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Posts Tagged ‘pandemia’

Caution and caution with new variants

30 Aug

In Brazil until Saturday, the Ministry of Health distributed more than 230 million of the vaccines against covid-19, these 187 million have already been applied, being 128.4 million in first doses and 59 million having completed the scheme, which gives 36 .9% of the population, and still not enough, as the new variants affect while the scheme is not completed.

The number of deaths and infections in Brazil has been falling slowly, but it is still in the range just below the 1,000 daily deaths of the moving average and close to 20,000 daily infections.

Extensive research carried out by FioCruz revealed that by completing the vaccination scheme, the AstraZeneca-Fiocruz and CoronaVac vaccines are effective against infection, hospitalization and death: AstraZeneca-Fiocruz with 90% protection and CoronaVac with 75%.

Thus, with 36.9% of the vaccination schedule, the current stage of immunization is still fragile, and the new protocols for flexibility have no scientific basis, except for research carried out with rigor and proven data, all information disclosed, even by official bodies, is not are reliable.

The infectologist and researcher at Fiocruz Julio Croda, said in an interview with CNN, that it is necessary to speed up vaccination to protect people more effectively against the Delta variant, and that the effectiveness drops for the elderly and people with comorbidities.

As for the possibility of using the mixed vaccine scheme, called interchangeability, a study conducted by the University of Oxford, UK, showed that the vaccines that show better immune responses are the combination of Pfizer and AstraZeneca, with an interval and four weeks, with the highest results being AstraZeneca followed by Pfizer.

Flexibility is the responsibility of government health agencies, but care is a personal measure that we can all take, while avoiding crowding, using masks correctly and using alcohol gel, must continue to follow the protocols.

A long period of pandemic also causes personal and psychological stress, it is necessary to find occasions for outdoor walks, relaxation in different ways and virtual contacts with friends and colleagues in the work environment.

 

 

 

Delta variant still worries

23 Aug

The cases of the Delta variant and the new Alfa variant, which came from the United Kingdom are still worrying, monitoring is needed, movement control, and in the case of Brazil, the state of Ceará, which has 43 cases, provides an example, having created a monitoring center and screening for travelers, Ceará has 43 Delta cases and there is already a case of the Alfa variant coming from the United Kingdom.

The cases in state of Ceará (Brazil) are 24 women and 19 men, the majority (33) are between 20 and 39 years old, which makes sense because the second dose is still happening at the ages, there are cases coming from Nova Friburgo (RJ) and São Paulo and the others live in 20 different municipalities in Ceará, all of whom had mild, moderate, or asymptomatic symptoms.

It is a moment of caution and the flexibility of many state governments may be premature, the curve of deaths and infections is at a stable level, and with vaccination, the expectation was for it to fall.

As reported by the consortium of press vehicles, the number of people who received the first dose is 122 million while 54 million took the necessary doses (a vaccine uses only one dose), were the data of last Saturday (21/08).

As safety for the delta variable is necessary for complete immunization, the exact number of 54,890,099 people (24.92%), which gives a quarter of the population, is too low for the new Delta and Alpha variants (which are already starting to advance in the country), the possibility of reaching 60% immune is still far, September will be a fatal month, and the level of infections and deaths is still high and stable.

Some states are slightly above (states of Brazil) Mato Grosso do Sul (40.59%), São Paulo (32.40%), Rio Grande do Sul (31.62%) and Espírito Santo (28.33%), the others are close or below of an average of 25% complete immunization, according to the press consortium.

Recents data indicate that the Southeast pulls the infection curve up by 7%.

We must learn from Southeast Asian countries as infections grow due to low vaccination rates, even countries like China, Japan and South Korea are seeing increasing outbreaks, as reported by the CNN website, data from Brazilian daily “O Globo” indicates data from some countries in the region, infections in blue and deaths in black (figure).

 

 

Genomic surveillance and precautions

16 Aug

According to José Eduardo Levi, coordinator of the Genomic Surveillance Scientific Project (Genov), 11 of the 1380 analyzed between May and June had a mutation called P681H, in which the amino acid proline is replaced by another one, histidine, and is being called Gamma plus.

The Delta variant is already spread across the country with a record of 760 cases up to 5 days ago, however, Gama-plus: “a convergent mutation with a characteristic of Delta, a variant that usually presents this structural change” said the project coordinator Genov.

Many experts have warned that easing may be premature, and we may have to live with restrictions for a while, although the rate of vaccination has advanced, it still does not have a sufficient safety margin beyond the risk of new variants.

