Italy has reported 44 coronavirus-related deaths on Monday, compared with 23 the day before, the health ministry said, while the daily tally of new infections fell to 4,168 from 5,923.
Rueters reports Italy has registered 128,795 deaths linked to Covid since its outbreak emerged in February last year, the second-highest toll in Europe after Britain and the eighth-highest in the world. The country has reported 4.49m cases to date.
Patients in hospital with Covid – not including those in intensive care – stood at 3,928 on Monday, up from 3,767 a day earlier.
There were 45 new admissions to intensive care units, up from 33 on Sunday. The total number of intensive care patients increased to 485 from a previous 472.
Some 101,341 tests for Covid were carried out in the past day, compared with a previous 175,539, the health ministry said.
China’s health authority has reported no new locally transmitted symptomatic Covid cases for the first time since the recent Delta variant outbreak began in July.
While it is unclear whether the figure will remain at zero in the weeks to come, experts said it was yet another sign that Beijing’s tough “zero tolerance” approach was unlikely to be changed.
More than 1,200 people have been confirmed infected in an outbreak that officials said was mainly driven by the highly transmissible Delta variant, which was brought in from abroad and caused a cluster in late July in the eastern city of Nanjing.
In the UK, 31,914 people have tested positive for Covid in the last 24 hours.
A further 40 people have died within 28 days of testing positive for coronavirus, according to the latest update to the government’s coronavirus dashboard on Monday.
Official figures showed another 40,345 people had their first dose of a Covid vaccine, with 116,352 getting their second jab. This means almost 77% of the adult population are fully vaccinated.
Following the full US approval for the Pfizer jab, New York City officials have been first to announce a vaccine mandate for school employees – in what is expected to be a flurry of such moves across the country.
The Associated Press reports that officials have said all New York City public school teachers and other staffers will have to get vaccinated against the coronavirus as the nation’s largest school system prepares for classes to start next month.
The city previously said teachers, like other city employees, would have to get the shots or get tested weekly for the virus. The new policy marks the first no-option vaccination mandate for a broad group of city workers in the nation’s most populous city, though mayor Bill de Blasio announced on Friday that coaches and students in football, basketball and other purportedly “high-risk” sports would have to get inoculated before play begins.
Now, about 148,000 school employees – and contractors who work in schools – would have to get at least a first dose by 27 September, according to an announcement from the Democratic mayor and the city health and education departments.
The city has not immediately said what the penalty will be for refusing, or whether there will be exemptions. The previous vaccinate-or-test requirement had provisions for unpaid suspensions for workers who did not comply.
At least 63% of school employees have been vaccinated. That figure doesn’t include those who may have gotten their shots outside the city.
New York City last week began requiring proof of vaccination t o enter restaurant dining rooms, gyms and many other public places, a first-in-the-nation policy that a few other cities have copied since it was announced. Meanwhile, New York state announced last week that hospital and nursing home workers would have to get inoculated, the AP reports.
Berlin nightclubs are set to reopen after a court repealed a blanket ban on dance events in closed rooms in the German capital, but only for the vaccinated or those who have recently recovered from Covid.
After a nightclub owner sued local authorities, a Berlin-Brandenburg court said that the restrictions were fair and sensible but “likely to be disproportionate” for those who have been vaccinated or recently recovered, DJ Mag reports.
However, for unvaccinated people – even with a negative test result – the ban continues to apply. The court said that an epidemic situation of national scope remained, and therefore that the regulations should continue to be generally applied, according to local media.
In other news, the Brazilian president, Jair Bolsonaro, has said that he will ask his health minister to set an end date for the use of face masks as a means of reducing Covid transmission
Reuters reports that masks have become a political issue in Brazil, with Bolsonaro long ranting against their use and frequently refusing to wear one in public despite a legal requirement to do so.
In a radio interview, the president argued that with much of the population already vaccinated or having caught the virus, masks are not needed and that he hoped a date would be set by the end of the day.
