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**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
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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 AnnouncementThe below are excerpts taken from the Introduction – Perspectives on Power, Gender and Marginalization, by Germain S, Yong 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
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.
JOURNAL
Annals of Internal Medicine
METHOD OF RESEARCH
Observational study
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Evolving Real-World Effectiveness of Monoclonal Antibodies for Treatment of COVID-19
Ethnic, religious, social differences in case rates between COVID-19 waves in England
Risk highest for Bangladeshis, Pakistanis, Muslims, Sikhs, and disadvantaged in wave 2 Highest for White British, Christians, the healthy, and relatively well off in wave 3
Peer-Reviewed PublicationThere were major ethnic, religious, and social differences in the risk of testing positive for SARS-CoV-2, the virus responsible for COVID-19 infection, between the second and third waves of the pandemic in England, finds research published in the open access journal BMJ Medicine.
The risks were highest for people of Bangladeshi and Pakistani ethnicities, Muslims, Sikhs, and those who were materially and socially disadvantaged in wave 2.
But in wave 3 the risks were highest for people of White British ethnicity, Christians, those with no underlying conditions or disabilities, and those who were relatively affluent.
These differences aren’t fully explained by geography, social or demographic factors, or a person’s state of health before the pandemic, say the researchers.
While the pandemic has affected all areas of the UK, some groups have been more affected than others. But rather less is known about the social and demographic inequalities underpinning the infection rates.
In a bid to plug this knowledge gap, the researchers drew on national population linked census, health, death registration and SARS-CoV-2 test data for 39 million people aged 10+ in England, to calculate the relative risk of testing positive for the virus during the second and third waves of the pandemic.
Social and demographic information for each person—sex, age, ethnicity, religion, disability status, educational attainment, job title, English language proficiency, and country of birth—were obtained from the 2011 census.
Positive test results from 1 September 2020 up to and including 22 May 2021 were classified as occurring during the second wave, and those from 23 May 2021 to 10 December 2021 as occurring in the third wave.
Just over half (52%) of the study participants were female; the average age was 47; and most (82%) identified as White British. Just under 5% identified as White other, nearly 3% as Indian, 59.5% as Christian, 25.5% as having no faith, and 5% as Muslim.
During the study period, 5,767,584 people (nearly 15%) tested positive for SARS-CoV-2.
In the second wave the risk of testing positive was highest for people of Bangladeshi (75% higher) and Pakistani (69% higher) ethnicities than it was for people of White British ethnicity, after accounting for potentially influential factors.
Similarly, those identifying as Muslim and Sikh were 51% and 64% more likely to test positive than were Christians. Case rates were lowest for those with no religion or who identified as Buddhist: their risks were 12% and 16%, lower, respectively, than for Christians.
Adjusting for geography, social and demographic characteristics, and state of health before the pandemic explained only 27% and 32% of the excess risk, respectively, for Bangladeshi and Pakistani ethnicities, and only 27% and 16% of the excess risk, respectively, for Muslim and Sikh faiths.
Greater area deprivation, social and economic disadvantage, living in a care home or urban area, and a low level of English language proficiency were also associated with higher relative risks of testing positive.
But during the third wave, identifying as Christian (average weekly rate of 353.8 per 100,000 people), White British (359.7), or as having no concurrent condition or disability (337.6), and being relatively affluent were all associated with a higher risk of testing positive.
Case rates were highest among people born in the UK (345 compared to 238.2 for those born outside the UK) and whose first language was English during this wave (342.2).
Once again, adjusting for geography, social and demographic characteristics, and state of health before the pandemic explained some, but not all, of the excess risk.
This is an observational study, and as such, can’t establish cause. And the researchers acknowledge that the information for the study was restricted to people in the 2011 census, from which all the social and demographic definitions were taken, and these might have changed since then.
National SARS-CoV-2 test data don’t represent the true extent of infections either because people are more likely to get tested if they have symptoms, add the researchers.
But they suggest that a possible explanation for the observed differences in case rates by ethnicity, religion, and social and economic factors during the two waves is that “levels of population immunity were higher for the groups that had the highest case rates in the first and second waves, even considering the potential for reinfection.”
