Hello Health Desk readers,
This week all eyes are on decisions to loosen public health restrictions, as COVID-19 cases decline globally and leaders face pressure to reopen. Nowhere is this playing out more publicly than in Ottawa, Canada. Truckers are occupying Canada’s capital and its other major cities in protest of the country’s vaccine mandates and public health measures. Without intervention, the demonstrations will soon enter a third consecutive week. Officials are increasing efforts for the protestors’ removal, but some are also loosening provincial restrictions as cases decline and other public health indicators stabilize. That’s a shift also happening in the United States, South Africa and several countries in Europe. In today’s newsletter we unpack what the data says on loosening these public health rules. We’re also looking at a variant of another virus—HIV—that is concerning scientists, and our experts walk through questions you asked about new data on vaccine side effects, efficacy and Omicron in kids.
Don’t forget to reach out to us with health and science questions at health@meedan.com and visit us at health-desk.org for our full website of explainers.
First, a look ahead…
Worrying HIV variant raising global alarms
One of the world's most daunting viruses continues to plague populations due to recent reports of a new HIV subtype. Recent research by the University of Oxford's Big Data Institute revealed that the variant has been circulating in the Netherlands for several years. The good news is it’s still responding to current treatment protocols. But the consequences of the variant are causing significant concern. It’s driving higher viral loads and doubling the rate of immune system decline. People with the variant are also developing AIDS two to three times faster. The virus has been the deadliest pandemic in recent time, leading to 36 million deaths and 79 million infections over the last 40 years. Seeing the rapid evolution of COVID-19's Delta and Omicron variants have given new weight to the subtype-B of HIV, as fears have emerged of future impacts it may cause, including increased rates of infection and the potential evasion of antiretroviral therapy. We do not believe the most dire of consequences will occur in the next few years because of this variant, but do feel it's a necessity for national health programs to scale up HIV prevention programming.
Reducing international COVID-19 mandates, despite data
The 7-day rolling average of COVID-19 cases is going down, and that’s undeniably great news. Africa, in particular, has seen strong declines in infections in the last month alone. This is leading many nations to open back up, largely due to decreasing rates of infection. Despite the hope this gives people who are exhausted from restrictions, many scientists fear loosening requirements may be premature, given the potential for unnecessary transmission and deaths. Political pressure to reopen may be stronger than the data that shows hospitalizations and disease spread are still occurring. We worry this repeal of national COVID-19 prevention strategies may lead to hundreds of thousands more symptomatic cases of the virus and the potentially preventable deaths of thousands.
Public health challenges in conflict zones
Since the Taliban's takeover of infrastructure systems in Afghanistan, where one million children face starvation and 90% of the population is beneath the poverty line, 33 hospitals have closed. In the five facilities that are able to provide COVID-19 treatment, supplies are limited and healthcare workers are going unpaid for months. In the Eastern region of Ukraine, Donbas has faced nearly a decade of fighting between separatist groups and the military, and the consequences have hit local health facilities. There are shortages of medicine, supplies and workers, mental health care demands and limited infectious diseases programming for HIV and tuberculosis. The result is a predicted 2.9 million people in need of humanitarian needs in 2022. We expect to see the burden of instability continuing to impact the most vulnerable in these nations, but hope the international community can help support their health system with supplies and funding.
And now, here’s what you asked our Health Desk experts:
What is the latest on COVID-19 shots and neurodegenerative diseases?
The current research shows that the risk of these neurodegenerative complications is much greater following a COVID-19 infection, and that risks of the vaccines are outweighed by the benefits. More research is needed to confirm any findings that suggest an association, and to understand how much risk of neurodegenerative diseases is increased by following COVID-19 vaccines, if at all.
A small amount of new data has emerged that suggests a possible association between COVID-19 vaccines and a slight increase in risk of certain neurodegenerative diseases. An October 2021 study found that there was a slight increase in neurodegenerative conditions Guillain–Barré syndrome and Bell's Palsy after the Pfizer-BioNTech vaccine and the AstraZeneca vaccine. However, this study was not randomized in the way that the vaccine trials were, which is the type of study that can definitively determine causality.
How effective are vaccines against Omicron in kids?
Without a vaccine, kids are more likely to get COVID-19. One study examined hundreds of pediatric (children) hospitalizations in six U.S. cities in the summer of 2021 and found that almost all of the seriously ill children were not fully vaccinated, indicating how protective the vaccines for kids can be.
“While we are seeing the hospitalization rates increase for infected children, especially ages 0 to 4, children overall still have a much lower risk of becoming severely ill than adults, even with Omicron. In addition, young children seem to have a lower chance of needing ventilators than children hospitalized during previous surges.
Whether or not Omicron is specifically more severe for children than other variants of COVID-19 is a question that’s still being researched, but early data suggests that not only is Omicron likely not more severe than previous variants, it actually appears to be causing milder illness in children than Delta.”
What's the current difference between getting COVID-19 with and without a vaccine?
According to the U.S. Center for Disease Control and Prevention (U.S. CDC) monitoring data, unvaccinated people are four times more likely to test positive for Covid-19, and 15 times more likely to die from a Covid-19 infection. Recent monitoring data from December 2021 shows little over twice the number of unvaccinated cases compared to vaccinated cases.
The gap is even bigger between the number of cases among fully vaccinated individuals who received a booster shot, and the unvaccinated (nearly four times as many unvaccinated cases).
“Data from Europe shows that despite the Omicron variant spreading among vaccinated people, the overall severity of the surge is low. This is likely because of the protection that vaccination with two doses and booster dose presents against severe illness from Omicron infection. Omicron can still infect vaccinated individuals, however the numbers of hospitalizations are by far mostly among the unvaccinated because of the protection of the vaccines.”