Influenza

WHO Claims We’re Only at “Halfway Mark” of Pandemic and Warns Against Treating Covid Like Flu

The World Health Organisation has said we are only at the “halfway mark” of the pandemic and warned against treating Covid like flu, days after the Government said it intended to do just that. MailOnline has the story.

David Nabarro, the WHO’s special envoy for Covid, said the comparisons were irresponsible because they suggest coronavirus “has suddenly got incredibly weak”.

He told Sky News: “It can also mutate and form variants and we’ve seen several but we know there are more not far away. 

“So quite honestly, we are not saying that this should be considered to be like flu or indeed like anything else – it’s a new virus, and we must go on treating it as though it is full of surprises, very nasty and rather cunning.”

The official called on leaders to “stay focused on the job” as he claimed we were only at the “halfway mark” of the pandemic. 

Parallels between coronavirus and influenza are being drawn in the U.K. now that Omicron is causing around the same number of deaths as a bad flu season.    

Boris Johnson last week signalled his intention to lift isolation rules for Covid sufferers, highlighting that people with flu don’t legally have to quarantine. 

And Health Secretary Sajid Javid pointed to the U.K.’s falling case numbers and relatively low hospital rates as he said “we need to learn to live with Covid in the same way we have to live with flu”.

Asked about the comparisons, Dr. Nabarro told Sky News: “I keep wondering what the people who make these amazing predictions know that I and my colleagues in the WHO don’t know.

“You see, what people are seeing from around the world and reporting to the WHO is this is still a very, very dangerous virus, especially for people who have not been vaccinated and who’ve not been exposed to it before.”

Did you spot the factual error there, saying Omicron was causing the same number of deaths as a bad flu season when deaths in the most recent week were well below average?

Dr. Nabarro’s comments also make no sense in the U.K. context, as he refers to “people who have not been vaccinated and who’ve not been exposed to it before”, which refers to almost zero percent of the U.K. population.

Will they ever let the emergency end?

Worth reading in full.

Now They’re Redefining ‘Endemic’ to Keep the Pandemic Going On and On

Uh-oh, now they’re trying to redefine the word ‘endemic’ in a way that moves the end of the emergency even further away.

Paul Nuki, of the Telegraph‘s Gates-funded Global Health Security team, has written a piece pushing this agenda (though to be fair to Bill Gates himself, last week he said Covid is now becoming like flu, an endemic disease). Here are some excerpts, with my comments interpolated in boldface.

Christina Pagel, a Professor of Operational Research at University College London, notes that “a virus isn’t endemic just because a Government minister says it is and just because people want it to be”. [Note that Prof. Pagel is a mathematician with no medical training.]

“The current pattern of waning vaccination, new immune evasive variants, and minimal public health response seem set to doom us to massive surges once or twice a year”, she tweeted last week. [A seasonal respiratory virus then.]

Dr Helen Salisbury, a senior GP and Oxford academic, added that people may regret talking about Covid becoming endemic as a good thing. “TB and smallpox were once endemic in the UK – it doesn’t mean mild, it just means widespread”, she warned. [But Covid, and particularly Omicron, is mild.]

So what does it really mean for a disease to become endemic and where do we stand as regards SARS-CoV-2?

Francois Balloux, a professor of computational biology at University College London, was one of the first to talk about Covid becoming an endemic disease and says, “in retrospect, we epidemiologists should have come up with a tighter definition”.

He says the common dictionary definition of the word – a disease regularly found among people in a particular area – is misleading. For epidemiologists, the term is more technical and relates to a virus’s reproduction value settling at around one.

“Essentially it means that things are kept in check up to a point by the immunity in the population”, says Prof Balloux. “There is a stability and a predictability to an endemic pathogen but the complication is that they can still go up and down”. [So is it stable and predictable or not?]

