Connect with us

Spread & Containment

Vaccines are necessary, but not sufficient without better healthcare and ventilation

Beating COVID cannot rely solely on the efforts of vaccines – economic policy must robustly support the path to full recovery, starting with healthcare and ventilation.

Published

on

A high vaccination rate is the foundation of any pandemic policy, but further protection is still needed. From an economic perspective, that protection comes from more investment in healthcare and air quality, which now seem essential complements to vaccines and face masks.

Looking at continental Europe over the last weeks, it seems the relative calm of the vaccine summer is over. The vaccines work wonderfully but are not a miracle cure. Austria is a painful example, where vaccination rates are low in mountainous areas (63% of total population), but much higher around Vienna (70%). And just as doctors in rural Salzburg were deciding between life and death three weeks ago, the situation got out of hand in Vienna as well. This culminated into a national lockdown, 2020 style.

Daily new confirmed COVID cases per million people

7-day rolling average. Due to limited testing, the number of confirmed cases is lower than the true number of infections. John Hopkins CSSE COVID data/Our World in Data

The reason is simple. The vaccines protect us against hospitalisation and severe disease (see graph below), but less against transmission with each month that goes by. Hence the term vaccine waning. As a result, the virus can still circulate in places with high vaccination rates, and crucially, pressure on hospitals can rise rapidly since vaccinated people still have a small risk of ending up there. A small percentage of a very large group is all it takes.

COVID-19 doses and confirmed deaths

Due to limited testing and challenges in the attribution of the cause of death, confirmed deaths can be lower than the true number of deaths. John Hopkins CSSE COVID data/Our World in Data

This pressure cooker would have been a lot more explosive without the vaccines, and we can be grateful for that, but it shows the limitations of a strategy solely based on vaccination. This goes for Western Europe, but also for the UK where COVID numbers have stabilised at an uncomfortably high level and are creeping up again.

More importantly, even if boosters can provide more sustainable protection against transmission, which seems increasingly likely, there is no guarantee this will also cover the latest Omicron variant. And adapting the vaccines to new variants takes 100 days at best.

Given this uncertainty, and to minimise the risk of further lockdowns which come with huge societal and economic costs, having a broader long-term strategy as we move from pandemic to endemic phase (the normal circulation of a virus, like flu) cannot hurt.

Increasing efforts

So what can be done? Besides getting that third shot into as many arms as possible, we can first of all boost healthcare itself. Since the crisis could last for years and we do not know what other crises lie ahead, this can be seen as a valuable insurance.

In the Netherlands for example, vaccination coverage is as high as in Belgium (75% of total population) but ICU capacity is lower (and only slightly lower than in the UK), which partially explains why Belgium was able to avoid a stricter lockdown last month.

Such a safety net then consists primarily of sufficient ICU, acute care, vaccination and testing capacity, but certainly also of more support for GPs and long-term care, since everything is connected.

As much of the current pressure on healthcare systems is due to absenteeism, protecting the mental health of healthcare workers and giving them a pay raise would be a quick win. Making lateral-flow tests freely and widely available across Europe to boost testing capacity, as the UK has done, is another. All in all, boosting healthcare can be seen as a productive investment, as it gives us more of a buffer before having to shut down schools or parts of the economy.

Subsidies to improve air quality could be a second strategy. Why not make this compulsory for all large office buildings and schools, and organise checks on CO₂ meters in the hospitality industry, for example? We have known for more than a year that the virus is also spread through the air – especially in enclosed spaces where the aerosol cloud can build up, just like cigarette smoke. So places need to be well ventilated. A recent study shows that indoor CO₂ monitoring reveals to be a practical proxy to Sars-CoV-2 transmission risk.

Better ventilation and air filters are a logical solution. Working with air filters is surprisingly cheap and flexible, and is a quick fix, while refitting existing buildings with better ventilation is more cumbersome and costly.

But even this would be a clear win in the long run, since studies show that well-ventilated spaces make for a better learning environment or workplace. Better air means fewer respiratory illnesses in general, so this investment would also increase our productivity in normal times.

Given that these are all productive investments, we can use our remaining fiscal flexibility to finance them. The benefits will outweigh the costs, which are still peanuts compared to the huge sums of state aid given to companies in the form of grants and loans during the pandemic, partially propping up “zombie companies”. The latter was a necessary evil, a side effect from saving entire economies from the brink in 2020-2021. But now the time has come to gradually phase out this support, and invest in strategies for the future.

Working from home

But even if we go for all those investments, we are not out of the woods yet. To fully eliminate the lockdown risk, we need to be able to switch up remote working relatively quickly. If the figures rise above a certain level, remote working could become the norm.

Experts will have to decide on the thresholds, and which jobs will qualify, but the principle is clear. When we are on the brink, we work from home as much as possible. Even when this causes efficiency losses, which is far from certain if we pick the right jobs, it must be clear to employers that the alternative of a lockdown is much worse. Unfortunately, we cannot continue paying for furlough schemes and state aid should something similar happen in future.