They add: “Changes in the rate ratios observed in wave three compared with wave two could also be due to changes in testing behaviours in response to rollout of vaccination, changes in the perceived risk of infection or reinfection, and policy changes related to isolation periods and compensation after testing positive for SARS-CoV-2.”
They conclude: “Further research is needed to understand why these inequalities exist and how they can best be addressed through policy interventions. Continued surveillance is essential to ensure that changes in the patterns of infection are identified early to inform [future] public health interventions.”
JOURNAL
BMJ Medicine
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Inequalities in SARS-CoV-2 case rates by ethnicity, religion, measures of socioeconomic position, English proficiency, and self-reported disability: cohort study of 39 million people in England during the alpha and delta waves
SARS-CoV-2 infection has no clear negative effects on human oocyte and early embryo development
Since December 2022, the nationwide control policy on the Coronavirus disease 2019 (COVID-19) epidemic has been changed in China. Fertility and in vitro fertilization (IVF) centers are receiving increasing numbers of infected patients. However, there is still a lack of high-quality evidence on the effects of the virus on human oocytes and early-stage embryos. Previous studies have not found the virus in the follicular fluid of infected individuals. However, SARS-CoV-2-associated receptors such as angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease (TMPRSS2) are co-expressed in gametes and fertilized eggs as well as in blastocyst ectodermal cells, and viral infection may cause immune response that is detrimental to embryonic development, it is reasonable to suspect that infection may affect oocyte and early-stage embryo quality. At some centers, the decision has been made to cancel cycles or simply freeze oocytes for infected patients due to safety concerns. Herein researchers established a prospective cohort study to assess the impact of COVID-19 on oocyte quality and embryo development.
Valid data from a total of 906 couples were obtained from three reproductive centers in Shandong province and Shanghai municipality. Couples were divided into COVID-19 and non-COVID-19 groups depending on whether one member of the couples had been infected with SARS-CoV-2 before oocyte retrieval. Based on the time interval from the infection of women to oocyte retrieval, the COVID-19 group was further subdivided into ≤7 days group, 7-14 days group and >14 days group. Oocyte quality and early embryo development indicators were followed-up and compared in each group to assess the effect of COVID-19.
Baseline characteristics were similar between COVID-19 and non-COVID-19 groups, with the exceptions of body mass index (BMI), vaccination status and ovarian stimulation protocols. There were no significant differences in oocyte-related outcomes and embryo development outcomes between COVID-19 group and non-COVID-19 group, except the number of bipronuclear (2PN) zygotes [6.0 (IQR 3.0–10.0) vs. 5.0 (IQR 2.0–8.0), P = 0.021] (Table 1).
Subgroup analysis showed ≤7 days group, >14 days group and non-COVID-19 group did not differ in oocyte and embryo laboratory outcomes with each other. However, for women who were infected 7-14 days before oocyte retrieval, more 2PN zygotes [8.5 (IQR 4.0-11.0) vs. 5.0 (IQR 2.0-8.0)] were obtained, along with a higher oocyte utilization rate [45.3% (IQR 34.6%-60.0%) vs. 35.0% (IQR 20.0%-53.8%)], than the non-COVID-19 group. We further performed multivariable linear regression analysis by adjusting BMI, vaccination status and ovarian stimulation protocols. The adjusted results suggested that infection 7-14 days before oocyte retrieval was found to increase the number of oocytes retrieved, the number of 2PN zygotes, and the number of good-quality embryos. But infection within 7 days before oocyte retrieval diminished oocyte utilization rate.
The study also investigated the effect of COVID-19 on the female only and male only infected populations. The female only infected group had a higher number of 2PN compared to the non-COVID-19 group, with no significant differences in other indicators. In the male only infected group, there was no difference in outcomes compared to the non-COVID-19 group, but a reduction in progressive motility of sperm and good-quality embryos rate were identified in male only infected group despite there was no statistical significance.
Overall, the study suggested that COVID-19 did not have a clear negative effect on oocyte quality or embryo development. However, the pros and cons should be fully weighed in women with acute infection. This study provided favourable evidence for the successful implementation of ART during epidemic. It is hoped that this will inform clinical work and strengthen the confidence of patients in receiving ART treatment during COVID-19 epidemic. Owing to the limitation of this study having a short follow-up and small sample size, the effects of COVID-19 on pregnancy and live birth are not clear yet. Researchers will further trace long-term pregnancy outcomes as well as the health of off-spring in this prospective cohort study.
