Showing posts with label COVID-19. Show all posts

Saturday, January 15, 2022

The Comparison of Real World Covid Charts

This 3-chart enables one to compare the infection and death rates of various countries in the World. They are enlarged charts linked to the following webpage

1. Many People Died After Vaccination

2. Why They Said Some Brands of Vaccine were Not Effective?

References: Infection vs Case Fatality Rate

Navigation:

1. 2 top buttons are for adding and selecting countries. The right button is for adding countries to pre-selected countries. It will be displayed when the region and type buttons are selected. The left button is for selecting & building up countries;

2. Use dropdown boxes provided to select the menu for charts;

3. Use <ctl><click> to select on country or <shift><click> to select several countries in <select countries>;

4. Use [Call/Save Chart] to call and save the existing chart. The data saved can be erased by browser memory clearances;

5. Use the [Expand] button to expand/contract and examine each chart.

6. To go to Our-World-in-Data page, just click the "full screen" symbols. It is located at the bottom right of every chart.

The death rate is usually more reliable than the infection rate; a lower testing rate will often give false readings in the infection rate

Case Fatality Rate of Various Countries

% of Population Vaccinated According to Vaccination Status

Share of the population partly or fully vaccinated against COVID-19

This is an animated bar chart showing the progress of vaccination in various countries. Click the play button at the bottom to play.

Vaccines Used in Some Countries

One can check from here the various brand of vaccines used by various countries. Unfortunately, not all countries are here

Thursday, December 9, 2021

Is Omicron more Transmissible But less Severe Than Delta?

Jump to

1) Update: 15 December 2021: Detecting Omicron
2) Update: 23 December 2021: Omicron, lesser hospitalization
3) Update: 29 December 2021: Omicron in GauTeng, SA

8 August 2018

The preliminary hospital data released by the South African (SA) Medical Research Council (SAMRC) appears to suggest that thus far. This article intends to keep track of the development of Omicron.

What has been found?

This chart released by SAMRC gives us a glimpse of what we say about Omicron as far as transmissivity & severeness are concerned.

The chart is showing us the following picture. It tells us Omicron is about 20% more transmissible but 6 times less severe in terms of death at the present moment.

Updated Chart (To be updated regularly)

The attached is superimposing the new cases and death charts taken from Our-World-in-Data. It is for the whole of SA and it is also showing that Omicron is more transmissible but less severe than the other variants. Until further notice, this chart will be updated regularly or when there are many changes.

The following chart is the situation in SA & Botswana where Omicron is the predominant virus to date. Omicron's new cases in SA have risen and are about to break their last record. The death rate still remains muted.

What Can We Expect?

Many are of the view that these preliminary findings cannot represent the real power of Omicron because Omicron is a new variant. It might mutate & further develop into a more fearful variant in the future. There is also a time lag between the death and the infection figures. In other words, we might expect Omicron to have more deaths at later dates.

While this concern is likely, the other variants are telling us the time lag between death and infection is usually about 10 to 20 days. So far, Omicron has been around for almost 9 weeks or 63 days. We don't think there will be much change unless Omicron mutates further at a later date into a more vicious variant.

What to expect for the 2-Dose Vaccinated?

Interestingly, SAMRC also provided breakdown figures for the vaccinated and unvaccinated for Omicron infection.

So far, SA has a vaccination of about 30% which means 1/3 of the population is vaccinated whereas the other 2/3 is unvaccinated. By using this vaccination ratio, we could roughly estimate the effectiveness of the vaccines in SA to be about 50% as shown in the following workouts.

The 50% vaccine effectiveness is not enough to keep Omicron at bay.

Again, the vaccine effectiveness is worked out based on the limited data. It cannot represent the actual and real result; however, it does reflect that the SA vaccine, which is predominately 2-dose Pfizer, has lower vaccine effectiveness against Omicron. These are also the findings of the most recent Pfizer laboratory work.

What are the Pfizer Laboratory Findings?

Pfizer in its latest press announcement on December 08, 2021, has the following important claims

1) The Pfizer's booster shot can induce antibodies that can neutralize Omicron to match the level comparable to other variants;

2) The existing Pfizer 2-Dose may not be able to protect against Omicron. It has been found to have a 25-fold reduction in the neutralization titers.

What is this 25-fold Reduction?

This is jargon in immunology. It is a measurement used to indicate the fold-increase or reduction in the levels of neutralization of antibodies. Here is a pictorial representation of how they work out the 25-fold increase/reduction.