Any such move could prove to be largely moot, however, with states and municipalities free to set their own Covid-19 restrictions in Brazil. Any federal government position on the matter would likely only function as a guideline, though it would be considered a victory by Bolsonaro’s far-right base.
Some epidemiologists say it is too early for such a move, especially due to the rise of the Delta variant in Brazil. Although nearly 60% of Brazil’s population have received their first dose, only 25% are fully vaccinated.
Bolsonaro said he had also commissioned a study into the use of mask wearing with a view to recommending an end to their widespread use.
Brazil, which at over 570,000 has the world’s second highest coronavirus death toll behind only the US, has faced claims that a lack of coordinated national social distancing measures have propelled the death rate.
But the acting FDA commissioner, Janet Woodcock, who said approval of the vaccine was “a milestone as we continue to battle the Covid-19 pandemic”, said the data has met its standards.
While this and other vaccines have met the FDA’s rigorous, scientific standards for emergency use authorisation, as the first FDA-approved Covid-19 vaccine, the public can be very confident that this vaccine meets the high standards for safety, effectiveness, and manufacturing quality the FDA requires of an approved product.
While millions of people have already safely received Covid-19 vaccines, we recognise that for some, the FDA approval of a vaccine may now instil additional confidence to get vaccinated. Today’s milestone puts us one step closer to altering the course of this pandemic in the US.
However, the decision to grant full approval has already met criticism. The British Medical Journal reports that the FDA should demand adequate, controlled studies with long term follow up, and make data publicly available, before authorising.
It said that Pfizer and BioNTech posted updated results for their ongoing phase 3 trial on 28 July, but without any new data and containing an identical topline efficacy result as the previous preprint – following its admission of significantly waning efficacy that it used to justify calls for booster shots.
Whatever one thinks about the ‘95% effective’ claims even the most enthusiastic commentators have acknowledged that measuring vaccine efficacy two months after dosing says little about just how long vaccine-induced immunity will last. The concern, of course, was decreased efficacy over time. ‘Waning immunity’ is a known problem for influenza vaccines, with some studies showing near zero effectiveness after just three months, meaning a vaccine taken early may ultimately provide no protection by the time ‘flu season’ arrives some months later.
If vaccine efficacy wanes over time, the crucial question becomes what level of effectiveness will the vaccine provide when a person is actually exposed to the virus? Unlike Covid vaccines, influenza vaccine performance has always been judged over a full season, not a couple months.
And so the recent reports from Israel’s ministry of health caught my eye. In early July, they reported that efficacy against infection and symptomatic disease “fell to 64%.” By late July it had fallen to 39% where Delta is the dominant strain. This is very low. For context, the FDA’s expectation is of “at least 50%” efficacy for any approvable vaccine.
He added that Pfizer allowed all trial participants to be formally de-anonymised to researchers starting last December, and placebo recipients to get vaccinated, after it received emergency approval. By 13 March, 93% of trial participants had been unblinded, officially entering “open-label followup” and therefore the preprint was based on the 7% of trial participants who remained anonymous at six months.
The US Food and Drug Administration has given full approval to the Pfizer vaccine for Covid-19. The vaccine and others have been in use under emergency use authorisation.
The decision is likely to trigger a wave of formal vaccine requirements from government departments, businesses, schools and other bodies.
Many observers hope formal approval will spur an increase in vaccine take-up among sections of the population, particularly in Republican-led states, so-far resistant to government advice.
Vietnam has today deployed soldiers to help enforce a strict lockdown in Ho Chi Minh City, its biggest urban area and centre of its worst coronavirus outbreak to date.
Reuters reports that Vietnam implemented movement restrictions in the capital in early July, but announced its harshest curbs last week as infections have continued to surge. Authorities claimed enforcement of recent curbs has not been sufficiently strict.
The government said on Friday a tighter lockdown would begin today, prohibiting people from leaving their homes, controversially even for food, and said the military would step in to help.
