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Posts Tagged ‘Pandemic’

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.

 

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.

 

 

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.

 

 

The Delta strain and new dangers

21 Jun

The new Indian strain, called Delta by WHO, re-infects and can become dominant, it is 40% more transmissible and can present twice the risk of hospitalization, in addition the symptoms are deceiving because they seem more like a bad cold and people continue to come out, according to the English newspaper The Guardian.

This is prompting the UK to re-evaluate the easing date, previously scheduled for 21 June, which is now expected to be delayed.

Vaccination continues, however, the effectiveness of some vaccines is beginning to be put in check, AstraZeneca itself already admits setbacks in the third phase of tests, carried out on a larger scale of vaccinated people, some newspapers mention 33% but the official WHO indication is 63.09%, slightly above Coronavac, which is around 51%, and below Pfizer, which is 70%, but with the 2nd. dose the numbers are similar around 80%.

A breakthrough in research, done by Beaumont Hospital in Dublin, finally explained why blood clotting in patients with Covid 19 is high levels of pro-coagulation VWF (von Willebrand Factor) molecules and low levels of ADMTSS (a plasma protease which is anticoagulant) due to alterations in proteins in severe cases of covid.

Basil received a batch of 824.4 thousand doses of the Pfizer/BioNTech vaccine from the Covax Facility consortium that arrived at Viracopos airport in Campinas (SP), the first batch of this vaccine by the consortium, the others were purchased.

Brazil reached the sad mark of 500,000 deaths, with a number of deaths above 2,000, and with a number of infected at around 80,000, these are still high numbers, but the leap above 3,000 would mean a third wave that continues to threaten us.

According to the consortium of companies in Brazil, more than 63 million people received the first dose, totaling almost 30% of the population, and almost 80% of the available vaccines were used, it is believed that this number could reach 100 million and total close to 50% of the population with the first dose, a number that we reaffirm will be enough to hold the 3rd. wave.

It is necessary to redouble the care and avoid crowding, more rigorous isolation measures need to be taken.

 

 

The metaphor and the ineffable

11 Jun

The epistemological challenge is pointed out by Paul Ricoeur of accepting the discovery model, since to reject it “or to reduce it to a provisional experience, which replaces, in the absence of a better one, direct deduction, is to reduce the very logic of discovery to a deductive procedure” (p. 369).

In this context, we highlight the function of the parable that creates a scene that bridges the ineffable and the reality it re-describes, it introduces a plot that produces something beyond the everyday, the parabolic utterance is also metaphorical in this sense.

Like describing a future reality that hasn’t happened yet, the logic has been to re-describe reality using rhetoric, which explores only present reality and denies utopia and fiction.

Ricoeur thus defines the parable as the conjunction of a narrative form and a metaphorical process and also means the narrative of a short fictional story with the aim of interpreting something else that according to the narrator is preferable, in order to interpret it well, to leave it in the sense of the metaphorical.

Future realities that cannot thus simply be described or deduced because they did not actually happen, what will our post-pandemic reality be, what will the human future be like.

Many authors try to unravel this ineffable reality, but it is not deductible, it is a “bridge”.

When explaining the divine realities in the Bible, because Jesus said it was ineffable, he compares it to different situations using a parable, he says in Chapter 4 of the Gospel of Mark (Mark 4:26-27: “Jesus told the crowd: “The Kingdom of God is like when someone scatters the seed on the earth. He goes to sleep and wakes up, night and day, and the seed goes on germinating and growing, but he doesn’t know how it happens…”, compares with the harvest and a tiny seed that is the mustard.

Thus to describe these realities only by logic and deduction is to ignore both the discovery of reality itself and to falsify, for a scientific path, as the divine realities, a tiny seed becomes a beautiful and leafy tree, and this also happens in history

 

 

The third wave is attenuated in Brazil

07 Jun

We posted here that it was possible to reach figures close vaccines to 50% by the end of June and that the first week was decisive, the data indicate a reversal of the curve, but it is necessary not to hesitate and continue the vaccination, Brazil received new doses from Pfizer (more than 500,000) and AstraZeneca’s vaccination continues to do well, and the forecast is for another 40 million doses by the end of the month.

It can be said that at this moment there is an attenuation, the number of deaths on Friday is 1689 while infection is above 66,000, figures that show the importance of vaccination as the number of infections is still very high and without vaccination the of deaths would remain high.

The deceleration of vaccination is pointed out in some media, but it is not clear whether it is the distribution or application, it can still be a third thing, operationalization, which would be very regrettable since the INSS and the health departments have a good structure and distribution.

In percentages the number of vaccines distributed, the government speaks of a number above 100 million and the states say they have received 90 million, and there are vaccines in stock, in percentage would be 52 million from AstraZeneca/Oxford/Fiocruz, 47.1 million from Coronavac and 3.5 million from the Pfizer/BioNtech vaccine, this variation is interesting due to its efficacy for different ages.

The distribution carried out so far already allows the application of doses, at least the first dose, in 18 of the 28 priority groups of the PNO (National Plan for the Operationalization of Vaccination against COVID-19), which was defined by social vulnerability and greater risks of comorbidities.

The current stage is beginning to prioritize comorbidities in different age groups and health professionals, but the trade that would be extremely important is not included in the plan.

The numbers in the world are still worrying, see the graph, there are still countries with the possibility of a third wave and a definite lesson from the Pandemic is that we must worry about everyone.

 

 

Third wave, new strain and new medicines

31 May

While we are looking ahead to a possible third wave in June in Brazil, the numbers are still around 2,000 deaths, as we posted last week if falling could mean contention (a high rate of 78,000 cases, but deaths below 2 thousand) and if it reaches above 3 thousand the third wave has arrived and a new isolation protocol will be necessary (see the graphic).