There is a relationship between vaccine effectiveness and fold-reduction but at the present time, there is no direct conversion available for working out the Covid vaccine effectiveness using the fold level reduction in antibodies.

What to Expect Now?

It has been found that Omicron is a heavily mutated variant. It has been identified to have 30 changes to its spike protein whereas Delta has only 13 changes. The scientists to date do not have many clues about how Omicron has acquired so many mutation changes and the speculation is that Omicron appears to be a much vicious variant compared to its predecessors.

The US expert, Dr. Anthoney Fauci, pointed to the evidence about Omicron being more transmissible but less severe. But he expected more evidence and data to come before he can reach a definitive conclusion. Because Omicron is more transmissible, it has been identified as a candidate "likely to mutate in places where vaccination is low and transmission is high,"

However, many experts including those in WHO are keeping track of Omicron closely as they are saying this Omicron could be a 'turning point" of the present pandemic because its behavior is much different from the rest of the variants. This Professor of Epidemiology, Prof Ralf Reintjes, from Hamburg University was of the view that "Omicron could mark a positive turning point in this pandemic". Let's watch what he was trying to tell us in this video.

Just to recap. The experts are warning us that this Omicron is very transmissible but at the moment, it is less severe than the rest of the variants. However, we are asked not to be premature optimism & expectation about Omicron.

Update: 15 December 2021

Detecting Omicron

The presence of Omicron can be detected using some brands of Antigen Rapid Test (ART) or LFT. One can also detect Omicron by using PCR tests. However, ART or LFT can only tell if one is infected and it cannot tell by which type of virus. Only the PCR test can tell the difference.

In the past, the laboratory will have to do genome sequencing to detect the difference. This genome sequencing could cost as much as USD1000/= per sample because the detecting agent is quite expensive. Fortunately, Omicron shares a testing pattern quite similar to Alpha which has almost extinct and some manufacturers can come up with PCR testing kits that can detect Omicron fairly quickly. So far, the following brands have claimed that their PCR testing kits can detect the Omicron variants.

1. Thermo Fisher Scientific, Abbott, Qiagen, Cue Health and Co-Diagnostics (US)

2. Roche (Germany)

3. Acumen (Singapore)

4. IIT Delhi (India)

FDA said the following PCR test kit will return false-negative results.

Applied DNA Sciences, Meridian Bioscience, and Tide Laboratories

Update: 23 December 2021

South Africa is presently having the highest proportion (96%) of Omicron patients in the World. Its National Institute for Communicable Diseases (NICD) has a daily surveillance report published on this website. It has a network called "DATCOV-Gen" where studies about Covid hospitalization details are often reported. One of its most recent studies published in BMJ, an internationally renowned medical journal, is shown here.

The study report concluded that those suffering from Omicron are likely to have lower odds of being admitted to hospitals as compared to non-omicron patients. The odds ratio (AOR) was estimated to be 0.2 @ 95% confidence interval (CI) 0.1-0.3). In other words, those suffering from Omicron would have an 80% lesser chance of being admitted to a hospital for treatment.

Update: 29 December 2021

The infection rate in Gauteng, SA has receded by 75% from 630 new cases per mil to about 120 cases per mil. The hospitalisation rate came down by about 30% and death rates appear to be muted as shown in this chart worked out by Dr. Ridhwaan Suliman

Thursday, November 25, 2021

Austria is Locking Down Again

Austria announced last Friday that they are locking down. This is the fourth national lockdown. The lockdown will begin on 24 November; it is likely to last for the next 10 to 20 days.

This lockdown shall make Austria the second European country, after Latvia, to impose lockdown measures since vaccines became widely available earlier this year. Further, Austria is contemplating making vaccination compulsory.

What's the use of Lockdown?

Lockdown is an effective but primitive way to curb the spreading of all types of diseases. Lockdown has been used for centuries whenever there is an epidemic. The idea is to isolate the patients especially those asymptomatic ones so that they won't have a chance to roam around, spreading the diseases to other healthy people in the Community. This article will show that asymptomatic patients are responsible for more than 60% of the Covid transmission.

Lockdown is good, but it comes with a price. Many people especially those in Western Countries so hated lockdown that they often went to the streets protesting against such practices.

Mass testing will also have the same effect of "isolating" those asymptomatic after "flushing" them out from the community. ART is a good alternative to mass PCR testings. Proper use and handling of ART is not only cheaper but also more cost-effective.