The announcement, later amended so that people in some areas could still shop for food, was subsequently reverted to a total ban, triggering confusion and panic-buying at supermarkets in the city over the weekend.
Witnesses said soldiers were delivering food to residents of the city and images broadcast by state media showed armed soldiers manning checkpoints and checking documents.
Vietnam has over recent weeks sent 14,600 additional doctors and nurses to the city and its neighbouring provinces to support its overwhelmed medical system, the ministry said. Even patients with mild or no symptoms have been told to self-isolate at home.
An army soldier checks identifications at a Covid-19 lockdown checkpoint in Ho Chi Minh City, on 23 August. Photograph: Vu Tien Luc/AP
A Spanish court has rejected a request by the regional government of Catalonia to reimpose a virus curfew in Barcelona and dozens of other cities, arguing the measure was “disproportionate” as infections have fallen.
AFP reports that the Catalan government on Friday sought court approval to impose a nightly curfew in municipalities of 20,000 residents or more where infection rates exceed 125 cases per 100,000 inhabitants over a seven-day period.
It came a day after Catalonia’s top court refused to blanket-extend across most municipalities in the north-eastern region, which is home to 7.8 million people. The high court of justice of Catalonia had given the green light to extend the curfew three times, but it argued the measure was now only justified in 19 municipalities.
Today, it ruled that the new request for a curfew “was even more unnecessary and disproportionate”.
Prof Robert Dingwall, a sociologist and critic of Covid jabs for children who recently left the UK government’s Joint Committee on Vaccination and Immunisation expert committee, has claimed government policies are being imposed on the basis of uncertain evidence.
In a blogpost, made a number of comments, including:
Nowhere, perhaps, is this more obvious than in the case of mandatory face masks in community settings, particularly, but not exclusively, in the USA. Otherwise well-respected scientists and scholars seem to have decided that, if they announce that black is white often enough, then this will indeed be the case.
Nothing that follows should be taken as an argument against the truly voluntary adoption of face masks by those who feel personally reassured by wearing them, regardless of the paucity of evidence. However, for masks to be mandated as an act of policy, whether by public or private interests, the bar must be set higher … Interventions without an evidence base are arbitrary acts of power, which rest on coercion, whether direct or indirect, for compliance rather than on the willing assent of those affected.
Classically, the most robust type of evidence for evaluating interventions of this kind is a randomized controlled trial (RCT). There is a dearth of these – and most have been conducted in the context of other respiratory infections – but they generally find little or no benefit. Well-respected figures in public health have been calling for investment in RCTs since the late spring or early summer of 2020 but opportunities have not been taken. Policy leaders have failed to fund RCTs of any NPI (non-pharmaceutical intervention) in the way they have funded trials of potential therapies or vaccine development.
The consequence, of course, is that we are nudged towards regarding our fellow human beings as no more than potential vectors of infection. Everyone is guilty until proven innocent. The trust on which everyday life depends in modern societies is fatally compromised.
If we do not think it is acceptable to have our lives ordered in ways that discriminate against large sections of the population, that impair the development of children, that damage the mental health of the nation and that make each of us fearful of the other, then it is time to hold the advocates of masking to account for the quality of evidence.
New South Wales premier Gladys Berejiklian has said zero-Covid strategies are ’completely unrealistic’
Reiterating a previously stated view, the Australian regional head told ABC that all states and territories must learn to live with the virus when borders are eventually permitted reopen.
It’s completely unrealistic. I don’t know any state or nation on the planet who abides by those rules. It’s just not possible. We can’t pretend we’re extra special or very different from other places.
There are opportunities for us to do everything we can to suppress the cases, to reduce the number of people we end up having in hospital, but also accept that every state’s going to have to go through a transition.
