Monday, April 17, 2023

Over 1 million lives saved across Europe by COVID-19 vaccines since the end of 2020

New research shows that 96% of all lives saved were in adults aged 60 and older

Reports and Proceedings

EUROPEAN SOCIETY OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES

**Note: the release below is from the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, 15-18 April)Please credit the conference if you use this story**

COVID-19 vaccination directly saved at least 1,004,927 lives across Europe between December 2020 and March 2023, according to new research being presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Copenhagen, Denmark (15-18 April).

The new estimates by WHO/Europe and presented at the conference by Dr Margaux Meslé,  Epidemiologist at WHO/Europe highlight the striking impact of COVID-19 vaccine programmes and also underscore the urgent need for countries with low vaccination coverage to fully vaccinate their older adults.

Since the emergence and subsequent spread of SARS-CoV-2 in early 2020, over 2 million COVID-19 laboratory-confirmed deaths have been officially recorded by WHO/Europe.

Countries in the WHO European Region (which includes all countries in the European Union and European Economic Area) have introduced COVID-19 vaccine programmes to protect vulnerable groups from severe disease with several waves of variants of concern (VOC).

The authors used weekly reported deaths and vaccination doses by 26 countries and areas to WHO/Europe and the European Centre for Disease prevention and Control between December 2020 and March 2023, to calculate the number of lives saved by vaccination dose, VOC period, age group (25 to 49 years, 50 to 59 years and 60 years or older) and country.

Vaccine effectiveness was considered in the context of each dominant VOC period.

The new estimates suggest that the majority (96%) of the lives saved were in people aged 60 years and older.

In this older age group, the first booster saved the most lives, accounting for almost two-thirds (64%) of lives saved.

Overall, across all age groups and countries, vaccines are estimated to have saved the largest number of lives during the Omicron wave, with at least 568,064 deaths prevented. This represents over half (57%) of the lives saved.

This research did not consider the indirect effects of vaccinations, differing healthcare capacities between countries and non-pharmaceutical interventions.

“We see from our research, the large numbers of lives saved by COVID-19 vaccines across Europe during the pandemic. However, too many people in vulnerable groups across the WHO European Region remain unvaccinated or partially vaccinated. We urge people who are eligible and who have not yet taken the vaccine to do so," says Dr Richard Pebody, Head of the High Threat Pathogen Team at WHO/Europe.

Notes to editors:

The authors declare no conflicts of interest.

This press release is based on abstract 01898 at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) annual meeting. The material has been peer reviewed by the congress selection committee. There is no full paper available at this stage, and the work has not yet been submitted to a medical journal for publication.

For full abstract click here


Coronavirus

CREDIT

PD

Beyond the Virus: Multidisciplinary and International Perspectives on Inequalities Raised by COVID-19


In their new book, The City Law School’s Dr Sabrina Germain and Dr Adrienne Yong explore social inequalities brought to the fore by the COVID-19 public health crisis

Book Announcement

CITY UNIVERSITY LONDON

Dr Adrienne Yong and Dr Sabrina Germain with their book 

IMAGE: DR ADRIENNE YONG AND DR SABRINA GERMAIN WITH THEIR BOOK view more 

CREDIT: DR ADRIENNE YONG AND DR SABRINA GERMAIN

The below are excerpts taken from the Introduction – Perspectives on Power, Gender and Marginalization, by Germain SYong A (eds) Beyond the Virus: Multidisciplinary and International Perspectives on Inequalities raised by COVID-19 (Bristol University Press, 2023).

During 2020, the COVID-19 pandemic took hold globally, claiming countless lives, yet more widely throwing everyday life into disarray for countless more. As the pandemic unfolded, it became more and more obvious that whilst everyone was susceptible to contracting the virus, there were stark social inequalities being brought to the fore in many areas outside simply direct health consequences. The topic of COVID-19 became central to many research areas in a multitude of different disciplines across the world, leading to an explosion of scholarship, mainly reactionary pieces of research published in response to the developments occurring in real time, leaving a gap in the literature for a broader reflection on what has happened since COVID-19 was declared a pandemic in early 2020.

