27 August 2021

• The British Medical Journal publishes a paper on the risk of blood clots with low platelets among adults in England (19 ,608 ,008 people who received the Oxford/AstraZeneca vaccine; 9 ,513 ,625 who received the Pfizer/BioNTech vaccine and 1 ,758 ,095 who tested positive for SARS-CoV-2). The risk of hospital admission or death associated with thrombocytopenia, venous thromboembolism, and arterial thromboembolism was significantly higher among people who fell ill with COVID-19 than the risk from vaccination. The authors noted an increased risk of thrombocytopenia, venous thromboembolism, and other rare arterial thrombotic events in short time intervals after the first dose of the Oxford/AstraZeneca vaccine, and of arterial thromboembolism and ischemic stroke after a first dose of the Pfizer/BioNTech. Importantly, the risks of these outcomes after vaccination were much lower than those associated with SARS-CoV-2 infection in the same population. Source 

• Inovio, which has struggled to secure funding for INO-4800, its experimental DNA-based coronavirus vaccine, was granted permission to start the phase III segment of its trial in Brazil; it plans to expand the trial to other countries in Africa, Asia and Latin America. The company has already secured approval to test the vaccine in China as a booster for Sinovac’s CoronaVac. Source 

• Bloomberg reports that globally, over 5.11 billion doses of coronavirus vaccines have been administered at a current rate of 38.4 million doses per day. Although enough doses have been given to cover 33.3 percent of the world’s population, distribution remains “lopsided,” with high-income regions vaccinating their populations over 20 times faster than the poorest countries. Source 

• Jacinda Ardern, New Zealand’s Prime Minister, extends the country’s lockdown until 31 August to control the Delta variant. Source 

• An analysis of real-world data from Israel finds that people who recovered from COVID-19 are less likely to become infected with the Delta variant than those who received both doses of the Pfizer/BioNTech vaccine. Vaccinated people were nearly six-fold more likely to contract Delta and seven-fold more likely to have symptomatic COVID-19 than people with natural immunity. Source 

• Lancet publishes a study of one-year outcomes among 1,276 people hospitalized with COVID-19 who completed follow-up visits at 6 and 12 months after they were discharged. The proportion of people who had at least one symptom decreased from 68 percent (831/1227) at 6 months to 49 percent (620/1272) at 12 months, although the proportion of people with difficulty breathing increased from 26 percent (313/1185) at 6 months to 30 percent  (380/1271) at 12 months and more people reported anxiety or depression at 12 months  (26% [331/1271]) versus 12- 23% (274/1187) at 6 months. Women were more likely than men to experience fatigue or muscle weakness, anxiety or depression and diffusion impairment (accumulation of different cells and swelling caused by fluid in the lungs that make exercise difficult). Overall, although many COVID-19 survivors were able to return to work and resume their normal lives, they had a higher rate of pain or discomfort and mobility problems than a matched group of uninfected people. Source

• Portions of an intelligence report on the origins of SARS-CoV-2 are declassified; although inconclusive, all involved agencies agree that the virus was unlikely to have been made as a biological weapon, and that the initial outbreaks that sparked the pandemic occurred no later than November 2019. The US National Intelligence Council and four other agencies believe that the most likely origin of the virus was via “ “…natural exposure to an infected animal through an animal infected with it, or close progenitor virus,” while one agency believes that the pandemic was the result of “a laboratory-associated incident, “ involving “…animal handling, or sampling by the Wuhan Institute of Virology.” Source           

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