult, and outbreaks will be almost impossible to control as people seek safety in any way they can.

Optimal conditions for transmission
As of mid-March 2022, an estimated 3 million Ukraine residents have fled their country.

Humanitarian groups and health agencies who look after refugee health are therefore likely to be receiving large numbers of people unvaccinated or partially vaccinated against COVID. On top of this, there are already are high levels of COVID around Europe, and the coronavirus burden among Ukrainians, while essentially unknown, is likely to be significant.

The most recently reported test-positivity value for Ukraine (the proportion of COVID tests taken that are positive) was 60% on February 18, 2022. This is an incredibly high value, and indicates that there were already uncontrolled outbreaks around the country before the war started. It suggests that even when case numbers recently hit record highs, they were likely being under-counted by a significant margin.

All told, this means that people vulnerable to the worst effects of COVID are mixing in groups in which there’s likely to be lots of the virus circulating. Being displaced or sheltering from the conflict will then add to this risk.

The refugee emergency accommodation in neighbouring countries, with necessarily dozens or hundreds of beds in one room, provide some basic shelter and respite for refugees. However, crowded indoor settings provide an ideal space for respiratory infectious diseases to thrive.
Transmission of coronaviruses is likely, with other infections such as influenza or tuberculosis also a potential public health concern. There’s also likely to be observed increases in several other infectious disease outbreaks, ranging from diarrhoea to scabies.

Measles, though, is perhaps the best analogue for COVID in this situation. It is a highly infectious respiratory virus that is often severe in unvaccinated children, and outbreaks are very common where routine healthcare is interrupted, such as in humanitarian crises and areas of conflict.

The basic reproduction number (R0) of measles – that is, how many people on average an infected person will go on to infect in a susceptible population – is often estimated at between 12 and 18. Omicron’s R0 is still being worked out, but the variant is known to be more infectious than previous ones. One estimate puts omicron’s R0 at 8.2. Because it spreads easily, the potential for outbreaks in conflict zones and refugee shelters is high, like with measles.

The risk of another variant
An additional factor to consider is that the greater the number of COVID cases, the greater the risk that new variants may emerge. The delta variant almost certainly emerged from the catastrophe that was India’s spring wave in 2021, which led to hundreds of thousands, if not millions, of COVID deaths. The alpha and beta variants are thought to have arisen in the UK and South Africa respectively, at times of uncontrolled outbreaks. With each new variant there are new risks, for example around vaccine effectiveness.

The unfolding tragedy that we see in Ukraine threatens the efforts the world has made to counter this novel coronavirus. Displaced and refugee populations need support, not just in Ukraine but elsewhere too, for example in Tigray or the Afghan refugees who have fled the Taliban regime. Bringing the COVID pandemic under control requires global cooperation around public health as well as highly vaccinated populations across all corners of the globe.

Here's how Covid-19 transitions from a pandemic to endemic [CNBC, 18 Mar 2022]

by Noah Higgins-Dunn

It’s been two years since Covid-19 crept across the globe, battered the U.S. economy and wreaked havoc on health-care systems unprepared to defend themselves against the novel pathogen.

Now, as the latest wave of infections driven by the fast-spreading omicron variant rapidly subsides, many are beginning to question: Is Covid-19 becoming endemic?

“There’s a high probability we’re moving into an endemic setting,” Moderna CEO Stephane Bancel told CNBC’s ‘Squawk Box’ in late February.

But what does it mean when a virus like Covid-19 becomes endemic? That can be unclear—even among global health experts.

“We’re going from the acute phase, the emergency phase, to a chronic phase where we’re going to have to look at long term sustained means of continuing to combat Covid-19,” World Health Organization spokesperson Margaret Harris told CNBC in an interview.

Meanwhile, the Biden administration recently unveiled a 96-page national preparedness plan it thinks will serve as a roadmap to return the nation to more normal routines. The White House’s pandemic playbook is already facing hurdles on Capitol Hill.

Lawmakers in Congress dropped additional Covid funding in their latest $1.5 trillion spending bill. The aid is critical for ensuring future supply of booster doses, antiviral pills, tests and more, according to administration officials.

Deltacron and Stealth Omicron differences explained as Covid infections in UK surge again [The Independent, 18 Mar 2022]

by Colin Drury

Two new Covid-19 variants are surging across the globe but what exactly are they? And should we be worried?

Hopes that the pandemic was over may have been premature if the latest Covid figures are anything to go by.

