Insights on the recent wave of COVID-19 infections in @Singapore
The present wave in Singapore is of interest since a significant large proportion (82.7%) of population has received 2 doses of #COVID19 #vaccines but nevertheless have a wave of infections and deaths.
With respect to COVID-19 variants and VoCs, clearly Delta (and 2 prominent sublineages AY.23 and AY.23.1) dominate the present wave of infections.
Data: @DiseaseOutbreak
There are some interesting insights, thanks to the data made available at data.gov.sg
While on first look there is a significant number of cases spread across all age-groups.
The community cases are largely dominated by the younger age-groups (59 years and above)
This trend reverses drastically when it comes to the hospitalized patients, with a huge majority of the patients coming from 60+ years.
Another interesting observation is indeed the disproportionate number of hospitalized children.
But when it comes to deaths, the significant majority seems to have occurred in 70years and above, compared to other age groups as also seen elsewhere.
The overall nos of deaths (and CFR) is low possibly due to the continued public-health measures.
A close look at the deaths and vaccination status suggests a significant number of people who die are unvaccinated/partially vaccinated. This re-emphasizes the now established fact that vaccination indeed protects against severe disease and death, though not as much against inf.
What are the take-home points ?
▶️ High overall vaccination numbers might hide the fact that a small number of individuals still remain vaccinated and therefore possibly more vulnerable.
▶️ We possibly need to ensure #everyone in the vulnerable age-groups are vaccinated.
Sorry for the typo : to be read as ... High overall vaccination numbers might hide the fact that a small number of individuals still remain un-vaccinated and therefore possibly more vulnerable.

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More from @vinodscaria

20 Oct
What do we know and don't about the Delta sub-lineage AY.4.2
ℹ️ AY.4.2 is a sub-lineage Delta (B.1.617.2) in the UK which has shown consistent increase over the past few months and has caught attention.
Plot: Sanger COVID-19 Genomic Surveillance Dashboard covid19.sanger.ac.uk/lineages/ Image
The background:
Delta had significant advantage over other lineages, in almost all regions, practically eliminating all other lineages as they spread widely.
The continued evolution of delta provided a number of sublineages
There are now ~55 sublineages (AY.1 - AY.41) of Delta
Some of the AY.x sublineages have geographical preponderance, due to mutations present at the time of introductions. For example, UK has a AY.4 sublineage. More about the lineages and distribution is available at cov-lineages.org/lineage_list.h… Image
Read 9 tweets
24 Jul
Closely tracking the delta+ lineages now across the world, one of the lineages AY.3 seems to be emerging in the United States of America. This tweetorial is to summarise the observations. I will be updating this thread as new evidence emerges.
Thanks Image
The interest in looking at this lineage closely comes from the fact that this lineage has been on the rise in USA in recent weeks.
Thanks @Unusual_Times for pointing this. Image
AY.3 seems to be localized to some states, like #Mississippi and #Missouri with nearby states slowly picking up. Image
Read 15 tweets
13 Jul
The recent outbreaks of #Zika Virus in #Kerala has renewed interest in this virus. This tweetorial explains some key aspects about the virus and why we should be actively using #genomics for #GeneticEpidemiology Image
The disease in most people is mild. Majority of people infected with Zika virus DO NOT develop symptoms. Symptoms are generally mild including fever, rash, conjunctivitis, muscle and joint pain, malaise, and headache, and usually last for 2–7 days.
Source: @CDCgov Image
Death is RARE
Infection during pregnancy can cause microcephaly & congential malformations.
Neurological complications like Guillain-Barré syndrome, neuropathy and myelitis are seen in some.
Read 13 tweets
8 Jul
Why are numbers in Kerala an anomaly ?
Here is my take on these numbers
No. of cases are not directly comparable across states, due to the large disparity in testing capacities. It is most likely that the high nos are just representative of the testing nos. Here is a comparison of some states. Data from covid19india.org
So are the COVID-19 deaths for the states. Of note and contrast would be Kerala and Bihar - see closely the no of tests and deaths
Read 8 tweets
13 Jun
As delta continues to evolve acquiring new mutations, there is a lot if interest in understanding these mutations. This tweetorial summarizes the emerging lineages of delta, otherwise named delta+

Data and analysis : @bani_jolly and @mercy_rophina
Understanding this continued evolution is of great importance in mapping the evolutionary landscape of emerging variants. Largely the virus has tried to optmise for transmission and immune escape by step-wise acquisition of new mutations.
One of the emerging variants is B.1.617.2.1 also known as AY.1 characterized by the acquisition of K417N mutation.

Thanks @bani_jolly for pointing out the mutation and lineage assignment.
Read 10 tweets
6 Jun
Interesting preprint on the antibody response after ChAdOx1-nCOV (Covishield) and BBV-152 (Covaxin) among Health Care Workers. (N=552 Covishield =456; Covaxin=96)
Both vaccines elicited👍immune response after 2nd dose. Seropositivity Covishield >Covaxin
medrxiv.org/content/10.110… Image
A number of factors include Age, Sex. Comorbidity including T2DM and Hypertension influence the antibody titres (Day 21-36 after 2nd dose) Image
More reasons why we should be eagerly looking forward to the Phase 3 data for Covaxin
Read 9 tweets

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