When the benefits of a policy outweigh the cost in any conceivable scenario, there is little reason not to do it. If politicians want to regain the trust they have lost along the way, showing us they can do the maths will restore our confidence in their competence.

Willem Sas does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Read More

Continue Reading

Spread & Containment

VIRI: Enrollment Complete in FORTRESS Trial; Results Expected in September 2022…

By David Bautz, PhD
NASDAQ:VIRI
READ THE FULL VIRI RESEARCH REPORT
Business Update
FORTRESS Trial Fully Enrolled; Topline Results in September 2022
On…

Published

on

By David Bautz, PhD

NASDAQ:VIRI

READ THE FULL VIRI RESEARCH REPORT

Business Update

FORTRESS Trial Fully Enrolled; Topline Results in September 2022

On April 28, 2022, Virios Therapeutics, Inc. (NASDAQ: VIRI) announced that it has completed enrollment of 425 fibromyalgia patients into the Phase 2b FORTRESS (Fibromyalgia Outcome Research Trial Evaluating Synergistic Suppression of Herpes Simplex Virus-1) trial, a randomized, double blind, placebo controlled study of IMC-1. The primary endpoint of the trial is reduction in pain and secondary endpoints include change in fatigue, sleep disturbance, global health status, and patient functionality (NCT04748705). An outline of the trial is shown below.

In parallel with the FORTRESS trial, Virios is continuing the chronic toxicology studies of IMC-1 in two animal species. The results of these studies are required by regulators before Virios will be allowed to dose patients for one year or more, which is the plan for the Phase 3 program. The results of the chronic toxicology studies should be known around the time of the completion of the FORTRESS trial, thus the company should be able to move into a final Phase 3 program following completion of the current study, pending positive results.

Testing Combination Antiviral Therapy for the Treatment of Long COVID

In February 2022, Virios announced a collaboration with the Bateman Horne Center (BHC) to test combination antiviral therapy for the treatment of Long COVID. Following an infection with SARS-CoV-2, the virus that causes COVID-19, approximately 30% of patients will experience symptoms that last for weeks or months, which is referred to as Long COVID. The range of symptoms varies from patient to patient, however the most commonly reported (from a recent meta analysis) were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%) (Lopez-Leon et al., 2021).

The main theories for what might be causing ...

Full story available on Benzinga.com

Read More

Continue Reading

Spread & Containment

Type-I interferon stops immune system ‘going rogue’ during viral infections

Hamilton, ON (May 17, 2022) – McMaster University researchers have found not only how some viral infections cause severe tissue damage, but also how…

Published

on

Hamilton, ON (May 17, 2022) – McMaster University researchers have found not only how some viral infections cause severe tissue damage, but also how to reduce that damage.

Credit: Georgia Kirkos/McMaster University

Hamilton, ON (May 17, 2022) – McMaster University researchers have found not only how some viral infections cause severe tissue damage, but also how to reduce that damage.

 

They have discovered how Type I interferon (IFN) stops the immune system ‘going rogue’ and attacking the body’s own tissues when fighting viral infections, including COVID-19.

 

Their paper was published in the journal PLOS Pathogens today.

  

Senior author Ali Ashkar said IFN is a well-known anti-viral signalling molecule released by the body’s cells that can trigger a powerful immune response against harmful viruses.

 

“What we have found is that it is also critical to stop white blood cells from releasing protease enzymes, which can damage organ tissue. It has this unique dual function to kick start an immune response against a viral infection on the one hand, as well as restrain that same response to prevent significant bystander tissue damage on the other,” he said.

 

The research team investigated IFN’s ability to regulate a potentially dangerous immune response by testing it on both flu and the HSV-2 virus, a highly prevalent sexually transmitted pathogen, using mice. Data from COVID-19 patients in Germany, including post-mortem lung samples, was also used in the study.

 

“For many viral infections, it is not actually the virus that causes most of the tissue damage, it is our heightened immune activation towards the virus,” said Ashkar, a professor of medicine at McMaster.

  

First co-author of the study and PhD student Emily Feng said: “Our body’s immune response is trying to fight off the virus infection, but there’s a risk of damaging innocent healthy tissue in the process. IFNs regulates the immune response to only target tissues that are infected.

 

“By discovering the mechanisms the immune system uses that can inadvertently cause tissue damage, we can intervene during infection to prevent this damage and not necessarily have to wait until vaccines are developed to develop life-saving treatments,” she added.

 

“This applies not just to COVID-19, but also other highly infectious viruses such as flu and Ebola, which can cause tremendous and often life-threatening damage to the body’s organs,” said first study co-author Amanda Lee, a family medicine resident. 

 

Ashkar said the release of harmful proteases is the result of a ‘cytokine storm’, which is life-threatening inflammation sometimes triggered by viral infections. It has been a common cause of death in patients with COVID-19, but treatment has been developed to prevent and suppress the cytokine storm.