Our own contribution to the COVID-19 scholarship was added in October 2020 in this way, through a co-authored journal article that brought together both of our expertise in health law, race and gender issues and migration from a feminist perspective in the context of the pandemic. It outlined our emerging research on the disproportionate impact on women possessing certain intersectional characteristics, centring on the barriers to accessing healthcare. However, the increasing amount of COVID-19 scholarship began to demonstrate that experts in the fields of law, policy and other humanities were interested in studying the diverse impact of the pandemic on populations in their specific fields, but had yet to take a multidisciplinary approach to understanding how the phenomenon has deepened existing inequalities outside direct health consequences. It was from this premise that the idea for the edited collection was born, having realised that the inequalities raised by the pandemic pervaded all areas of society and worldwide.

Streams of Inequality

Beyond the Virus has provided us with an opportunity to fill a significant gap in the literature, with its carefully crafted array of chapters from multiple disciplines and international experts who are proudly from a variety of different backgrounds. The originality in this volume is thus its consideration of these issues in relation to the pandemic, focusing on thematic strands to gain a greater understanding of these underlying problems, including how the law, or absence of it, has exacerbated inequalities. We identified three strands in particular that emerged from considering inequalities beyond just the virus itself: on power and governance, on gender, and for marginalised communities. It is under these three themes that this collection uncovers how unequal the pandemic truly is.

The first section on power and governance seeks to interrogate whether the State has taken into account external factors in their governance of the COVID-19 public health crisis beyond just the medical aspects of the virus. The second section on gender seeks to investigate how gender inequalities have been forgotten in the imposition of and messaging around accommodations made to curb the spread of the virus. The third section on marginalised communities seeks to give voice to groups of vulnerable individuals and understand whether during the pandemic they have become more sidelined because of the prioritisation of the public health crisis.

Diverse perspectives

Diversity was considered in all of our chapters and contributors in various forms. It was in the sense of seniority in the academy, with our collection including doctoral scholars and early career researchers alongside mid-career researchers and Professors. It was in the context of a balance of genders and ethnicities, both in terms of the subject matter of chapters themselves as well as the identities of the authors themselves contributing to the volume. Diversity was also considered geographically. The collection does not solely focus on a Western nor single national perspective. We sought to represent both the Global North and the Global South in areas of the world which the pandemic has drawn attention to, demanding a more critical evaluation of countries in the spotlight of global media. The intersectional nature of a number of the issues was also salient and a key factor. Finally, diversity was also important to us in terms of methodologies and disciplinary approaches. This was especially necessary given the pandemic’s ubiquity. We drew from politics, sociology, culture and media and journalism to enrich our exploration of issues beyond just the law in order to provide a unique outlook on the pandemic domestically, internationally and globally.

These inequalities have long existed without sufficient political attention and are questions that are now more urgent due to the widespread global effects of the pandemic. They are complex questions requiring a multi-layered approach and a more focused and in-depth analysis. With its explicit focus on promotion of diversity as seen through the international and multidisciplinary approaches taken by the range of chapter contributors, this collection can critically assess how the COVID-19 pandemic has had an effect on social inequalities in the context of the three streams, with the specific intention of looking beyond the virus, and towards many other areas of inequalities that has hit so many so hard.

Contributors to the edited collections are as follows:

· Buhm-Suk Baek, Professor of Public International Law, Kyung Hee University (South Korea).

· Louise Bernier, Professor in Health Law & Bioethics, Law Faculty, Université de Sherbrooke (Canada).

· Gwilym David Blunt, Senior Research Fellow at the Centre for International Policy Studies, City, University of London.

· Julia Boelle, PhD graduate of Cardiff University’s School of Journalism, Media and Culture.

· Mylaine Breton, Professor in the Department of Social Science and Medicine, Université de Sherbrooke (Canada).

· Valentina Cardo, Associate Professor of Politics and Identity, Winchester School of Art, University of Southampton.

· Y.Y. Brandon Chen, Assistant Professor, Faculty of Law Faculty, University of Ottawa (Canada).

· Marie-Ève Couture Ménard, Professor at the Faculty of Law Faculty, Université de Sherbrooke (Canada).

· Jean-Frédéric Ménard, Assistant Professor, Faculty of Law, Université de Sherbrooke (Canada).

· Naomi Finch, Lecturer in Social Policy, Department of Social Policy and Social Work, University of York.

· Roy Gilbar, Professor in the School of Law, Netanya Academic College (Israel).

· Simon Halliday, Professor in Socio-Legal Studies, York Law School, University of York.

· Nili Karako-Eyal, Senior Lecturer, Haim Striks School of Law College of Management (Israel).

· Jed Meers, Lecturer in Law, York Law School, University of York.

· Natalia Pires de Vasconcelos, Assistant Professor of Law, Insper Instituto de Ensino e Pesquisa (Brazil).

