Pfizer and BioNTech conclude Phase 3 study of COVID-19 vaccine candidate, meeting all primary efficacy endpoints, Pfizer, November 18, 2020, pfizer.com. Up until recently, the original Omicron strain, BA.2, had been the dominant strain. Beta and Gamma have also affected the trajectory, but to a lesser degree; their evolutionary advantage was not great enough to become globally dominant.39Tracking SARS-CoV-2 variants, World Health Organization, who.int. WebA barrier on the state border of Queensland and New South Wales preventing interstate travel in April 2020 during the COVID-19 pandemic in Australia. Further, higher-than-expected efficacy may help offset coverage challenges that surveys have suggested. Second, herd immunity relies on the efficacy of vaccines at reducing transmission (rather than the usually reported efficacy at preventing disease in the vaccinated person). The order and pace of these steps will vary by geography. Lockdowns pulled functions from outside the home into the home. We've come a long way from chained-off beaches and scare photos of heaving crowds at Bondi, though we're not all quite ready to live with that reality yet. For this reason, the continued global rollout of COVID-19 vaccines remains an investment in our collective safety as well as an imperative to protect individuals. Pfizer and BioNTech to submit Emergency Use Authorization request today to the US FDA for COVID-19 vaccine, Pfizer, November 20, 2020, pfizer.com; Modernas COVID-19 vaccine candidate meets its primary efficacy endpoint in the first interim analysis of the Phase 3 COVE study, Moderna, November 16, 2020, moderna.com. Their behavior and effects, regarding these characteristics, will determine the extent to which they displace existing variants and affect the prospects for reaching the end of the pandemic. Use and care of masks, Centers for Disease Control, February 25, 2022, cdc.gov. COVID data tracker weekly review, accessed August 15, 2021; Niharika Mandhana, From pandemic to endemic, Singapore creates model for living with Covid-19,, Alexis Madrigal, A simple rule of thumb for knowing when the pandemic is over,. When we refer to herd-immunity timelines for a country, we mean the point at which the entire nation or a significant portion reaches herd immunity. Other authors have compared the burden of COVID-19 with that of other diseases, such as influenza, as a way to understand when endemicity might occur.97Alexis Madrigal, A simple rule of thumb for knowing when the pandemic is over, Atlantic, February 23, 2021, theatlantic.com; Stephen M. Kissler et al., Projecting the transmission dynamics of SARS-C0V-2 through the postpandemic period, Science, May 22, 2020, Volume 368, Issue 6493, pp. represent a material advancement and increase the chance that the impact of the Omicron variant can be controlled. Join the conversation with your fellow The New Daily readers and see their replies. We acknowledge Aboriginal and Torres Strait Islander peoples as the First Australians and Traditional Custodians of the lands where we live, learn, and work. Globally, we should aim for an always on response systemthat can scale quickly. Note that the values shown define ranges of immune protection against symptomatic infection, since that is the metric most of the published literature uses. But with strong community response to prevention measures, hard work from the health sector and a stroke of good luck, we dodged the worst-case scenarios. Other epidemiologists have called into question those hopeful estimates and note that policy should be based on conservative estimates of herd-immunity thresholds until better information is available.9Abstractions Blog, The tricky math of herd immunity for COVID-19, blog entry by Kevin Hartnett, June 30, 2020, quantamagazine.org; Apoorva Mandavilli, What if herd immunity is closer than scientists thought?, New York Times, August 17, 2020, nytimes.com. The impact of COVID will only be seen in the data for the year 2021. Depending on vaccination progress over the summer (whether the United States is on the earlier or later end of the herd immunity window), there may be a smaller fall wave of disease in third to fourth quarter 2021. At the latest, the transition to normal will come when herd immunity is reached. : TransmissibilityDelta is significantly more transmissible than either the ancestral COVID-19 variant or other variants. Because more-transmissible variants raise herd-immunity thresholds, there will also be less tolerance