Overall coronavirus cases in the UK continue to rise, with more than 170,000 new cases reported on March 14 alone.

New Covid-19 sub-variants are believed to be behind a global surge that has resulted in China’s first deaths in a year, record numbers of infections in South Korea, a 14 per cent jump in cases in Africa and, here in the UK, rising hospital numbers.

Deltacron and Stealth Omicron are two strains that appear to be ushering in yet another new phase of the fight against coronavirus.

But what exactly are they? And should we be worried?

What is Deltacron?
As the name suggests, it’s a Covid-19 strain that is made up of elements from both the previous Delta and Omicron variants: it almost certainly came into existence in a patient who was infected with both at the same time.

So far it has been detected in several regions of France and appears to have been circulating since early January.

But it was only officially recognised as a new variant after its full genomic sequence was submitted to the international Covid database, GISAID, by virologists from L’Institut Pasteur in Paris.

Around 30 cases have been detected in the UK, according to the UK Health Security Agency.

How dangerous it could be remains open to conjecture. Analysis suggests it is largely similar to Delta but comes with Omicron’s spike protein – the part that binds a virus to human cell.

By rights, this could be a worry because it means it combines Delta’s severity with Omicron’s infectiousness.

Yet because of growing human immunity to both variants, scientists suggest it is, so far, doing relatively little harm.

What is Stealth Omicron?
The better known of the two variants, this is a direct sub-lineage of Omicron also known as BA.2 (Omicron was BA.1) and first discovered in the UK in December. The UKHSA currently labels it a “variant under investigation” rather than a variant of concern.

Yet experts suggest it may be the most transmissible strain of coronavirus yet.

“The basic reproduction number…for BA.2 is about 12,” wrote Professor Adrian Esterman, a former World Health Organisation epidemiologist, on Twitter: “This makes it pretty close to measles, the most contagious disease we know about.”

Already, it is thought to account for more than half of all new cases in England, while it has also been detected in Germany, China and India. In Denmark, it is thought to have caused a huge surge through February.

That’s the bad news.

The good? Denmark’s surge plateaued remarkably quickly and is now receding, while initial data suggests that Stealth is no deadlier than the original Omicron and just as susceptible to vaccines.

How many cases are there of each?
Global numbers remain unclear for Deltacron. About 30 cases are thought to have been identified in the UK with 17 more in the US but there have also been several found in France where it was first identified, as well as in the Netherlands and Denmark.

For the more established Stealth, there is better data. In England, it is said to have accounted for 57 per cent of the 27,000 new cases recorded in the final week of February, while in the US it is thought to make up 23.1 per cent of all cases.

Surges in China, Hong Kong and South Korea – where there is far less natural immunity – are thought to be down to both the original Omicron and Stealth.

How serious could they both be? Inevitability, just by sheer force of numbers, greater transmissibility ultimately means more serious infections and more deaths.

Countries with low natural immunity and less vaccine uptake will be especially vulnerable.

Omicron and Omicron Stealth, experts say, are very much behind the large numbers of deaths in Hong Kong during the last two months, as well as growing serious case numbers in China and a record surge in South Korea.

In the UK, the picture appears more complex.

Case numbers have risen by more than half a million in the last seven days with a small but significant uptick in hospital number.

How much this is down to the seriousness of the new variants and how much is down to loosening of restrictions and waning vaccine coverage is something that currently remains unclear.

UK Covid cases are back on the rise as government scraps travel restrictions [CNBC, 18 Mar 2022]

by Vicky McKeever

LONDON — Cases of Covid-19 are rising once again in the U.K., according to the latest figures from the Office for National Statistics, just as the government lifts its remaining travel restrictions.

ONS figures published Friday showed that close to 1 in 21 people, the equivalent of 3.28 million, in the U.K. were estimated to have tested positive for the coronavirus in the week to March 12.

In England alone, 4.87%, equal to around 2.1 million or 1 in 20 people, were thought to have been infected with Covid-19 last week. That was up from an estimated 3.8% of England’s population in the week to March 5.

Hospitalizations linked to the virus were also up in England last week, to around 13 per 100,000 people, from 11 per 100,000 the previous week.

The uptick in cases comes as the U.K. lifted the last of its Covid travel restrictions. As of Friday morning, people entering the U.K. are no longer required to test for the virus or complete a passenger locator form.

The prevalence of the omicron BA.2 subvariant was said to have increased last week across England, Scotland and Wales, according to the ONS, while the number of omicron BA.1 subvariant infections decreased.