Regardless of the third wave, there are already several cases of the Indian virus, the new strain, which arrived in Brazil without a strict isolation protocol, it will spread and this is almost hopeless.

The news of an Australian antiviral and an Israeli remedy, the latter MesenCure uses mesenchymal stromal cells (MSCs) isolated from adipose tissue from healthy donors, relieve respiratory symptoms in infected patients and reduce inflammation.

The Australian drug made by scientists at Griffith University, in collaboration with the American City of Hope Research Center, uses a technology that involves gene silencing RNA (siRNA) that directly attacks the virus’s genome and prevents its replication, the test so far it has been done on rats.

We have to keep trying to create protocols as the vaccination does not progress (21.5%).

The state of Rio de Janeiro tries to do a massive vaccination, despite not having enough medicines, the idea is to open the vaccination for the rest of the population, until now only people over 60 and some special classes like nurses, bus drivers and cops.

The state of São Paulo will test, but in two small municipalities Taquaritinga and Batatis, providing RT-aPCR tests and rapid antigen tests, starting with a vertical isolation strategy so criticized at the beginning of the Pandemic, Butantan will make a home visit in 2 thousand homes dividing each municipality into 11 regions called “clusters”, the idea of ​​networks.

It is, therefore, a test by sampling and the population that is not drawn can make a self-assessment through an application called Taina/GHM and answer quick questions.

 

 

The danger of the third wave and the vaccine for the poor

24 May

The richest countries in the world have only 13% of the total population and for this first semester already have more than half (51%) of the doses of vaccines against covid-19 in development, the search for profit and the market dispute has led to this.

A strain of the virus is advancing in India that does not yet have very decisive data on the effectiveness of vaccines, so sending a test to the state of Maranhão is important, we will be able to know the effectiveness of the 3 vaccines that are already in Brazil for this variant , Coronavac, AstraZeneca and Pfizer, although the number of doses is still small, Brazil made a purchase of 100 million doses for October.

We need to go through the reverse with some security, the CNN website (figure) warns of the real danger of the third wave, the production of more vaccines with input already made in the poorest countries will be decisive for an increase in vaccination, which is still slow.

In percentage terms the logic is simple, if by the first week of June we are close to the level of 4 thousand daily deaths, the third wave has arrived, if we are below 2 thousand it has been stopped.

A shipment of Active Pharmaceutical Ingredients (IFA) arrived this Saturday at FioCruz, and will be used for the production of 12 million doses of vaccines, with the production of inputs in the country already started we can reach around 20 million doses (the promised is 18 million doses), will still be insufficient if Coronavac does not increase its production.

The government beckons with a total of 90 million doses, and the second dose for people over 70 is about to start, but it is necessary to respect the 90-day interval of the AstraZeneca vaccine.

In the case of Coronavac, the ideal interval is 21 to 28 days, to increase the effectiveness to 62.3%, but it is being used in an interval of 14 to 28 days, this effectiveness, which is low, can be maintained.

The essential thing now is to keep an eye on the new strain of India that already has registered cases in the country, make a strict isolation and maintain the protocols of maximum security, a poorly done thing.

 

 

Pandemic´s time of the planet

17 May

The data observed by the Opera Mundi website, there you can see the pandemic numbers all over the world, show that in the pandemic cycles, despite the vaccination that according to the website reached 1.5 billion doses administered on Sunday night (if the world population is around 7.5 billion people) this means 20% of vaccination worldwide, of course it varies in many regions.

India for example, which is the worst case of Pandemic at the moment, is the third most vaccinated with more than 179 million doses, but has a population of almost 1.4 billion people and this gives 7% only vaccinated, well below the world average (above) of 20%. The number of deaths falls, but the number of infections grows.

Brazil with approximately 37 billion vaccines for at least the first dose (the number of more than 50 billion vaccines is added to the first with the second dose, which counts those who took the 2nd dose twice) also means a number below average, with a population of more than 200 million inhabitants (211 in the last estimate), this is 20%, which means on average, but the seriousness of the Pandemic still requires greater efforts.

The purchase of 100 million doses of Pfizer could make us optimistic, if it weren’t for October, and the value of 6.6 billion reais means this means 66 reais per dose, something around 10 euros or 9 pounds sterling in exchange current, expensive price and the vaccine requires special logistics because it must be kept at low temperature (dry ice, refrigerated transport, refrigerators, etc.).

All of this could make us optimistic, but the reality is not quite this, it is observed that even in countries where there was a sharp drop (England and Portugal for example) you cannot let your guard down because the world is a global village and even with few flights people circulate, and a case of infection, and there are new strains of the virus, can trigger the whole process again.

It is time for the planet, we can and we must take a planetary attitude, we have not yet done so, and even regulators, governments and health agencies still seem to fall short of the measures to be taken, for example, in the case of India and in the creation of protocols for travel, a global plan is required.

There is a fair concern that this is done exclusively by political and non-technical-sanitary criteria, which is a fact, but as politics has not helped, we can help politics with sanitary attitudes, in a current language: public health policy.

The campaign is simple and global: vaccine for everyone, global protocols in relation to types of vaccines, by age, type of comorbidity, equitable distribution (for example, reaching 20% vaccination in all countries as a target for this month), we could think 50% by July that it would be an audacious attempt, but doing the math: there will be the production of 3.5 billion doses by July counting all vaccines (we are already at 1.4 billion) does not seem an impossible number.

Vaccine for everyone !!! aid to poor countries and countries of major pandemic crisis.