for low vaccine effectiveness. However, the risks to these timelines are realherd immunity may not be achieved by the end of the year if vaccine hesitancy is high, if countries experience disruptions in vaccine supply, or if a variant that renders existing vaccines less effective spreads widely. While data indicate that the most likely scenario is to reach this state on the timelines described above, five risks could delay progress. and Regenerons EUA for its antibody cocktail REGN-COV2 for EUA was approved on November 22. Expect no meaningful policies in that direction. A fair bit of this disposable income will be used to make the family home more liveable. Gen X is taking over even more leadership positions. To achieve that, we will need to see significant progress on the epidemiological end point, including an effective vaccine receiving Emergency Use Authorization approval during the fourth quarter of 2020 or the first quarter of 2021, followed by a smooth rollout and adoption by high-risk populations. 22. Meanwhile, social tolerance for vaccination incentives and mandates appears to be growing, with more European locations adopting vaccination passes92 EU Digital COVID Certificate, European Commission, accessed August 15, 2021, ec.europa.eu; Covid passports: How do they work around the world?, BBC News, July 26, 2021, bbc.com. On another front, there is hope that wider use of the oral therapeutics paxlovid and molnupiravir will further decrease the number of severe cases,36Pfizer Shares In Vitro Efficacy of Novel COVID-19 Oral Treatment Against Omicron Variant, Pfizer, January 18, 2022, Pfizer.com.37Merck expects COVID-19 pill molnupiravir to be effective against Omicron, Reuters, January 11, 2022, reuters.com. NSW 'could' have 25,000 COVID-19 cases per day. Exhibit 4 provides a global view of seven factors that are likely to drive herd-immunity timelines for the rest of the world. Nature, June 17, 2022. The long tail of the curve shows falling probabilities to Q3 2023 and beyond. Other questions relate to the impact of the new therapeutics in blunting an Omicron-driven wave of disease. Others have also advanced this view; for an example, see Grady McGregor, Evidence mounts that Omicron is more infectious, less severe than Deltabut Fauci, other experts warn against premature optimism,, Ewen Callaway and Heidi Ledford, How bad is Omicron? Data released this week saw the fertility rate fell to an all-time low of 1.58 kids per woman in 2020. This group includes countries such as Singapore that have been most successful in limiting mortality associated with COVID-19 to date.101From pandemic to endemic, July 1, 2021; Renju Jose, Sydney daily COVID-19 cases hit record high, more troops to enforce lockdown, Reuters, August 13, 2021, reuters.com. Lots has been written about this. Recent projections suggest that it is likely to take until late 2022 or early 2023 for these countries to achieve high vaccine coverage.104 Sara Jerving, Africa not on track for 10% COVID-19 vaccination rate by end of year, Devex, July 30, 2021, devex.com; Over half a billion COVID-19 vaccine doses administered in WHO South-East Asia Region as countries scale up vaccination efforts, World Health Organization, August 6, 2021, who.int. This economic definition is related to the individual behavior definition, but may take longer to reach because those secondary effects, including supply chain imbalances, labor market disruptions, and global asymmetries affecting travel and trade, may linger. Let me know in the comments or via social media onTwitter, Instagramor Facebook if you disagree with my predictions or want to add some of your own. Andrews told reporters in Wangaratta on Tuesday: The seven day average is very pleasingly coming down, so that says to me that the peak has come and gone. The next wave of medical advances will also prompt questions. CDC Health Advisory: Using Therapeutics to Prevent and Treat COVID-19, The Centers for Disease Control and Prevention (CDC), December 31, 2021, emergency.cdc.gov; Berkeley Lovelace, Jr., Covid pills are easier to find as the Omicron surge subsides, NBC News, February 23, 2022, nbcnews.org. More-infectious viruses require that a higher percentage of people be simultaneously immune to reach herd immunity.136Ken Eames, Paul Fine, and David L. Heymann, Herd immunity: A rough guide, Clinical Infectious Diseases, 2011, Volume 52, Number 7, pp. 9. Vaccinating more people is a nonlinear challenge. Email Us cs@namanmarket.com.vn. One step toward