The BA.2 variant has been described as a “stealth” variant because it has genetic mutations that could make it harder to distinguish from the delta variant using PCR tests, compared with the original omicron variant, BA.1.

Indeed, the rise in cases across Europe more broadly is being attributed to the BA.2 subvariant.

Cases were found to be rising across the U.K, with Scotland estimated to have had around 7% of its population testing positive for Covid last week, up from 5.7% the week prior.

The case rate in Wales was estimated to have risen to 4.1% from 3.2% over the same period.
ONS said the percentage of cases in Northern Ireland had increased in the two weeks up to March 12 but the trend was uncertain in the most recent week.

The number of deaths linked to Covid-19 across the U.K. fell to 814 in the last week, down from 879 for the week through to March 4.

Elsewhere, China is also dealing with its worst Covid-19 outbreak since the initial phase of the pandemic.

Covid resurgent across UK with infections in over-70s at record high [The Guardian, 18 Mar 2022]

by Hannah Devlin and Richard Adams

A resurgence of Covid cases is under way across the UK, with infections in the over-70s at a record high and school leaders fearing that preparations for A-levels and GCSEs are being disrupted by outbreaks among staff and students.

Based on random swab tests taken in the community, the Office for National Statistics (ONS) estimates that almost 5% of the population in England, or 1,544,600 people, had Covid in the week ending 12 March, and 3.5% of people in the oldest age group. Infections also reached a record high in Scotland, where one in 14 tested positive.

The high prevalence among older people has prompted unease, after reports this week that vaccine immunity declines steeply in care-home residents. It is six months since many people in this age group had their last vaccine dose.

“Older age groups, especially people who have been isolating for so long, are now quite vulnerable even if they have kept up to date with their vaccines,” said Paul Hunter, a professor of medicine at the University of East Anglia.

The increase in infections is being driven by the more transmissible Omicron BA.2 variant, which has become the dominant strain across the UK. It transmits more readily than the original BA.1 strain but there is good cross-immunity between the two variants.

“It’s basically sweeping up everyone who didn’t get Omicron the first time around,” Hunter said. This, he added, meant the current wave was more likely to follow a short, sharp trajectory as seen in Denmark and the Netherlands where there had been an Omicron BA.2 wave.

“It wouldn’t surprise me if it peaks before the end of March,” he said.

Prof James Naismith, a director at the Rosalind Franklin Institute at the University of Oxford, noted the higher prevalence in Scotland than England despite its more stringent rules, including a continued mask mandate in shops and on transport.

“My main concern is for the vulnerable, for whom this disease is serious and for those whose lives will be blighted by long Covid,” he said.. “Every effort must be made to triple-vaccinate as many people as possible, quadruple-vaccinate the most vulnerable and make available antivirals.”

Sarah Crofts, the head of analytical outputs for the ONS Infection Survey, said: “These latest figures show further increases in infections across most of the UK with high levels of infection everywhere, and in Scotland the highest our survey has seen.

“It’s notable also that infections have risen in all age groups, with the over-70s reaching their highest estimate since our survey began.”

Schools in England have recorded rising numbers of Covid cases and absences as part of an “exit wave” of Omicron-variant infections. It comes after the ending of most safety measures in schools, including requirements for students to take twice-weekly tests.

Attendance data compiled by FFT Datalab shows that pupil absences in England are rising nationally for the first time since January. The south-west, including Cornwall, shows the highest rate of pupil absences, with nearly 10% of secondary school students off midway through March.

Tretherras secondary school in Newquay told parents this week that entire year groups would have to stay at home and learn remotely because more than 30 staff members were absent, including 22 with confirmed Covid cases.

Parents were told that sixth formers in year 12 were to work from home on Monday, following years 9 and 10 students working remotely this week.

“Please know that closing a school bubble is a last resort, and we have looked at alternative solutions and year groups, however, due to staffing implications this is not possible,” the school’s executive headteacher told parents.

Richard Lander school in Truro has also had more than 30 staff members off sick, the majority Covid-related, forcing it to tell students in years 8, 9 and 10 to work from home until next week.

Headteachers said supply staff remained hard to find, with schools prioritising teaching for students taking A-level, BTec and GCSE exams starting in eight weeks time.

“We are dealing with unprecedented levels of staff absence due to Covid, and despite our best efforts to ensure that all our students have a specialist, known teacher in front of them – or indeed a supply teacher – we have reached a point where sadly it is not possible,” said the head of one school who is organising a rotation of year groups working remotely.