The Situation Right Now in Austria

It is not looking good. The infection cases shot up about 3 times from 586 per million on Oct 12 to about 1562 per million on Nov 22 for slightly more than 40 days. It is sad to see that the death rate has also doubled in that period. However, it was not as serious as before and after 2/3 of the residents have been vaccinated.

What could have happened?

A new Covid wave has been formed except this time, Austria is better prepared as shown by the following charts.

The charts show clearly that Austria has done plenty of testing. The rate is around 77 tests per 1000 people. This rate is about 4 times more than the UK's 13.5 and 15 times more than Singapore's 3.2. However, the positive rate of the test is not high @ 2.8%. The exceptional high testing rate in Austria explains why its infection rate has gone up so fast and so sharp. The charts also show that Singapore's positive rate is exceptionally high @ about 17% which is about 4 times that of the UK's 4.6%.

Why Singapore has such a high Positive Rate?

Normally, any Epedilogist will say countries having a high Positive Rate is not a good thing. It means the infection is very serious; there must be a lot more other infection cases still roaming in the streets. The infection wave is not over. More new cases are expected. However, this is not the case in Singapore. Singapore has just seen its new cases drop by 2/3 over one month. This is as shown in the following chart which is plotted in the daily-infection interval. The new cases dropped from 976 per million on 27 October to 326 per million on 23 November.

Why so?

It has something to do with the mandatory Antigen Rapid Testing (ART) that Singapore has just implemented in September 2021, and the detail of which is explained here. Singapore managed to find 5 times more or about 3,000 to 4,000 asymptomatic patients per day using ART and isolate them quickly to prevent them from spreading Covid in the community.

As the Singapore Authority is replacing the screening PCR testings, they cut down the PCR testing frequency, resulting in higher positive rates as illustrated in this chart

In Singapore's case, the higher positive rates are not caused by the seriousness of the infection.

Of late, the experts in Singapore are questioning the needs of the electronic system that traces Singaporeans' outdoor movement for reasons to track the contacts of infectious patients.

How Austria can Get such a high Testing rate but a low positive rate?

This might have something to do with the free and uniquely PCR Self-Test method introduced by Austria in September 2021.

https://www.afr.com/policy/health-and-education/why-citizens-in-pandemic-vienna-keep-gargling-20210922-p58tzr

In such an exercise, everyone in Vienna will be given a PCR test (gargle box) free. They can pick up the box at any of the 22 BIPA outlets. After doing the test, the box is handed over to the REWE outlets or the petrol stations. Users can get the test result within 24 hours.

The exercise could have gathered lots of PCR testing samples. Because 2 tests are required to confirm infection cases and they have to go through each and every one of those samples, the positive rate would naturally be lower.

Because of the very high testing rate and high infection cases which primarily are assumed to be asymptomatic patients, Austria should see the crisis over in a very short time.

Can Other Countries do the same as Singapore?

There should not be any reason why other countries cannot do and repeat the same; after all, the ART testing method started in Europe and the US. All they have to do is to make ART testing kits easily accessible to residents. People are curious by nature and afraid to die. They will want to know what's wrong with them. They will use the testing kits one way or another.

As for Singapore, it should not rest on its laurels. It should continue to make improvements, making ART test kits freely available and accessible to all Singaporeans, residents, and even the short-term travelers at no or little cost over 24/7 outlets using ATM machines located all over the island. After all, asymptomatic are the ones that contributed most of the infection cases because of the sheer numbers. The government could save the cost through savings in the reduced numbers of PCR testings.

Tuesday, November 23, 2021

Estimating the Transmission Risk of Asymptomatic in a Community

It is generally known that symptomatic patient has a higher transmission risk. According to this article by Yale Medicine, a Delta symptomatic patient can spread to maybe 3.5 or 4 other people. As for asymptomatic patients, the common knowledge is that its transmission risk is relatively low. This article will try to examine from a different approach why some were saying that asymptomatic or people without symptoms are responsible for about 59% of the Covid transmission.

What happens at the site?

Ministry of Health (MOH) of Singapore has this pie chart showing that about 98.7% of the patients are asymptomatic or patients with mild symptoms. This has been the case for many months. It is quite clear that there are lots of asymptomatic/patients with mild symptoms in the community.

How are they Responsible for the Transmission?