this endpoint could be shifting the focus of public-health efforts from managing case counts to managing severe illnesses and deaths. Over the twelve months to the December 2022 quarter, the CPI rose 7.8%. Exhibit 2 shows potential outcomes if more stringent public-health measures were to be employed in the United States; this could lead to a disease burden that is similar to or only moderately worse than seen in the past six months, depending on the characteristics of the virus. Those two factors could advance the timeline, and make Q3 a little more likely than Q4. In parallel, however, more-infectious strains of the virus have been detected in South Africa, the United Kingdom, and elsewhere and have spread to an increasing number of countries.134Miriam Berger, U.K. Merck and Ridgeback Biotherapeutics provide update on results from MOVe-OUT study of molnupiravir, an investigational oral antiviral medicine, in at risk adults with mild-to-moderate COVID-19, Merck, November 26, 2021; Pfizers novel COVID-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of Phase 2/3 EPIC-HR study, Pfizer, November 5, 2021. Pfizer announces additional Phase 2/3 study results confirming robust efficacy of novel COVID-19 oral antiviral treatment candidate in reducing risk of hospitalization or death, December 14, 2021. COVID-19 Projections After December 16, 2022, IHME will pause its COVID-19 modeling for the foreseeable future. 45762, nature.com. It nevertheless helps illustrate the relative threat posed by the two diseases. Once the threshold is reached, the whole population is protected. As Exhibit 3 shows, Pfizer and Moderna are expected to deliver sufficient vaccine doses to vaccinate all high-risk Americans during the first half of the year. We will The proportion of the population with effective immunity from both COVID-19 vaccines and prior infection is estimated based on an assumption that both events occur randomly in the population, there is a multiplicative benefit on Omicron immunity for an individual having had both a COVID-19 vaccine and prior infection. A basic formula for estimating that threshold is one minus the reciprocal of the basic reproductive number.7The basic reproductive number (R0) is a measure of contagiousness or transmissibility. Basic formulas fail to account for variations in the way populations interact in different places.159Kevin Hartnett, The tricky math of herd immunity for COVID-19, Quanta Magazine, June 30, 2020, quantamagazine.org. variant continues to spread around the world as coronavirus pandemic enters 2021,, Michelle R. Smith, Governors scramble to speed vaccine effort after slow start,, Ken Eames, Paul Fine, and David L. Heymann, Herd immunity: A rough guide,, Sabin Russell, Vaccines stop COVID-19 symptoms, but do they stop transmission?,. Now they're back in Kyiv, 34 injured and houses destroyed after Russia launches early morning strikes on Ukraine, US authorities 'auction' First Republic Bank after second biggest bank failure in history, Donald Trump denied mistrial in rape accuser Carroll's civil case, based on an informed community taking the lead on protection, alongside vaccine supply certainty and a focus on taking the pressure off hospitals, BA.5, BA.2.75, BQ.1 and XBB are among those moving through the community, which can target two strains of the virus, which are most effective at reducing severe illness when taken shortly after an infection begins. Watch the U.K. to understand Delta, August 2021; Grady McGregor, Sophie Mellor, and Biman Mukherji, Delta waves in India and the U.K. have already receded. For an example of a low-end estimate, see Max Fisher, R0, the messy metric that may soon shape our lives, explained,, Frank Ball, Tom Britton, and Pieter Trapman, A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2,. Of course, we're not alone the whole world is being buffeted. 