· Joe Tomlinson, Professor in Public Law, York Law School, University of York.

· Mark Wilberforce, Senior Research Fellow, Social Policy Research Unit, University of York.

Ends

Two years of patient data reveal real-world efficacy of COVID-19 treatments


Peer-Reviewed Publication

UNIVERSITY OF PITTSBURGH

Kevin Kip, Ph.D. 

IMAGE: KEVIN KIP, PH.D., VICE PRESIDENT OF CLINICAL ANALYTICS AT UPMC view more 

CREDIT: KEVIN KIP

PITTSBURGH, April 3, 2023 – The COVID-19 pandemic created a real-life experiment that demanded health care providers nationwide rapidly stand up clinics to administer an evolving offering of monoclonal antibody treatments that — while initially proven safe and effective in clinical trials and approved under federal emergency use authorization — had never been tested at such a scale.

The task was massive and the real-world benefit uncertain, particularly for monoclonals approved later in the pandemic based only on laboratory data. An analysis published today in the Annals of Internal Medicine by UPMC and University of Pittsburgh School of Medicine clinicians and scientists shows that it was worth it.

“The virus was a moving target, and, for two years, monoclonal antibodies were approved, revoked, sometimes reauthorized and sometimes scarce,” said lead author Kevin Kip, Ph.D., vice president of clinical analytics at UPMC. “Using UPMC’s database of patients treated with monoclonal antibodies —one of the largest in the U.S. — we are finally able to conclude that pushing through all these challenges unequivocally saved lives and prevented hospitalizations.”

Monoclonal antibodies are human-made antibodies specifically designed to prevent a pathogen — in this case the virus that causes COVID-19 — from entering human cells, replicating and causing serious illness. The U.S. Food and Drug Administration granted emergency use authorization to five different COVID-19 monoclonal antibody treatments at various times between 2020 and 2022. All were restricted to people age 12 and older with risk factors that made them more susceptible to bad outcomes from COVID-19. The treatments had to be administered intravenously or through injection by a health care professional. As the virus evolved, new monoclonal antibodies were introduced and older ones, which were no longer effective, were removed.

Starting with the first authorization at the end of 2020, UPMC opened dozens of clinics, set up emergency department infrastructure and arranged home visits to maximize its ability to provide monoclonal antibodies to patients in Pennsylvania, New York and Maryland. After the emergency use authorization was revoked for the last monoclonal antibody on Nov. 30, 2022, and no new monoclonal antibodies were introduced, UPMC pulled anonymous clinical data on 2,571 patients treated with monoclonal antibodies and matched them with data from 5,135 patients with COVID-19 who were eligible for monoclonal antibodies but did not receive them.

On average, people who received monoclonal antibodies within two days of a positive COVID-19 test reduced their risk of hospitalization or death by 39% compared to their peers who did not receive the treatment. Patients with immunocompromising conditions, regardless of their age, had an even greater reduced risk.

Patients treated when the alpha and delta variants of the virus were circulating experienced greater benefit than their untreated peers compared to those treated when the omicron variant was circulating, likely because earlier variants were more deadly and people had less prior immunity from previous infection or vaccination. By the time omicron was circulating, risk of death and hospitalization had fallen in general, so monoclonal antibody treatment had less overall benefit, but still clinically meaningful benefit, particularly in vulnerable patients, explained co-author Erin McCreary, Pharm.D., director of infectious diseases improvement and clinical research innovation at UPMC.

“Right now, COVID-19 has a relatively low risk of death for the general population, but we have seen how quickly this virus can mutate and spread. Nobody can say with certainty that a future variant won’t be more deadly,” McCreary said. “Should that happen, our real-world data give reassurance that investing in the infrastructure and health care worker knowledge to quickly give antibody treatments keeps people in the communities we serve alive and out of the hospital.”

Additional authors on this research are Kevin Collins, M.B.A., Tami E. Minnier, M.S., Graham M. Snyder, M.D., M.S., William Garrard, Ph.D., Jeffrey C. McKibben, M.S., Donald M. Yealy, M.D., Christopher W. Seymour, M.D., M.S., David T. Huang, M.D., M.P.H., J. Ryan Bariola, M.D., Mark Schmidhofer, M.D., Richard J. Wadas, M.D., Derek C. Angus, M.D., M.P.H., Paula L. Kip, Ph.D., and Oscar C. Marroquin, M.D., all of UPMC, Pitt or both.

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