Influenza is a good example. Its seasonal waves are largely predictable and kept in check through a mixture of natural immunity, vaccines and behaviour change. [Flu being endemic and ‘kept in check’ has nothing to do with vaccines or behaviour change. Vaccines probably reduce the death toll but it was endemic and ‘kept in check’ before vaccines came along. And what has behaviour change got to do with anything – when did anyone change their behaviour during a winter flu wave, besides possibly staying at home when unwell?]. There are good years in which it kills very few and bad years where it can dangerously stretch health services. …

Adam Kucharski, an Associate Professor at the London School of Hygiene and Tropical Medicine, thinks it may take longer for things to become predictable.

He notes the evolution of SARS-CoV-2 may not yet have settled into a gentle foreseeable drift, where each new variant comes from a known lineage. Omicron didn’t emerge from the Delta lineage and Delta didn’t emerge from the Alpha, Beta or Gamma lines, he says.

“I suspect we’ve still got a period of uncertainty before we can predict the coming years with any confidence”, he told the Telegraph. “Covid evolution might pause in an Omicron-shaped corner for a while, or Omicron might give rise to another variant, much like we’d see for seasonal coronaviruses and flu, or we could see another evolutionary surprise”. [When did evolutionary predictability become a condition of being endemic? Flu is not predictable, which is one reason the vaccines are hit and miss. Indeed, Dr. Kucharski admits the endemic coronaviruses and flu virus themselves give rise to new variants, so why should this exclude SARS-CoV-2 from being endemic?]

For now, Omicron cases appear to be plateauing in parts of the U.K. On Saturday, Dr Susan Hopkins, the UK Health Security Agency chief medical adviser, said the number of infections were flat in London and the South East and rising only slowly now in the North. [Plateauing? Rising? Plummeting more like, including in the North. This is a flat-out inaccurate description of the current state of the outbreak.]

“All of that means we are seeing a slowdown in the number of admissions to hospital but they are slowing down rather than reversing”, she said. [The number of Covid patients in hospital and ICU has been declining for some days now – anyone can see this on the Government Covid dashboard.]

With hospitalisations still running at over 2,000 a day and most regular NHS business still on hold, Dr Hopkins will be hoping SARS-CoV-2 becomes endemic in the UK at a somewhat lower level than it is today. [We’re at the peak of the winter wave of a seasonal respiratory virus, what a ridiculous thing to say; of course it will not remain endemic at this level.]

Otherwise, as the US Centers for Disease Control suggests, we may be needing yet another new word. “Hyperendemic refers to persistent, high levels of disease occurrence”, it notes. [Well yes, if a virus was to persist at its winter peak level throughout the year that could be a problem. But it doesn’t, so we don’t need a new scary-sounding term to refer to it, thank you very much.]

There’s no need to over-complicate this. Flu is endemic. By endemic we mean like flu, so we can go back to normal. Covid is now like flu. Next topic.

Not worth reading in full.

Brits Suffering from ‘Super Colds’ Due to Weakened Flu Immunity Following Lockdowns

The decline in flu immunity during lockdowns has resulted in Brits complaining of suffering from ‘super colds’, with extra disruption to life likely to be caused by some health experts advising those with symptoms to isolate before ruling out Covid through testing. The Mirror has the story.

Social media is seeing users increasingly talking about having caught a “Super Cold” as Covid tests come back negative. …

[Professor Neil Mabbott says:] “As [lockdown] measures are eased and people start mixing more indoors and travelling on public transport we can expect to see a significant rise in colds and other respiratory diseases.”

Professor Alex Richter, of Birmingham University, said: “It is impossible to tell the difference between a cold and Covid clinically.

“They present so similarly that only PCR testing can differentiate between the two. Lateral flow testing can help with screening, but if someone has symptoms then they should go for a PCR swab test.”

“It is unlikely we are seeing the circulation of a ‘Super Cold’,” Professor Mabbott added.