5. But rollout is off to a slow start. Theyre hoping theyll be able to get it approved around August When that comes out, it will definitely be worthwhile.. Such therapies are also easier to administer in lower-resourced regions than injected or infused treatments are. In the process Millennials will hipsterfy suburbia, the urban fringe, and regional Australia. It isnt yet clear whether public interest in boosters will continue to decline or demand will in time match the historical uptake of flu vaccines (around 50 percent of adults). Companies have indicated that modified or new vaccines could be available in a few months, though the scale and global availability are unclear.58Pfizer and BioNTech provide update, December 8, 2021; Khristopher J. Brooks, CEOs and scientists on whether existing vaccines will work against Omicron, CBS News, December 8, 2021. Charlie Giattino et al., Excess mortality during the coronavirus pandemic (COVID-19), Our World in Data, December 7, 2021. Genomic epidemiology of novel coronavirus - Africa-focused subsampling, Nextstrain, December 11, 2021. Implications of the further emergence and spread of the SARS CoV-2 B.1.1.529 variant of concern (Omicron) for the EU/EEA first update, European Centre for Disease Prevention and Control (ECDC), December 2, 2021; Loni Prinsloo, Toddlers make up 10% of hospital cases in Omicron epicenter, Bloomberg, November 29, 2021. In the base-case scenario, US COVID-19-related hospitalizations could peak significantly higher in the next six months than in the past six months. Will oral therapeutics be available quickly enough to blunt a potential Omicron surge in December 2021 and January 2022? We need to get that up to nearly 100%, he said, adding that people over 65 should get their fourth Covid jab as soon as possible. but the real-world impact of their use at scale is not yet known, and supplies of paxlovid are still scaling.38CDC Health Advisory: Using Therapeutics to Prevent and Treat COVID-19, The Centers for Disease Control and Prevention (CDC), December 31, 2021, emergency.cdc.gov; Berkeley Lovelace, Jr., Covid pills are easier to find as the Omicron surge subsides, NBC News, February 23, 2022, nbcnews.org. V Chng Ti | Tin Tc Nam An | The proportion of unvaccinated people with past infections in a country is roughly correlated with its overall COVID-19 mortality, since unvaccinated but infected people have been at greatest risk of bad outcomes. The UK Health Security Agency recently summed up its view: Early estimates of vaccine effectiveness (VE) against symptomatic infection find a significantly lower VE [against] Omicron infection compared to Delta infection. But it seems likely that purchases of tests (like online searches of flu near me) are an indicator and could provide some advance warning of future waves of the disease. Levels of natural immunity from prior infection vary within the European Union but are generally in the same range as in the United Kingdom and the United States.125SeroTracker, last accessed March 15, 2021, serotracker.com. "I think a lot of this work is going to have to be done retrospectively, to understand from various hospital diagnoses and GP diagnoses around how much long COVID is around," Dr Lydeamore said. Get The New Daily free every morning and evening. The curve rises sharply from Q1 2021 to a peak between Q3 and Q4 2021. "The danger will be that, if a variant emerges somewhere that can be anywhere in the world that is more severe, starts to put more people in hospital or increase mortality, that's when the real risk comes in for the next 12 months.". Catch up on the latestCOVID-19 news here. are seeing their worst peak yet, and continuing to tighten restrictions. When confidence is restored, people will again fill bars, restaurants, theaters, and sports venues to full capacity; fly overseas (except for the highest-risk populations); and receive routine medical care at levels similar to those seen prior to the pandemic. Dr Lydeamore also said while next year would likely be an easier pandemic year for Australia, some of its neighbours in the Asia-Pacific region could be facing a year similar to Australia's 2022: marked by enormous strain on their health systems. In the meantime, the current approach appears to have had substantial and mostly negative effects on both the Chinese and the global economies.4Paul Mozur and Alexandra Stevenson, In China, concerns grow over the economic impact of zero Covid, New York Times, May 26, 2022; Ji Siqi, China coronavirus: Shanghai restrictions caused more severe economic hit than previous lockdowns, China Macro Economy, June 1, 2002. Alisa Odenheimer, Israel is preparing for possible fourth Covid vaccine dose, Bloomberg, September 12, 2021. Prime Minister confirms move to plan B in England, United Kingdom, December 8, 2021. COVID data tracker weekly review, Centers for Disease Control and Prevention, last accessed August 15, 2021, cdc.gov; See our earlier perspectives, below, for definitions of normalcy and herd immunity. Our analysis offers some scenarios to understand potential outcomes. In a pandemic of medical misinformation, how do you deal with