 

Ashkar said that steroids like dexamethasone are already used to rein in an extreme immune response to viral infections. The authors used doxycycline in their study, an antibiotic used for bacterial infections and as an anti-inflammatory agent, inhibits the function of proteases causing the bystander tissue damage.

 

Lee added: “This has the potential in the future to be used to alleviate virus-induced life-threatening inflammation and warrants further research.” 

 

The study was funded by the Canadian Institutes of Health Research.

 

-30-

 

Editors:

Pictures of Ali Ashkar and Emily Feng may be found at https://bit.ly/3wmSw0D

  

 

 


Read More

Continue Reading

Spread & Containment

mRNA vaccines like Pfizer and Moderna fare better against COVID-19 variants of concern

A comparison of four COVID-19 vaccinations shows that messenger RNA (mRNA) vaccines — Pfizer-BioNTech and Moderna — perform better against the World…

Published

on

A comparison of four COVID-19 vaccinations shows that messenger RNA (mRNA) vaccines — Pfizer-BioNTech and Moderna — perform better against the World Health Organization’s variants of concern (VOCs) than viral vector vaccines — AstraZeneca and J&J/Janssen. Although they all effectively prevent severe disease by VOCs, the research, publishing May 17th in the open access journal PLOS Medicine, suggests that people receiving a viral vector vaccine are more vulnerable to infection by new variants.

Credit: Carlos Reusser Monsalvez, Flickr (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

A comparison of four COVID-19 vaccinations shows that messenger RNA (mRNA) vaccines — Pfizer-BioNTech and Moderna — perform better against the World Health Organization’s variants of concern (VOCs) than viral vector vaccines — AstraZeneca and J&J/Janssen. Although they all effectively prevent severe disease by VOCs, the research, publishing May 17th in the open access journal PLOS Medicine, suggests that people receiving a viral vector vaccine are more vulnerable to infection by new variants.

By March 2022, COVID-19 had caused over 450 million confirmed infections and six million reported deaths. The first vaccines approved in the US and Europe that protect against serious infection are Pfizer-BioNTech and Moderna, which deliver genetic code, known as mRNA, to the bodies’ cells, whereas Oxford/AstraZeneca and J&J/Janssen are viral vector vaccines that use a modified version of a different virus — a vector — to deliver instructions to our cells. Three vaccines are delivered as two separate injections a few weeks apart, and J&J/Janssen as a single dose.

Marit J. van Gils at the University of Amsterdam, Netherlands, and colleagues, took blood samples from 165 healthcare workers, three and four weeks after first and second vaccination respectively, and for J&J/Janssen at four to five and eight weeks after vaccination. Samples were collected before, and four weeks after a Pfizer-BioNTech booster.

Four weeks after the initial two doses, antibody responses to the original SARS-CoV-2 viral strain were highest in recipients of Moderna, followed closely by Pfizer-BioNTech, and were substantially lower in those who received viral vector vaccines. Tested against the VOCs – Alpha, Beta, Gamma, Delta and Omicron – neutralizing antibodies were higher in the mRNA vaccine recipients compared to those who had viral vector vaccines. The ability to neutralize VOCs was reduced in all vaccine groups, with the greatest reduction against Omicron. The Pfizer-BioNTech booster increased antibody responses in all groups with substantial improvement against VOCs, including Omicron.

The researchers caution that their AstraZeneca group was significantly older, because of safety concerns for the vaccine in younger age groups. As immune responses tend to weaken with age, this could affect the results. This group was also smaller because the Dutch government halted use for a period.

van Gils concludes, “Four COVID-19 vaccines induce substantially different antibody responses.”

#####

In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003991

Citation: van Gils MJ, Lavell A, van der Straten K, Appelman B, Bontjer I, Poniman M, et al. (2022) Antibody responses against SARS-CoV-2 variants induced by four different SARS-CoV-2 vaccines in health care workers in the Netherlands: A prospective cohort study. PLoS Med 19(5): e1003991. https://doi.org/10.1371/journal.pmed.1003991

 

Author Countries: The Netherlands, United States

 

Funding: This work was supported by the Netherlands Organization for Scientific Research (NWO) ZonMw (Vici grant no. 91818627 to R.W.S., S3 study, grant agreement no. 10430022010023 to M.K.B.; RECoVERED, grant agreement no. 10150062010002 to M.D.d.J.), by the Bill & Melinda Gates Foundation (grant no. INV002022 and INV008818 to R.W.S. and INV-024617 to M.J.v.G.), by Amsterdam UMC through the AMC Fellowship (to M.J.v.G.) and the Corona Research Fund (to M.K.B.), and by the European Union’s Horizon 2020 program (RECoVER, grant no. 101003589 to M.D.d.J). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


Read More

Continue Reading

Trending