#DELTA DIARY: It is clear we are now dealing with a virus that spreads far more easily - probably more than twice as easily - as the version that emerged in #Wuhan at the end of 2019 1/
The #Ro was around 2.5 when the pandemic started in Wuhan and could be as high as 8.0 for the Delta variant 2/
DELTA is evolving: A new, more genetically diverse cluster, lineage AY.1 (which is termed as #Delta+) with a new spike substitution #N417K having immune escape property, has emerged independently in some countries @vinodscaria 3/
The new AY.1 lineage(Delta+) may be resistant to even monoclonal Abs cocktail!
It is quite possible that changes in the virus that make it better at avoiding vaccines could end up compromising its ability to transmit in an absolute sense 4/
#Beta variant - which has a mutation called #E484K that helps evade the immunity but hasn't managed to take off - is an example of this. However, the #Delta does have mutations that both help it spread and partially dodge immunity. Worryingly, it is bolstering it’s arsenals 5/
The #Delta has now evolved in to a SUPER SARS-2 virus! The most transmissible & probably the most immune evader. And, if we believe reports from #China, the most virulent too! 6/
“So are we doomed to a never-ending parade of new and improved variants that get harder and harder to contain? Or is there a limit to how much worse coronavirus can become?” writes @JamesTGallagher in bbc.co.uk/news/health 7/
Most virologists believe that the #SARSCoV2 would become milder in order to spread more easily. And, within a couple of years, should settle as an endemic, #fifth common cold coronavirus causing mild illness mostly in children 8/
But, there is very little evolutionary pressure on the virus for that to happen.
"We're in a really interesting, intermediate and somewhat unpredictable phase, it is difficult to predict how that's going to play out a year from now” @JamesTGallagher 9/
In the #US & #Mexico trial of #Novavax vaccine (where 50% were #Alfa variant), it shows an overall efficacy of 90.4% & 100% efficacy against moderate or severe disease, on par with the vaccines made by Pfizer-BioNTech and Moderna nytimes.com/2021/06/14/hea…
“Novavax may be used as a booster in the U.S., but it’s certainly will be the first vaccine a lot of people are going to see around the world”
#Novavax new booster vax against #Beta variant is also found highly immunogenic in #baboon studies. A strong anamnestic response was demonstrated in baboons boosted with rS-B.1.351 approximately one year after immunization with #NVXCoV2373 (rS-WU1)
After almost 6 months of global rollout of #Covid19 vaccines, we have some data to assess their comparative efficacy/effectiveness. There seems to be a gradient in their performances:
*Best performing: BNT162b2 (Israel, US & UK) & Moderna’s mRNA & Sputnik-V (Bahrain) 1/
But on safety front, the #inactivated vaccines have scored over all others, both on reactogenicity front & as far as rare, serious AEFIs are concerned 3/
What does #HerdImmunity mean in context with #SARSCoV2?
We don’t need the entire population to be vaccinated or the vaccines to be 100% effective (they never are); we just need them to reduce infection rates enough to get us <1. That is herd immunity 1/
The issue is more complex. Despite achieving high seropositivity in certain regions, resurgences have occurred. And in certain regions/countries, the virus suddenly retracted even in the absence of a significant sero-positivity 2/
It is not a pure mathematics. There is an interplay of infection or vaccine-induced immunity & the evolution in the virus. The 'Ro' is not a fixed number--keep on changing with the virus transmissibility. With this changes the thresholds to achieve 3/
How did #India fare? The graphic tells the whole story:
➡️Brutal onslaught by #B16172: having the highest transmissibility & most immune evader of all VOCs with higher virulence?
➡️No support from Vaccination (negligible coverage & high breakthrough, but reinfections rare) 1/
➡️ Social mitigation measures worked! Or the virus ran out of steam? Or still too early to conclude?
➡️ India struggled (significant mortality/health infrastructure collapsed) but survived!! 2/
New study on immune escape potential of #B16172 in comparison to #B1351 w/ #BNT162b2 vaccine: More immune evader than even B1351 VOC! Significant loss of antibody neutralisation vs live B16172 (-5.8x, akin to B.1.351) @TheLancet 3/ thelancet.com/journals/lance…
#CDC has recently reported myocarditis & pericarditis cases following #mRNA#vaccination in adolescents & young adults in the US. Are these the first reported cases of cardiac involvement following mRNA vaccines? 1/ cdc.gov/coronavirus/20…
Fortunately, these incidents are extremely rare events. But, have the agencies overlooked earlier signals? Are these cases indeed related to mRNA vaccines? Are the vaccines responsible? If yes, what could be the probable mechanism? 2/
Few cases of post-vaccination myocarditis, heart failure & heart attacks have been reported in #Israel since December soon after the launch of #Pfizer mRNA vaccine. Health officials referred them as “A murky wave of heart attacks” 3/ israelnationalnews.com/News/News.aspx…
We know that the two Ad-vector based vaccines, #AstraZeneca & #JNJ lead to clot-related complications like cerebral venous sinus thrombosis. We also know these events are referred to as ‘Vaccine induced Thrombotic Thrombocytopenia’ (VITT). But what lead to these complications? 1/
Now a new explanation for VITT seen with vector vaccines. “Vaccine-Induced #Covid19 Mimicry” Syndrome: Splice reactions within the #SARSCoV2 Spike ORF result in ‘Spike protein variants’ that may cause thromboembolic events in patients immunized with vector-based vaccines 2/
These soluble Spike #variants may initiate severe side effects when binding to #ACE2-expressing #endothelial cells in blood vessels 3/