One can always argue that asymptomatic is not responsible for the spreading of Covid in the community. It is always the symptomatic patients passing on the Covid to the asymptomatic.

According to this study which examined and traced the contact histories of about 7,000 people, asymptomatic patients have a transmission rate of 0.06% whereas symptomatic patients have a rate of 1.12%

In other words, let's say we have 10,000 people in a community, 9,800 people are asymptomatic and 200 people are symptomatic or pre-symptomatic as found out according to the MOH Singapore, we might have this situation:

Therefore, there is a possibility that the asymptomatic can be 75% responsible for the spreading of Covid in the community.

Other Studies

There are also other studies that have similar findings; for example, this study from Oxford Academy found that the secondary attack rates of symptomatic and asymptomatic were 4.1% (128 of 3136) and 1.1% (12 of 1078), respectively. This Oxford study indicates that asymptomatic can have an even higher transmission risk, causing or contributing more infections in the community.

Conclusion

This simple example confirms this article saying that asymptomatic or people without symptoms are responsible for about 59% of the Covid transmission. Therefore, we mustn't underestimate the importance of asymptomatic patients who are usually hiding in the community. These patients will always stay and spread Covid in the community until there is a mass-testing done to flush them out. In the case of Singapore, instead of using mass testings, they introduced in September 2021 the mandatory Antigen Rapid Testings (ART) for the workers and residents. This has helped to flush out about 4 to 5 times the number of these asymptomatic patients hiding in the community.

Thursday, November 18, 2021

The Unvaccinated Are Not Happy Today

They are not happy because they are thinking the Governments, almost all over the World are trying to fix them. They are:

1. Beginning to "open up" allowing only the vaccinated to travel;
2. Implementing unfair practices to restrict their movements such as visiting the public places, PUBs and eatery shops;
3. Forcing them to be vaccinated; last but not lest;
4. Talking about them responsible for spreading the Covid.

They demanded to know why people always blame them.

Why?

To understand why we must be prepared to know why the governments all over the world are doing so much to stop the spread of Covid. Why aren't they worked up about the spread of the Common flu? They have only one thing in mind, which is to "save their Health Service from collapsing".

They are not worried at the beginning when only a few were sick and eventually died although they had tried their best to save them. They analyzed the data and found that there were more unvaccinated getting sick and the vaccinated are having either no symptoms or mild symptoms. They also found that there are more unvaccinated than vaccinated getting infected. As people with symptoms are having a higher chance to spread Covid, they started to blame the unvaccinated.

When the majority are vaccinated, the situation changed, more and more vaccinated are getting sick. Of late, even the rate of vaccinated is getting infected, at times having higher rates in hospitalisation than the unvaccinated. They began to understand the effectiveness of the vaccine had started to wane. They introduced booster shots. At the same time, the fewer unvaccinated leftover is getting even more skillful and careful. They prevented themselves always from getting infected.

However, one thing has never changed. There are more unvaccinated getting severely sick and dying eventually. This has unfortunately loaded up the Government's Health Services. They tried to fix this. This MOH Singapore chart tried to show that the unvaccinated have 9.4 times and 22.5 times the chance of getting severely sick and dying respectively.

They changed their tone now to say they are protecting the unvaccinated.

https://www.moh.gov.sg/news-highlights/details/protecting-the-vulnerable-securing-our-future

Why VTL?

Rightly speaking, there is no real good reason to ban those fewer unvaccinated who can take extra precautions to have the chance to travel. The Governments must be thinking that although these unvaccinated can take such extra precaution back home, they might not be able to do so when traveling abroad. It is likely that unvaccinated will have a hard time trying to convince their Governments that they are equally capable of preventing themselves from contracting Covid while traveling overseas. And until the unvaccinated can do so, the "decree" is likely to remain.

New Measures Poping up

Because the unvaccinated are more prone and vulnerable to being severely sick, there will be calls everywhere from the vaccinated, demanding the unvaccinated to pay for the medical bills if they get infected.

The unvaccinated will definitely be very unhappy, but in countries like Singapore where the unvaccinated are the minority, their voices would not be loud. The country will start charging Covid patients who are ‘unvaccinated by choice’ by 8 December

Conclusion

The unvaccinated have every reason to be unhappy about the present restrictions imposed on them especially they can show data and statistics that vaccinated are equally vulnerable to infection and hospitalisation. However, one thing they cannot change is the higher rate of unvaccinated getting severely sick and then dying. This is the only reason and they now saying "they are protecting the unvaccinated"

Monday, November 15, 2021

Why should Elderly be Vaccinated?