The death of actor Tarcisio Meira from complications of covid-19, having taken the two doses of the vaccine, rekindled the debate on the effectiveness of vaccines, but experts are categorical in saying, based on studies by USP and UNESP, that 91.49% of those who died did not have the second dose or the single dose in the case of the Janssen vaccine.

On the other hand, the Delta, Delta-plus and Gama-plus variants are of concern to infectologists around the world and many countries are reviewing the flexibility measures, however the WHO itself warns of the “false sense of security” due to 80% of cases of infection of the last 4 weeks are of the Delta variant.

It should also be noted that the younger population, the most prone to activities that can cause crowding, still do not have the second full dose and it is important to maintain restrictions so that the new, more lethal variants do not cause countless deaths.

 

Delta variant and slow vaccination

09 Aug

The delta variant of covid 19 has lit a warning around the world that the pandemic may not yet be under control. In Brazil, the recent Oswaldo Cruz Foundation Bulletin (FioCruz) states after a study that there is a dangerous combination, high Delta contagion and slow vaccination .

The risk of the explosion of a new wave of contamination and infection is worrying, the study points out that Brazil already has 435 confirmed cases of the Delta variant and in 19 states the levels of contamination are dangerous despite being declining.

In an interview with CNN, last Friday (08/06), deputy director Jarbas Barbosa of the Pan American Health Organization (PAHO) warned that confirmed cases of the Delta variant in Brazil are just the “tip of the iceberg” and highlighted the importance “that the vast majority of cases of the variant are asymptomatic or mild, which do not realize and are not tested”.

We cannot relax prevention and isolation measures, recalled Jarbas Barbosa, in the cases of Chile and Uruguay that after relaxing measures had a new wave of infections, although Uruguay announced a weekend without deaths for the first time.

The contagion comparison made with the Delta variant is didactic, as contagious as chickenpox, can cause more severe symptoms than the previous variants and are also transmissible among vaccinated, according to the US Centers for Disease Control and Prevention ( CDC), in an article published in The Washington Post, in a note signed by Maíra Menezes, the Fiocruz postcard also warns of the danger of this variant.

Vaccination is important, which is still slow, the current numbers are close to 45 million for the two doses and 100 million for the first dose, it is possible to accelerate and as there is still no explosion of the Delta variant in the country, if combined with preventive measures, we can prevent a new wave of infections, hospital overflows and deaths.

Both infections and deaths that fall slowly in Brazil have a tendency towards stability with a slight increase, it is too early to say that it is the Delta variant, but a policy of testing and prevention would be important, researchers of Fiocruz warns of the lack of a plan B.

 

 

The danger of the delta variant and vaccination

02 Aug

Concerns are growing about the delta variant of the coranavirus,  the indication is that some vaccines may not be fighting this variant, the growing number of infections, even in countries with advanced vaccination, is worrying.

WHO Director Tedros Ghebreyesus said two days ago to various media outlets at a press conference: “New cases of contamination and deaths continue to rise. There were 4 million new cases in one week. At this rate, we will surpass the mark of 200 million of infected in two weeks, although we know that this is an underestimated number”, he pointed out.

Since the third week of July, Europe and the United States have again registered an increase in infections due to the delta variant.

Even in China, which had controlled the pandemic, this number grew again, still small (200 cases), but it is already spread over several regions. peoples in dangerous cities will be tested.

In Brazil the moving average is below a thousand daily deaths, it slowly drops as vaccination progresses, but cases of the delta variant already appear in the country, and the real effectiveness of the vaccine in relation to this variant is concerned, there is poor monitoring in some states, testing should begin immediately and en masse, there is no evidence.

The idea of making the measures more flexible continues and will probably not go back until another outbreak, only one state (Rio de Janeiro) registers an increase, 8 states in stability and 15 in decline (São Paulo is one of these).

The WHO and the World Bank call for the urgent application of vaccines in poor countries, the average in high-income countries is the application of 98.2 doses per 100 inhabitants; while in low-income groups, the number is 1.6 doses per 100 people.

Regardless of the effectiveness of vaccines, vaccination must continue and so must restriction.

 

Vaccines and the delta variant

26 Jul

The number of people vaccinated in Brazil approaches 50% in the first dose (46.7%) and 20% in the total vaccination (17.6%) however the effectiveness of vaccines for the delta variant is being studied in the last week of the Institute Butantan started a study to see the effectiveness of CoronaVac.

The delta variant may cause a fourth wave, the warning is from the WHO, which asks that the measures of distance, use of masks and control of social gatherings not be relaxed.