Even a state that’s had zero cases for a long time is going to have to open up its borders eventually. And whenever that happens, and whenever that is, you’re going to see an influx of cases. That’s just how the virus works. No amount of government intervention or lockdown is going to get you to zero cases.
I don’t want to ever, ever give a number [of deaths] that’s acceptable, never. And our job is to prevent death and keep people safe. But what we do have to accept is when you are in the middle of a pandemic which is impacting our nation as it has been other nations that we need to appreciate that, unfortunately, lives will be lost.
Reuters has this fun piece from Lesotho.
Suggest a holiday in Africa and most people picture baking hot sun, palm-fringed beaches or herds of wildebeest galloping across the savannah. Few think of skiing.
Yet the continent contains five mountain ranges with enough seasonal snow to make potential slopes, of which two host rudimentary ski resorts.
Tucked into South Africa’s stunning Drakensburg range, one such resort in the mountain kingdom of Lesotho attracts tourists seeking a more adventurous skiing destination – despite visitor numbers being drastically slashed by Covid-19.
“Yes, it isn’t much,” said snowboard instructor Hope Ramokotjo, glancing over his shoulder at bare brown hills beyond a lone white slope. “But people come here and have a whole lot of fun. For me, as a local, I don’t have to fly out: I’ve got a vacation right here.”
As with other tourist spots, the pandemic – and severe travel restrictions enforced worldwide to try to curb it – has drastically slashed visitor numbers.
They fell to virtually nothing last year and are still only half the usual 17,000 this year, owner of the nearly two-decade old Afriski Resort, Pieter Peyper, said.
People ski at Kapoko Snow Park at Afriski Mountain Resort in Butha Buthe, Lesotho, 31 July. Photograph: Sumaya Hisham/Reuters
The Wall Street Journal has queried why the Food and Drug Administration is attacking ivermectin, a medication it certified as a safe and effective anti-parasitic in 1996 which has received a Nobel prize and has been administered billions of times around the world.
It reports that a group of 10 doctors who call themselves the Front Line Covid-19 Critical Care Alliance have said ivermectin – which cam fight a number of viruses – is “one of the safest, low-cost, and widely available drugs in the history of medicine”.
The FDA’s warning against ivermectin includes this statement: “Meanwhile, effective ways to limit the spread of Covid-19 continue to be to wear your mask, stay at least 6 feet from others who don’t live with you, wash hands frequently, and avoid crowds.” The WSJ said this was not based on the quality data that the FDA requires for drug approvals.
Ivermectin is being studied by University of Oxford scientists as a possible Covid treatment as part of a UK government-backed study that aims to aid recoveries in non-hospital settings.
It is being used officially to treat Covid in some countries, including India, Mexico, Bolivia, and elsewhere in South America and Asia, despite the lack of World Health Organization approval.
A report in the Times has described ivermectin as a Covid “wonder drug” saying that the data from where it was being used was “compelling” and suggested mortality had fallen.
The Financial Times has also reported on a University of Liverpool metaanalysis which it said “could cut chance of Covid-19 deaths by up to 75%” – with striking results from a number of smaller RCTs.
As full US authorisation of the Pfizer coronavirus vaccine drew near, the federal Food and Drug Administration (FDA) is urging people not to take anti-parasite drug ivermectin.
As with other purported alternative treatments for Covid-19, misinformation about ivermectin has spread on social media and through rightwing media and politicians.
In July, Bret Weinstein, an evolutionary biologist, told Fox News host Tucker Carlson: “[If] ivermectin is what those of us who have looked at the evidence think it is … the debate about the vaccines would be over by definition.”
In a Senate hearing last December, doctors touted ivermectin alongside hydroxychloroquine, once championed by Donald Trump, and other alternatives.
In comments shared widely on social media, Dr Pierre Kory, a pulmonary and critical care specialist at Aurora St Luke’s medical center in Milwaukee, called ivermectin a “wonder drug”.
Experts said then that test results suggesting ivermectin could inhibit replication of the Sars-CoV-2 virus did not amount to official authorisation for use.
