Another new study worth looking into-- Delta variant #covid19 outbreak in a London nursing home.
Many residents/staff were <14 days since receiving dose 2 of Astra Zeneca vaccine; secondary attack rate among partially vaxx residents was 81.3% (13/16)
2/ Table 1 has a break down by demographics and vaccination status
Unique situation here as most residents/staff were getting dose 2 right when the index case was diagnosed with #covid19
3/ Reassuring- hospitalization uncommon; no deaths here. And this was among a care home population where we know #covid19 has caused immense suffering/death this past year.
Index case here was described as getting dose 1 in January, but unclear whether they ever got dose 2.
4/ Less surprising- nursing home residents (likely older + comorbidities) comprised twice as many cases as did the staff, despite there being equal numbers in both groups. #covid19
Somewhat surprising--> 3 people were >14 days post dose 2; all 3 reported as becoming cases.
5/ But- as mentioned in previous threads-- testing positive on rtPCR is very different than having clinically significant disease. From this study, it seems that there were no deaths and very few hospitalizations, which is reassuring.
2/ Some have commented previously on reasons that mRNA vaccines may be preferable to the J&J vaccine esp during non-surges; but at a population level, vaccines with ease of storage & single dose would be preferable in hard to reach groups
3/ The variable of interest here is vaccine efficacy against variants like Delta; two dose mRNA regimens seem to still hold up against this variant (unless there’s newer data I haven’t seen); I still have to take a closer look at J&J & Novavax results against Delta
This piece is on point— but also not surprising. Individualism has plagued public health for a long time; it is a byproduct of our society & American culture at large. At the center of this is a *disregard* for equity. This is not new. @edyong209 theatlantic.com/health/archive…
2/ That an institution like @CDCgov would make statements that refocus on individual responsibility is not surprising. This is a great way to shift blame and accountability to the public and away from the institution. This is the same as the “stay home” rhetoric
3/ The type of messaging referenced here telling individual to take matters into “their own hands”— that speaks to people who view the world through their lens of privilege & view others who aren’t living to their standard as being worthy of blame rather than in need of resources
Removing barriers for vaxx is our next big task to close inequities
Part of that is information, but I think a bigger part is overcoming pragmatic challenges:
•paid time off to get 💉/recover
•on-site vaxx in workplaces
2/ For the past year, I rarely had any #covid19 patients who worked from home
The inequities of who got sick were baked right into the way our society was already set up
We are seeing vaxx inequity play out the same — being able to get the vaxx is a big privilege (time,$ etc)
3/ While attitudes don’t explain the whole story, there is an interesting reduction in the % of “definitely not” getting 💉 group when you subdivide it into “college grads” v “non-grads” seen across categories
2/ no mandated mask use*; and says many did not wear a mask; after this outbreak, the article reports that Hong Kong mandated mask use in exercise facilities.
Again- March 2021; but, with low vaccination rates, the epidemic will continue to spread.
3/ It seems from the report that many of these patients were younger/healthy (average age 38); none were reported to have any severe outcomes and a number were asymptomatic.
Big takeaway: large susceptible unmasked/unvaxxed populations are still vulnerable
2/ And yet, half-way across the world-- I am in contact with my relatives in India daily. My cousin, uncle, and aunt all were sick with the virus. We tried to manage my uncle at home for days; eventually got him a hospital bed.
We will continue to see this dichotomy globally.
3/ While it may feel like we are out of the woods here, the surges in South Asia are reminders that inequity- primarily but not solely vaccination inequity- will haunt us all.
#Covid19 will be an endemic disease; unvaccinated places will likely suffer epidemic surges.