Monitoring carried out in the country registered and located 145 confirmed cases of this variant in the Federal District and in the states: Maranhã, Minas Gerais, Rio de Janeiro, Rio Grande do Sul, Santa Catarina and São Paulo.

The death curve continues to fall slowly in Brazil (see photo).

An article published in the scientific journal New England Journal of Medicine points out that the Pfizer and AstraZeneca vaccines protect against the Alpha and Delta variants, especially after the second dose, according to the article, Pfizer avoided 88% of symptomatic cases and AstraZeneca 67%.

The Department of Health of the United Kingdom (PHE in English) released a study made with more than 1 million people in risk groups and pointed out that with two doses the effectiveness of these two vaccines rise to 93% and 78% respectively, when treats people aged 16 to 64 years.

In the Netherlands, the government announced that it will re-impose restrictions on nightclubs, festivals and restaurants, these restrictions had been lifted in June, but the infection picture freaked out with 7,000 records of the disease in the last week, before the cases were already less than thousand.

The picture is a setback for Spain and Portugal, who wanted the resumption of tourism.

 

Accelerated vaccination and new concerns

19 Jul

Vaccination accelerated in July as was the optimistic expectation, the fall in infections and deaths is still very slow and the new waves of infection in countries in the region such as Chile and Argentina light a warning sign, Peru was already in high numbers and some countries in Europe, such as Russia, also show that the Epidemic is far from over.

Argentina reached on Wednesday (14/7) the symbolic mark of 100,000 deaths, high for a population of 44.5 million inhabitants, and entered a new lockdown, with results already containing the new high, the numbers in week fell again.

Brazil like Argentina reaches the number of vaccinated 16% and 11% respectively, while the first dose in Brazil reaches 44.5% and Argentina 45% (see chart above), the next numbers suggest greater attention to the possibility of a new ascending curve, it would be a greater expansion of the delta variant, climatic factors (Chile and Argentina are colder) or even a variant called lambda , and the effectiveness of the Russian Sputnik is questioned.

The lambda variant detected in Peru is frightening, called C.37, its preliminary studies indicate greater lethality and the ability to circumvent vaccines is serious. Researcher Pablo Tsukayama, coordinator of the Microbial Genetics laboratory at the Cayetano Heredia de Lima University, detected that the variant it is already 100% of the infected cases in Peru as of April 2021.

The lack of open data hinders the research, the Ministry of Health of Peru does not disclose it and Professor Tsukayama is one of those protesting this lack of access.

Another issue of concern is the lack of scientific data on the effectiveness of vaccination for the new variants, there are many people who make statements trying to compromise, but do not present clear scientific studies, for example, on new variants such as lambda.

One of these studies, reported by the newspaper El País on July 11, is by Chilean virology Ricardo Soto Rifo, who focused on the CoronaVac vaccine, the main one used in Chile, in a group of volunteer health workers who discovered that lambda presents “increased capacity for infection and immune escape against neutralizing antibodies”, the extent of such loss remains to be clarified.

Another study pointing out in El País is that of the Pfizer and Moderna vaccine, from the University of New York, pointing out that the results were “relatively lower”, but Professor Tsukayma makes a less than encouraging observation: “It is practically impossible to predict how a virus will suffer mutation”, but reducing transmission is possible through vaccines and this is effective.

 

 

Fall trend and vaccination in Brazil

12 Jul

According to the consortium of press vehicles, the number of vaccine doses in Brazil reached 83,794,712 for the first dose, while 28,108,088 for the second, to this value must be added 2,465,295 single doses, for a total of 114.3 million doses applied, it is expected to grow to maintain the declining curve seen in infections and deaths.

In percentages it means 14.4% who have already received either the second dose or Janssen, which is a single dose, while the percentage that received the first dose is close to 40%, this being important to contain the most offensive variants, the delta and the delta plus, which are already in the country.

It should be noted that clinical analyzes indicate that the second dose is needed for the new variant, and a wider range above 60% starts receiving the second dose, but the application of Janssen is the most optimistic because the number of can make the immunization grow.

When will we achieve so-called herd immunity that will allow for the relaxation of protective measures is the question we all want to know, Anthony Fauci, head of the US National Institute of Allergy and Infectious Diseases, one of the leading physicians in the efforts against covid-19 in there, it estimates that it should reach 70% of the population, but there are others who indicate that it would be 80% to 90%, as the biggest problem is the mutability of the virus.