Caroline Derbyshire, the chair of the Headteachers Roundtable group and executive head of Saffron Walden County high school in Essex, said her trust has had as many staff off with Covid in the four weeks since self-isolation and testing measures were ended as the previous 12 months.

Kevin Courtney, the joint general secretary of the National Education Union, said: “At such a critical time, with exam season looming, leaders are now faced with challenges on staffing and in some cases a sudden increase in remote learning.

“The government should reconsider its decision to end regular testing in schools and must certainly drop its premature proposals to start charging for test kits. ”

The provision of free Covid tests for the public in England is expected to end on 30 March.

COVID-19 Policies Carry Implications for South Korea's Presidential Election [Fair Observer, 18 Mar 2022]

By Timothy Rich, Andi Dahmer, Madelynn Einhorn

President-elect Yoon will need to address a changing COVID-19 environment amid a fatigued and divided Korean public.

On top of a highly contested presidential race and the election of People Power Party (PPP) candidate Yoon Suk-yeol on March 9, South Korea’s COVID-19 numbers are rapidly rising, with the country experiencing over 300,000 infections a day and record rates of COVID-related deaths. Despite the increase in cases, the South Korean government has removed several COVID-19 policies, including extending business closing times and removing the vaccine or negative test requirement to enter many public spaces.

Although South Korea has reduced its prior strict contact tracing policies, the percentage of critically ill patients is less than the country’s last peak in December 2021. The key question now is what the South Korean public thinks about the government’s COVID-19 response.
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South Korea’s 2020 national assembly election was internationally praised for balancing ease of voting amid pandemic restrictions and provided a blueprint for other countries, with President Moon Jae-in’s administration largely praised for its efficient response to the pandemic. South Korea even allowed citizens who have tested positive to cast a ballot at the polls once they recovered, even if voting had officially ended.

However, with cases rising in late 2021, evaluations of the Moon administration’s handling have soured, although still hovering around 40% — the highest in the country’s democratic history for an outgoing president and similar to his vote share in 2017. Yet Yoon and the Democratic Party’s Lee Jae-myung, both polling under 40% in the run-up to the election, declined to outline any pandemic response plan until November, when there was already a shortage of hospital beds — likely a result of the government’s “living with COVID” plan.

Similarly, minor candidates have not presented clear COVID-19 policies. Even beyond the “living with COVID” strategies, candidates have not shared concrete plans to build back infrastructure after the public health crisis.

To understand South Korean evolving perceptions of COVID-19 policies, we conducted a pre-election web survey of 945 South Koreans on February 18-22 via Macromill Embrain using quota sampling on gender, region and age. We asked respondents to evaluate on a five-point Likert scale the following statement: “I am satisfied with the South Korean government’s response to the coronavirus outbreak.”

We found, at best, mixed support for the government’s response, with overall disagreement outpacing agreement — 43.6% versus 35.8%. As before, perceptions deviate on party identification, with supporters of the ruling Democratic Party (DP) largely satisfied with the response (64.8%), while supporters of the main conservative party, the PPP, are largely dissatisfied (71.4%).

Supporters of the two smaller parties, the progressive Justice Party and the center-right People’s Party, showed responses that were more mixed, perhaps because candidates had not emphasized COVID-19 policies in campaign rhetoric. Regression analysis finds that women and older respondents are more supportive of COVID-19 policies, while after controlling for age, gender, education, income and political ideology, supporters of the DP were still more likely to evaluate pandemic policies favorably while PPP supporters were less likely to do so.

Noting this partisan divergence, we next wanted to identify whether views on COVID policy may have indirectly influenced support for one candidate over another. Regression analysis finds that even after controlling for demographic factors and party identification, satisfaction with COVID-19 policies negatively corresponds with voting for Yoon and positively for Lee.

However, we also found that views of COVID-19 policies largely correspond with evaluations of President Moon’s job performance, questioning whether these measures were driving evaluations of Moon or whether perceptions now may simply be picking up sentiments regarding Moon irrespective of the actual policies. Further analysis shows that including evaluations of Moon’s performance in our earlier statistical models results in the COVID-19 evaluation failing to reach statistical significance.

Whereas COVID-19 policies helped Moon Jae-in’s party in 2020 win a clear majority in the national assembly, our evidence suggests evaluations now may have contributed to an anti-incumbency vote even as both of the major candidates lack clear policy prescriptions related to the pandemic. Regardless, President-elect Yoon will need to address a changing COVID-19 environment amid a fatigued and divided Korean public.