conspiracy believers? Since so few results from home tests are reported, it has been difficult to estimate the current waves true magnitude in the United States. In just 10 months, the cost of servicing an average $600,000 mortgage will have risen by more than $14,000 per year once those rate hikes are fully passed through. This service may include material from Agence France-Presse (AFP), APTN, Reuters, AAP, CNN and the BBC World Service which is copyright and cannot be reproduced. In the pessimistic scenarios, the peak number of hospitalizations for COVID-19 could be much higher in the next six months than in the past six months, whereas in the optimistic scenario, the number would be higher but similar to that seen in the second half of 2021, as waning immunity causes ongoing disease from a combination of the Delta and Omicron variants. Original reporting and incisive analysis, direct from the Guardian every morning, 2023 Guardian News & Media Limited or its affiliated companies. The initial evidence indicates that the efficacy of these therapies is unlikely to be reduced by the mutations present in the Omicron variant.67Jason Gale and John Lauerman, How does Omicron challenge the treatments for Covid?, Bloomberg, December 9, 2021. "And I would have liked to think we've learned from that by now and we just focus, once again, on those basics to minimise the impact of this virus, wherever it is.". We are more confident in this timeline for the United Kingdom than for the United States, given that the first has already experienced a wave driven by a more infectious variant, whereas the latter could still face one. But the fact of the matter is its still there. Previous editions of this article invoked a comparison of the COVID-19 burden to that from other diseases such as flu. Ranges reflect the uncertainty around immunity levels and describe population averages. Subscribe for free to get the latest breaking news and analysis sent to your inbox. Update on Omicron, WHO, November 28, 2021. Emma K. Accorsi, Amadea Britton, Katherine E. Fleming-Dutra, et al, Association Between 3 Doses of mRNA COVID-19 Vaccine and Symptomatic Infection Caused by the SARS-CoV-2 Omicron and Delta Variants, January 21, 2022, jamanetwork.com. In the short term, an accelerated rollout of booster doses of COVID-19 vaccines is likely to be one of the best protections against an Omicron-fueled wave of the disease. And some data inconsistencies have emergedfor example, it is unclear why molnupiravirs efficacy in an interim analysis dropped in the final readout.69Merck and Ridgeback Biotherapeutics provide update, November 26, 2021. This means downsizing is pushed backwards too. Many are already recommending fourth doses for those at highest risk of severe disease, given recent studies highlighting the additional benefit provided.7CDC strengthens recommendations and expands eligibility for COVID-19 booster shots, US Centers for Disease Control and Prevention, May 19, 2022; Updated joint statement from ECDC and EMA on additional booster doses of COVID-19 vaccines, European Centre for Disease Prevention and Control, July 11, 2022. At this point, significant, ongoing public-health measures are not needed to prevent future spikes in disease and mortality (this might be achieved while there are still a number of people in particular communities who still have the disease, as is the case with measles). Research and findings of the past two months have shed light on a number of uncertainties and in some cases have raised new questions. As the name implies, a transition will include a series of steps that will gradually normalize aspects of social and economic life. The strain is likely to continue spreading in the coming months, propelled by its reproductive advantage over the original. WebA fantastic post on the top 10 issues of 2022. Eyewitness News, Coronavirus vaccine updates: Scientists concerned over New York's escape variant, ABC, Inc., WABC-TV New York, March 16, 2021, abc7ny.com. Expect quite a bit of spending out of this cohort. Again, when a new "national" set of rules for close contacts and testing were announced on Thursday with four different timelines, and exceptions in South Australia, an "in principle" yes but no changes in WA and an announcement to come from the NT. Salma Khalik, Moving from Covid-19 pandemic to endemic: Singapores strategy and how it can unfold,, Frances Mao, Fortress Australia: Why calls to open up borders are meeting resistance, BBC News, May 26, 