“Rather our immune systems have had limited exposure to colds over the past 18 months, so our immunity to these diseases will have waned during this period and will be less effective against colds than would be expected normally.” …

Professor Alan McNally is Professor of Microbial Evolutionary Genomics at the University of Birmingham and was Infectious Disease lead at the Milton Keynes Lighthouse Lab.

He said: “If you have any symptoms of respiratory infection you should stay at home to prevent transmission and get a test done for Covid to rule in or out.

“Trying to self-diagnose is a sure-fire way to send Covid case rates soaring again.”

Worth reading in full.

Stop Press: The Telegraph has some advice for those suffering from the ‘super cold’.

Covid May No Longer Be “The Most Significant” Threat to Health, Says Head of U.K. Health Security Agency

With talk ramping up about the danger posed by seasonal influenza this winter – especially given the impact lockdowns and social distancing are likely to have had on immunity – the Chief Executive of the U.K. Health Security Agency has acknowledged that Covid is no longer the “most significant” threat to health. The Sunday Telegraph has the story.

[Dr. Jenny Harries] said today that Covid was possibly no more dangerous than flu, as she warned that there would be a lower immunity to the illness this year.

She said: “It is important to remember that for an average flu season it’s about 11,000 deaths a year, it’s somewhere between four (thousand) to 22,000 over the last four to five years.

“So we are starting to move to a situation where, perhaps Covid is not the most significant element, and many of those individuals affected will of course have other comorbidities, which will make them vulnerable to serious illness but other reasons as well.”

It comes as the NHS launched its biggest ever flu vaccination drive amid fears flu deaths could be the worst for 50 years because of lockdowns and social distancing.

More than 35 million people will be offered flu jabs this winter, amid concern that prolonged restrictions on social contact have left Britain with little immunity.

Officials fear that this winter could see up to 60,000 flu deaths – the worst figure in Britain since the 1968 Hong Kong Flu pandemic – without strong uptake of vaccines.

There is also concern about the effectiveness of this year’s jabs, because the lack of flu last year made it harder for scientists to sample the virus and predict the dominant strains.

Meanwhile Dr. Harries added that the dominance of the Delta variant globally has seen other coronavirus variants “become extinct”, but warned we still need to “stay alert”.

“With the dominance of Delta, it does look as though many of the other variants which have been detected are becoming extinct, and a number of variants under investigation have risen slightly, we’ve seen cases, and they’ve become extinct,” she told The Andrew Marr Show.

However she cautioned that it was imperative to “stay alert”, as she said it was “still very early days of a new virus”.

Worth reading in full.

Decline in Flu Immunity Due to Clampdown on Socialising Has Led to ‘Worst Colds Ever’

Some Brits say they are suffering from their “worst cold ever” as scientists warn that the decline in flu immunity during continued lockdowns could lead to a difficult winter. The Independent has the story.

For Rebecca London, 24, from Bournemouth, a usual cold would mean “a runny nose, sneezing, a bit of a sore throat and feeling a bit rundown”.

“Nothing like this,” she told the BBC, saying she could barely sleep during her illness, which numerous lateral flow tests confirmed was not Covid.

Others have spoken of being “floored” by their colds, some of which lasted for more than a month.

Dr. Philippa Kaye, a GP in London, told the broadcaster: “We’ve actually been seeing a rise in the number of coughs and colds and viral infections.

“We are mixing in a way that we haven’t been mixing over the past 18 months.

“During those first lockdowns, we saw numbers of other [non-Covid] infections fall. We think that that was primarily due to the restrictions on meeting up.”

In more positive news, the World Health Organisation’s latest influenza update suggested that global cases were “at lower levels” than predicted for this time of year, despite fears of mass outbreaks.

However, with winter approaching, the situation could get worse, as Professor Anthony Harnden, the Deputy Chair of the Joint Committee on Vaccination and Immunisation, has warned. He said that low flu immunity “could be potentially a bigger problem this winter than Covid”.

Worth reading in full.