The de facto leader of a group of New York state hospital employees who are against mandatory vaccination and testing has been suspended without pay.
John Matland, a CT scan technician at Staten Island University hospital, has led opposition to his employer Northwell Health requiring unvaccinated staff to get weekly coronavirus tests by nasal swab or risk losing their jobs, the New York Times reports.
It comes after governor Andrew Cuomo announced that all healthcare workers must have at least one dose of the vaccine by 27 September.
Matland and his allies have said they are being singled out because testing is not required for vaccinated people, despite them still being able to get infected and transmit the virus.
At the radiology department at the hospital’s southern campus, Matland said four out of 10 staff were unvaccinated and “many will not cave”. He told the NYT: “Losing four of us in radiology would cripple the entire department.”
Phlebotomist Nelly DeSilvio told the paper that half of the 30 people in her department were unvaccinated: “If we all left, this would be huge. We are already short-staffed now.”
A new study from researchers at the University of Cambridge and Addenbrooke’s hospital suggests that hospital-acquired Covid-19 tends to be picked up from other patients, not from healthcare workers.
The peer-reviewed paper analysing data from 22 cases where patients were infected in hospital between March and June last year established that a minority of individuals can cause most of the transmission. It said 20 of the infections were the result of inter-patient spreading.
Dr Chris Illingworth, a lead author on the study, who carried out his research while at Cambridge’s MRC Biostatistics Unit, said:
The fact that the vast majority of infections were between patients suggests that measures taken by hospital staff to prevent staff transmitting the virus to patients, such as the wearing of masks, were likely to have been effective. But it also highlights why it is important that patients themselves are screened for Covid-19 regularly, even if asymptomatic, and wear face masks where possible.
The World Health Organization has posted this video on what it knows about natural immunity v vaccine-induced immunity, featuring its chief scientist Soumya Swaminathan.
World Health Organization (WHO)(@WHO)
If you had #COVID19 do you still need the vaccine? How long should you wait after recovery to get vaccinated? What do we know about natural immunity vs vaccine induced immunity? WHO’s Chief Scientist @doctorsoumya explains in #ScienceIn5 this week pic.twitter.com/70mtKDyVWj
It follows an interesting story on the BBC which asked whether the differences to your immune defence following a natural infection after Covid could for some people effectively be more robust than those gleaned from vaccination.
Even asking the question bordered on heresy a year ago, when catching Covid for the first time could be deadly, especially for the elderly or people already in poor health. Now, we’re no longer starting with zero immunity as the overwhelming majority of people have either been vaccinated or have already caught the virus.
It is now a serious question that has implications for whether children should ever be vaccinated. And whether we use the virus or booster shots to top up immunity in adults. Both have become contentious issues.
“We could be digging ourselves into a hole, for a very long time, where we think we can only keep Covid away by boosting every year,” Prof Eleanor Riley, an immunologist from the University of Edinburgh, told me.
Prof Adam Finn, a government vaccine adviser, said over-vaccinating people, when other parts of the world had none, was “a bit insane, it’s not just inequitable, it’s stupid”.
You get a broader immune response after being infected with the virus than vaccination. Whether you’ve had Moderna or Pfizer or Oxford-AstraZeneca, your body is learning to spot just one thing – the spike protein.
This is the critical part of the virus to make antibodies to, and the results – by keeping most out of hospital – have been spectacular. But having the other 28 proteins to target too, would give T-cells far more to go at.
“That means if you had a real humdinger of an infection, you may have better immunity to any new variants that pop up as you have immunity to more than just spike,” said Prof Riley.
There is clear evidence that adults who have not had any vaccine dose will have stronger immune defences if they do get vaccinated, even if they have caught Covid before.
But there are two big questions: do vaccinated adults need to be boosted, or is exposure to the virus enough; do children need vaccinating at all, or does a lifetime of encountering build a good immune defence?
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