2021, bbc.com; Meena Thiruvengadam, New Zealand to keep its borders closed through the end of 2021,. Beyond vaccines, science is also progressing in therapeutics for COVID-19. The worst-case scenarios were avoided. Booster vaccinations will be important in maintaining immunity levels over time.100 US to advise boosters, August 16, 2021. What scientists know so far, Nature, December 2, 2021. We have written previously about two endpoints for the COVID-19 pandemic: a transition toward normalcy, and herd immunity. More data are likely to emerge on this in the weeks ahead. They have typically maintained tight border restrictions and a strong public-health response to imported cases. The study, co-led by UNSWs Kirby Institute for Infection and Immunity in Society and the National Centre for Immunisation Research and Surveillance, analysed 5185 samples from blood donors between the age of 18 to 89 six weeks after the outbreaks peak. Covid pandemic: Biden eyes 4 July as Independence Day from virus, BBC, March 12, 2021, bbc.com. As opposed to the basic reproduction number, which was used at the start of the pandemic, the Reff (effective transmission number) assumes that people have some immunity to the virus either from being vaccinated or having already been infected. Limited evidence also suggests that vaccinated individuals who are infected by the Delta variant can transmit it to others as efficiently as unvaccinated people do. If immunity wanesfor example, if booster vaccines are not fully adoptedthen COVID-19 could become more widely endemic. Some recent studies suggest that a significant number of people who havent contracted COVID-19 have cross-reactivity in specific immune cells (T cells). The data continue to indicate, as stated in our earlier perspectives, that a significant transition toward UK and US normalcy will occur in the second quarter of 2021, although the potential for a variant-driven wave in the United States is real and would blunt the transition (Exhibit 1). What does that mean for your organization?, On pins and needles: Tracking COVID-19 vaccines and therapeutics, COVID-19: Saving thousands of lives and trillions in livelihoods, Why tech transfer may be critical to beating COVID-19. Its also possible that once most people in the highest-risk groups have received vaccinations, the pace of vaccination will slow if lower-risk groups do not embrace the opportunity. Michael Ollove, Amid Omicron Uncertainty, States Resist New Mandates, PEW, December 10, 2021, pewtrusts.org. Whats more difficult to estimate is when a new variant of SARS-CoV-2 will emerge. The threshold for achieving herd immunity for COVID-19 is the percentage of a population that needs to develop immunity to disease to prevent sustained future transmission. The situation may be dynamic as vaccines are approved at different times, each with its own considerations in manufacturing and distribution. Paxlovid and other COVID-19 therapeutics are now widely available in high-income countries. Could the same happen in the U.S.?,. Singapores government has announced that it will make this shift, and more countries may follow its lead.96 Niharika Mandhana, From pandemic to endemic, Singapore creates model for living with Covid-19, Wall Street Journal, July 1, 2021, wsj.com. The first two factors combine to drive the number of cases, while the third determines the number of severe cases and deaths. Last week, Andrews flagged the vaccinated economy, QR codes and isolation requirements for close contacts of Covid-19 cases could be scrapped after the latest outbreak peaked. The approval, in at least one country, of vaccines made by Pfizer and BioNTech, Moderna, Oxford and AstraZeneca, Sinopharm, Serum Institute, Bharat Biotech, Gamaleya, and others within a year of viral sequencing smashed all records for development timelines. The fall in COVID-19 cases across much of the world over the past ten weeks signals a new dawn in the fight against the disease. Globally, of the approximately 30 million people known to have COVID-19, more than 900,000 have died.1Coronavirus Resource Center, Johns Hopkins University & Medicine, September 18, 2020, coronavirus.jhu.edu. Countries like New Zealand have avoided significant COVID-19-associated mortality but appear to be further from herd immunity because so few New Zealanders have infection-driven immunity to SARS-CoV-2. Patrick Knox and Laura Gesualdi-Gilmore The Sun 3 min read December 30, 2021 - 9:00AM

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