Total Focus On Covid Could Mean Flu Vaccines Less Effective This Year

Medical experts are concerned that flu vaccines may be less effective this winter as resources have been focused on Covid over the past year and there has been a significant drop in the number of global shipments of influenza surveillance samples. MailOnline has the story.

Every year a new influenza vaccine is developed to protect against several strains of the virus that have been circulating around the world.

But over the past year, surveillance of flu strains dropped to a fraction of normal levels as medical resources were turned over to monitoring Covid.

There has also been a lack of flu infections because of lockdowns worldwide, which has also reduced surveillance.

The effectiveness of flu vaccines varies from one season to the next but it is estimated at between 30 and 60%.

It comes amid fears of a bad bout of influenza this year due to a lack of natural immunity caused by lockdowns.

Last September – five months before experts decide which strain to protect against – global genetic sequencing of flu had dropped by 94%, according to jab makers.

And global shipments of influenza surveillance samples have dropped by 62% compared to before the pandemic.

Dr. Beverly Taylor, Head of Influenza and Scientific Affairs at Seqirus, which provides Britain with seasonal flu jabs, said: “We could have reduced the opportunity to identify viruses as they emerge.

“We certainly have reduced the opportunity to look at which viruses would give the best overall protection and the best coverage of all the circulating viruses.”

There are concerns the NHS could be overwhelmed this winter by a triple-whammy of surging flu and Covid admissions, and backlog patients needing treatment.

Experts also fear immunity to flu has waned over the year-and-a-half since the pandemic began because so few people have caught the virus.

Worth reading in full.

Weekly Deaths in England and Wales Now Lowest Since 2014

There were 10,311 deaths registered in England and Wales during the week ending March 19th. The weekly number of deaths was below the five-year average in both nations, as this chart from the ONS indicates:

In a piece for The Observer, David Spiegelhalter and Anthony Masters note that 10,311 deaths is the lowest figure since 2014 for the same week (i.e., the week ending on or around March 19th). This is noteworthy, given that the number of deaths in England and Wales has been trending upward since 2011, due to population ageing (the increase in the number of people in the oldest age-groups).

The authors suggest several reasons why the number of deaths is so low at the moment. First, the weather is fairly mild. Second, because of the lockdown, there are fewer road accidents than usual (though this is a minor contributor).

Third, there are fewer flu deaths than usual: the influenza virus is less infectious than SARS-CoV-2 (it has a lower reproduction number) meaning that lockdowns and social distancing have resulted in fewer people catching flu this year. Fourth, some of the people who would have died now sadly lost their lives in the spring of 2020 or the winter of 2020-21 instead. (One could say their deaths were “brought forward” by the pandemic.)

Spiegelhalter and Masters’ article is worth reading in full.

Is Covid the Most Deadly Infectious Disease in a Century?

A new report from the Office for National Statistics (ONS) was all over the papers on Monday afternoon making the striking claim that COVID-19 caused more deaths last year in England and Wales than other infectious diseases have caused in any year for more than a century.

Here is the story in the Mail.

The ONS report, entitled “Coronavirus: A Year Like No Other”, was released to mark the one year anniversary of people in the UK first being told to limit their non-essential contact with others and to stop all unnecessary travel. 

The report confirmed that COVID-19 caused more deaths last year than other infectious diseases caused in any year for more than 100 years. 

More than 140,000 people have died in the UK with coronavirus either described as the underlying cause or as a contributory cause on their death certificates.

Some 73,500 people in England and Wales who died in 2020 had COVID-19 registered as the underlying cause of death. 

The ONS said coronavirus is “likely to be classed as an infectious and parasitic disease”, allowing a comparison with previous deadly outbreaks. 

The statistics body said: “This means COVID-19 was the underlying cause of more deaths in 2020 than any other infectious and parasitic diseases had caused in any year since 1918; that year there were just over 89,900 deaths from various infectious and parasitic diseases registered in England and Wales.”