Japan, which has numbers close to Brazil, 17% for the two doses and above 30% for the first dose, has already announced that there will be no public at the Olympics starting in a week, and the athletes’ trips will be monitored with all measures of protection.

At the pace of vaccination, all precautions are still needed, whenever there has been some relaxation, there has been an increase in cases and deaths, we expect the curve to keep falling.

 

 

There will be no return to frivolity

06 Jul

Although media philosophers and optimists out of context want some return to some kind of normality, we already have two irreversible structural changes, the need to understand total interdependence, no one is isolated and the restructuring of social and urban life.

England about to return to normality and the United States, which celebrated its Independence Day, thinking of celebrating the independence of the coronavirus, admit failure, in both countries the authorities declared that we must live with this difficulty, in UK the same.

The concept of coimmunity was developed by Peter Sloterdijk in another context, a kind of mutualism in which everyone is responsible for everyone, finding scapegoats either in the creation of the virus or in ineffective combat became difficult to accept conspiracy theories, in both cases political opportunism is present, even though it is possible to perceive a fight that is not always effective.

On the individual commitment aimed at mutual protection, Peter Sloterdijk thinks that neither is the time for national withdrawal nor has the world become small for everyone, consumption exists thanks to frivolity, there is no public consumption if there is no appeal to it.

What should happen is a new requirement of mutualism, it is still just a trend, but the idea that we will not easily get out of living with the danger of the virus and new mutations leads us to the need for a new community consciousness, in addition to the one mentioned and not practiced.

What Sloterdijk calls mutualism could become something even broader, he said in an interview with the newspaper El País: “The need for a universal shield that protects all members of the human community is no longer a utopian thing. The huge medical interaction around the world is proving that this already works”, the problem is that disputes and nationalism prevent this.

Sloterdijk’s answer is quite interesting: “these movements are not operational, they have impractical attitudes, they express dissatisfaction, but they are in no way capable of solving problems. I think they will be the losers of the crisis”, I agree with him.

The only caveat is that these disputes can lead to irreversible clashes, which would be catastrophic for all of humanity and, moreover, a topic that he also touches, democracies are at risk.

His answer is: “in the future, the general public and the political class will have the task of monitoring a clear return to our democratic freedoms”, the desire to suppress them is on the agenda every day.

 

 

Falling curve but slow vaccination

05 Jul

Despite the curve of infections and average deaths (see curve), the problem starts to be the second dose that is stable at 12% in the last week, we warn that the problem could get worse because the number of doses of AstraZeneca and Coronavac should increase because of the second dose.

The number of confirmed cases on Friday was 54,101 and the moving average of the last 7 days was 50,905 infections (in 14 days a drop of 30%), the number of deaths, although still high, is below 2,000 deaths, and there is no state in high, also the ICUs are beginning to be relieved, the most serious regions are around 70% hospitalizations, but in decline.

The controversies of expired vaccines, and the case of Janssen who had many vaccines frozen (they need a special temperature system of -2°C) but are safe, says the Ministry of Health, in addition and Belo Horizonte now also Campinas applied doses of the vaccine in homeless people, a commendable humanitarian measure, since this vaccine immunizes in a single dose and these people have difficulties with sanitary measures.

Cases of expired vaccines are being identified in several cities, some places like the city of Rio de Janeiro had wrong registration in the system, the situation is not out of control and in several cases a new vaccination is already being done, it is important to check with precision the cases where the vaccine was really expired, where there was a system error and the exact number.

The case of the purchase of the Indian Vaccine Covaxin became the center of the government’s political crisis due to accusations of corruption, the negotiation was suspended by the Ministry of Health and the purchase should be canceled, in addition to the politicians, the CGU should also continue with the investigation process.

The serious problem is the slowness of vaccination, we warn that in July, several factors could put the process in check, the need for a second dose, which upon arrival in the municipality is immediately available for vaccination.

The executive secretary of the National Council of Cities Secretariats in Brazil (Conasems), also explaining the case of expired vaccines, guaranteed that the vaccines arriving are immediately made available to the population, so the problem is Anvisa’s (Health Control in Brazil) this control.

Mauro Junqueira, the secretary of Conasems however clarified that it is not always possible to have direct control on the tablet or computer system, sometimes it is done on paper and then placed in the computerized system, the diversity of municipalities in the country explains this easily.

We insisted on the need to increase the production of vaccines for the month of July, the number last Wednesday according to CNN was 3 million doses of Janssen vaccine, 3.33 million doses of Pfizer’s immunizing agent and another 7.15 million of the AstraZeneca/Fiocruz product, total 13.5 million.