Governments all over the World are trying to pass on the message that the elderly, older than 60 years of age are vulnerable to infection. Many of those deaths are in the 80+ age group. They tried to post all sorts of charts and figures, supporting their claims; however, many elderly are still not serious. Why?.

How Vulnerable are these Elderly?

Yahoo has an interesting graphical table showing the death rate of various age groups in a week from July 11 to September 4. This table must have been constructed using data from US CDC.

Source: https://news.yahoo.com/age-still-huge-coronavirus-risk-090059106.html

Explanation

The table shows, for example, 54 among 100,000 unvaccinated people above 80 will die each week. On the other hand, 10 of 100,000 vaccinated people in this will also die each week if they are not careful.

What is the Difference from Other "Stories" Being Told?

There is no difference. This "Story" is still too complicated for most of the elderly. Not many elderly will understand especially when many have only gone to elementary schools when they were young. These people are more sensitive to numbers than rates, which is a mathematical term. After all, they are the ones deciding if they should get vaccinated.

Why Elderly in Singapore not Excited?

Many a time, we read about forumers in the discussion groups always asking why Singapore Government does not publish death numbers by vaccination status. This is despite Singapore Government has made an effort to publish and compare the % of people dying by vaccination status on a daily basis.

Unfortunately, this MOH's chart is not showing the numbers for the elderly. It is showing the rate for vaccination and unvaccinated across all age groups. The figure of 5.4 per 100,000 for the unvaccinated is 10 times smaller than the 54 per 100,000 for those 80+ as reported by Yahoo.

Then What are the numbers?

According to MOH of Singapore, the following is the position of vaccination among the various age groups.

https://www.moh.gov.sg/covid-19/vaccination

The chart clearly shows that about 12% of those >80 are unvaccinated. 6% of those 70-79 and 5% of those 60-69 are unvaccinated

About 770 or 1.5% of those elderly above 60 in Singapore who are unvaccinated are expected to die each year. Those aged above 80 and unvaccinated has the highest death rate @ about 300 or 3% per year. The breakdown figures for Singapore is as shown in this table.

Estimated Death Numbers for Unvaccinated of Age Above 60 @ 7 Nov 2021 for Singapore
	Age Group			Total	Remarks
Age Group	60-69	70-79	>80
Population number (I)	500,124	244,727	96,228		Data source: https://data.gov.sg/dataset/resident-population-by-ethnicity-gender-and-age-group?view_id=2f273a73-de27-4242-a602-8165789f96d3&resource_id=d5d35678-cd15-4f43-b347-d671d1870655
% Unvaccinated in Group (II)	5%	6%	12%		Data Source: https://www.moh.gov.sg/covid-19/vaccination
Unvaccinated Nos(Estd) III=(I*II)	25,006	14,684	11,547	51,237
Death per 100K per week(IV) (Yahoo expressed in %)	13.08	35.96	54.39		https://news.yahoo.com/age-still-huge-coronavirus-risk-090059106.html
Death per week (Estd) (III*IV)	3	5	6	15
Death per year (Estd) (III*IV)	170	275	327	771
% of Unvaccinated	0.68%	1.87%	2.83%	1.51%

One could work out a similar table for other countries using the same method. As the death rate might differ from country to country, the working should only be taken as a reference.

Update: 17 November 2021

MOH has just published this new chart reporting on the death rate of vaccinated and unvaccinated for those between 60 – 69, and above 70 years old. This chart shows that the death rate of unvaccinated is about 12 to 14 times higher than vaccinated for these 2 elderly age groups.

If we compare Singapore's rate to the USA's rate, we can get this table:


Average Weekly Death Rate (Numbers per 100,000
Age Group	USA	Singapore	USA	Singapore
Age Group	Unvaccinated		Vaccinated
80+	54	13	11	1.1
65-79	36	3	2	0.2
55-64	13		1

USA: for period between July 11-Sept 4
Singapore: for period between Oct 9 to Nov 16
Note: some discrepancy expected as Singapore's figure is for 60-69 and >70 instead of 65-70 and >80

No wonder the Singapore Authority recently claimed Singapore was having one of the lowest death rates in the World.

The comparison table might not be fair to the US considering that Singapore is a city-state and a small country and US is a big country with many different demographics,

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