See the article:
The effect of SARS-CoV-2 infection on human embryo early development: A multicenter prospective cohort study.
http://engine.scichina.com/doi/10.1007/s11427-023-2291-0
JOURNAL
Science China Life Sciences
DOI
Long-COVID a greater burden for migrant groups than the native population
Amsterdam UMC study shows more long-covid among every migrant group than in the Dutch population
Peer-Reviewed PublicationAll prominent migrant groups in the Netherlands are suffering more from long-covid than the native Dutch population, research from Amsterdam UMC has found. The study, published today, in The Lancet Regional Health – Europe, shows that in some groups the rates of long-covid are up to 50% larger than in the Dutch population. Resulting in many migrant groups “suffering in silence,” in the words of senior author Professor Charles Agyemang.
COVID-19 has had a devastating impact on vulnerable communities, particularly people from ethnic minorities and migrant backgrounds. Research from Amsterdam UMC already found that these populations have been severely impacted by the virus and were several times more likely to be infected with and die from COVID-19 compared to majority populations in high-income countries. Various factors, including poor social and economic circumstances, communication barriers, and health literacy contribute to this disparity.
To investigate the long-term impact of COVID-19 on patients from diverse backgrounds, including Dutch origin patients, African Surinamese, South Asian Surinamese, Moroccan, and Turkish origin patients, Amsterdam UMC collaborated with the University of Copenhagen and Stockholm University to conduct a study.
Their findings revealed that about 26% of the patients who were hospitalized with COVID developed long-COVID. All the migrant groups had a higher risk of developing long-COVID than Dutch patients. Among the Turkish population, this risk is 50% higher than in the native Dutch population. Females, as well as patients who stayed longer in the hospital, were admitted to the intensive care unit, and received oxygen, were also more likely to develop long-COVID than those who did not.
The study also found that the experience of long-COVID symptoms differed between the groups. For example, experience of dizziness, and muscle and joint pain were highest among Turkish origin patients compared to other patient groups. On the other hand, experience of a racing heart, and trouble sleeping were highest among patients from Moroccan origin. Finally, the study found that about 14% of long-COVID symptoms were still persistent at one-year post-discharge, particularly among South Asian Surinamese origin patients.
According to the senior author of the paper, Professor Charles Agyemang, Professor of Global Migration, Ethnicity & Health at the Amsterdam UMC, the findings were not surprising as "the social determinants of health that shaped the disproportionately high rate of COVID-19 infection and deaths in ethnic minority and migrants are still at play."
"Many vulnerable populations in the community are suffering from long-COVID in silence due to a lack of awareness of the condition in these communities. Promoting awareness about long-COVID and facilitating easy access to healthcare and services in ethnic minorities and migrant communities and other vulnerable populations is crucial to addressing these health inequalities," adds Agyemang
The lead author, Dr Felix Chilunga, an Assistant Professor at the Amsterdam University Medical Centre, added that "patients with long-COVID are likely to face functional limitations in their daily lives, such as being unable to work or do activities of daily living. The extent of these limitations is still unknown. Therefore, checking the extent to which long-COVID affects daily activities can ensure a targeted approach to the symptoms that contribute to the greatest limitations."
JOURNAL
The Lancet Regional Health - Europe
METHOD OF RESEARCH
Data/statistical analysis
SUBJECT OF RESEARCH
People
ARTICLE TITLE
Differences in incidence, nature of symptoms, and duration of long COVID among hospitalised migrant and non-migrant patients in the Netherlands: a retrospective cohort study
ARTICLE PUBLICATION DATE
7-Apr-2023
COI STATEMENT
B.A. and M.v.V. report Patient Led Research Collaboration (PLRC) grant paid to the host institution. W.J.W. reports consultancy fees from Pfizer, GSK, and AstraZeneca paid to the host institution, as well as being a member of GSK data and safety monitoring board (fees paid to host institution). All other authors declare that they have no competing interests.
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