NEW: for the first time in the pandemic, a Covid infection now carries less mortality risk than a flu infection in England, the result of widespread immunity and the emergence of a less virulent variant in Omicron.
Our story:
https://www.ft.com/content/e26c93a0-90e7-4dec-a796-3e25e94bc59b
In England, a Covid infection is around 40x less likely to result in death now than it was in January 2021 at the height of the Alpha wave before vaccines.
Mass vaccination reduced the infection fatality ratio (IFR) by 11x, boosters did some more, then Omicron cut it another 4x.
To be clear, infection-acquired immunity has also played an important role in building immunity, but by overlaying cumulative vaccination and infection rates onto IFR, we can see that vaccination was by far the biggest driver of the reduction in lethality.
Science: it’s good!
Most significantly, we can now show for the first time that not only is a Covid infection less lethal than flu at the population level, it is slightly lower *even for the elderly* (and significantly less lethal for young adults).
But of course, if we want to know the total toll Covid is having on mortality, IFR is only half of the equation.
A virus can be less lethal on a *per-infection* basis but still cause more deaths overall if it infects more people.
So in our story we explore exactly this point.
We looked at total deaths caused by major respiratory diseases — flu, pneumonia & Covid — over the last 8 years.
Last winter, Covid increased mortality risk enormously. 7x more deaths than in a typical flu season, far more than even a bad flu season.
But what about one year on?
In Jan/Feb 2022, Covid is still increasing the winter respiratory death toll by around 50% compared to a typical year.
As we know, vaccines and Omicron have made Covid far less lethal on a per-infection basis, but sheer volume of infections means *risk of death remains elevated*
And there are more caveats to the "Covid is now no worse than flu" line:
First, we know Covid is not only a threat during winter. If that red line bumps upwards again in the coming months (more on this in a moment…), that would further increase mortality risk relative to flu.
And second, I think a lot of people still fail to appreciate quite how much work reduced social mixing has continued to do…
Total mortality from major respiratory diseases has actually been *lower* this winter than a typical flu season for young adults and children.
That’s because of less flu/pneumonia than if we were all mixing at pre-pandemic levels.
Now, back to Covid’s threat extending beyond winter:
Whereas flu is typically waning by March, the number of Covid-positive patients in English hospitals has been rising again in the last couple of weeks.
So do we need to worry again?
Well, if we dig deeper into today’s data, we see that in almost all regions — especially those with the biggest rises — more of the increase is coming from people who are not being treated primarily for Covid, i.e those who have mild or no symptoms, and do not have severe Covid.
As always, this does not mean they "don’t count", but it does mean that we should interpret this not as a big new wave of disease, but as what happens when we have a highly transmissible virus circulating in a population that is gradually increasing its social mixing.
Pandemic precautions such as avoiding public transport, working remotely, staying away from big social gatherings and mass events, are all now at their lowest point since March 2020, and still falling.
The result is we now have more close contacts than at any time in the last two years, and we’re also taking fewer precautions with those contacts.
So we shouldn’t be surprised that the virus is still getting around!
But good news is, as we’ve shown, it’s less lethal than ever.
So to summarise Covid in England in March 2022:
• 40x less lethal than Jan 2021, now less lethal than flu
• But spreads very efficiently, and we’re also doing more mixing
• So Covid still adding to overall mortality risk, but it’s now only adding marginally rather than 7-fold
Here’s our story again, from me and @mroliverbarnes, featuring comment from @drraghibali @chrischirp @p_openshaw and others
https://www.ft.com/content/e26c93a0-90e7-4dec-a796-3e25e94bc59b
And a special thanks to @ONS for making such incredibly detailed data available!
Now, back to Ukraine-watching.
Originally tweeted by John Burn-Murdoch (@jburnmurdoch) on March 10, 2022.
The average number of patients with Covid in critical care in hospital in Wales has dropped into single figures for the first time since last summer.
There has been a daily average of nine patients in the last week on critical care or on ventilation with Covid.
It is the lowest total since mid-July.
Wales is set to scrap its remaining Covid restrictions from 28 March, the Welsh government announced last week – the last part of the UK to totally lift its coronavirus rules.
Eight of the Covid patients in critical care on Monday were in Cardiff.
The other one, in the Hywel Dda health board area of mid and west Wales, was being treated primarily for something else.
Nearly 80% of patients with positive tests for Covid in acute beds are in hospital primarily for treatment for another condition, according to Digital Health and Care Wales figures..
In Hywel Dda, there were no Covid patients at all in acute beds who were being treated “actively” for the virus.
A drug used to treat rheumatoid arthritis could help to save the lives of patients with severe Covid, researchers have found, and they say its benefits can be seen even when it is used on top of other medications.
Experts involved in the Randomised Evaluation of Covid-19 Therapy (Recovery) trial say baricitinib, an anti-inflammatory drug taken as a tablet, can reduce the risk of death from severe Covid by about a fifth.
However, they add that when the impact of other medications used alongside the drug are also taken into account, the risk of death could be lowered by well over 50% – although the figure will vary from patient to patient.
“What we have now is a suite of drugs which tackle the immune system at different levels, and slightly different ways, which depending on the patient and their circumstances, and their other illnesses and so on, can be used either alone or in combination and further reduce the risk of death,” said Prof Sir Martin Landray, a joint chief investigator of the trial at the University of Oxford. He said the drugs did not appear to pose undue risks.
Writing in a preprint that has yet to be peer-reviewed, the team report how they looked at outcomes for 4,008 patients hospitalised with Covid between February and December 2021 who were given usual care – which included interventions such as oxygen, the steroid dexamethasone, the arthritis drug tocilizumab, which has to be given intravenously, and the anti-viral drug remdesivir.
These outcomes were compared with those for 4,148 patients who were given baricitinib for up to 10 days in addition to usual care.
The results reveal 546 patients given usual care died within 28 days of being admitted to hospitaland 513 patients who were also given baricitinib.
“This result was consistent across the very wide range of people we studied, younger people and older people, men and women,” said Landray.
Landray noted that those given bariacitinib were also more likely to be successfully discharged alive within the first 28 days, although the size of the effect was small, and less likely to require mechanical ventilation.
https://www.theguardian.com/world/2022/mar/03/arthritis-drug-could-help-save-covid-patients-study
Two doses of either the Pfizer-BioNTech or the Moderna Covid-19 vaccines provide minimal protection against symptomatic illness caused by the omicron variant of the coronavirus, but a booster shot was able to restore protection, new research finds.
The study, published Wednesday in the New England Journal of Medicine, found that the Pfizer vaccine’s effectiveness against symptomatic disease plummeted to about 8 percent from about 65 percent six months after the second dose of a primary vaccination series.
The effectiveness of the first two doses of the Moderna vaccine was similarly reduced, falling to about 15 percent from about 71 percent over the same period.
A booster shot of either the Pfizer or the Moderna vaccines increased the protection back to levels seen after two doses, before it starts to wane again after about two months, according to the researchers.
The study, funded by the U.K. Health Security Agency, adds to growing evidence that two doses of the existing Covid vaccines appear to offer little protection against mild illness from the omicron variant, although experts note that the shots still provide strong protection against severe disease and death.
The findings underscore the importance of the booster shot, the authors wrote, adding that third doses provide a “rapid and substantial” increase in protection against both mild and severe illness.