Statins may slightly lower COVID-19 death risk; using a different vaccine as booster may offer more protection

By Nancy Lapid

(Reuters) – The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be certified by peer review.

Statins may protect slightly against COVID-19 death

Widely-used statin drugs for lowering cholesterol may be linked to a slightly lower risk of dying from COVID-19, new data suggest. Researchers at Karolinska Institute in Sweden reviewed the medical records of nearly 1 million residents of Stockholm over the age of 45 between March and November 2020, roughly 18% of whom had been prescribed a statin, such as Pfizer Inc’s Lipitor (atorvastatin) and Merck & Co’s Zocor (simvastatin). The people prescribed statins had more risk factors for poor COVID-19 outcomes: they were older, more often male, had more medical conditions, lower education levels and less disposable income. After taking all that into account, statin users were still 12% less likely to have died of COVID-19 during the study period, according to a report published on Thursday in PLOS Medicine. The researchers did not compare outcomes in people who actually got infected with the virus, however. And they only had data on prescriptions – not on whether patients took the medicine as prescribed. A formal clinical trial would be needed to confirm the findings. Still, they conclude, their data “suggest that statin treatment may have a modest preventive therapeutic effect on COVID-19 mortality.”

Boosting with a different vaccine is safe, may be better

People who got Johnson & Johnson’s COVID-19 vaccine as a first shot had a stronger immune response when boosted with vaccines from either Pfizer Inc/BioNTech SE or Moderna Inc, according to a study run by the National Institutes of Health. The trial, which included more than 450 adults who received initial shots from Pfizer/BioNTech, Moderna, or J&J, also showed that “mixing and matching” booster shots using different vaccine technology is safe in adults, the researchers reported in a paper posted on medRxiv on Wednesday ahead of peer review. Moderna’s and Pfizer’s vaccines are based on messenger RNA (mRNA) while J&J’s uses viral vector technology. The trial looked at a total of nine combinations of initial shots and boosters. Using different types of shots as boosters generally produced a comparable or higher antibody response than using the same type, the researchers reported. Mixing booster doses “may offer immunological advantages to optimize the breadth and longevity of protection achieved with currently available vaccines,” they said.

Old age alone does not predict COVID-19 mortality risk

Older patients are known to be at higher risk for poor outcomes after infection with the coronavirus, but among those hospitalized with COVID-19, other characteristics help predict who is likely to do poorly, new data suggest. In a review of data on 4,783 people age 65 and older who were hospitalized for COVID-19 early in the pandemic, researchers at Northwell Health hospitals in New York found that age itself did not independently predict whether a patient was more likely to die. Instead, they reported on Thursday in BMC Geriatrics, more important predictors of death for elderly patients were factors such as how independent they were before the infection, how sick they were when they arrived at the hospital, and their pre-existing medical conditions, such as high blood pressure, kidney disease, lung disease and dementia. The researchers noted that in facilities forced to ration care or facing resource shortages, some guidelines use advanced age as a reason to deny care. “Our findings support the American Geriatrics Society position statement indicating age alone should never be used to make decisions regarding resource allocation under conditions of resource scarcity,” the researchers said. “Although age is still an important factor in the overall risk of COVID-19 mortality… a comprehensive approach that accounts for the above factors is essential in preventing ageism.”

(Reporting by Nancy Lapid and Carl O’Donnell; Editing by Bill Berkrot)

New York must allow religious exemptions to COVID-19 vaccine mandate, judge rules

By Tom Hals and Nate Raymond

(Reuters) -A federal judge ruled on Tuesday that New York state cannot impose a COVID-19 vaccine mandate on healthcare workers without allowing their employers to consider religious exemption requests.

U.S. District Judge David Hurd in Albany, New York, ruled that the state’s workplace vaccination requirement conflicted with healthcare workers’ federally protected right to seek religious accommodations from their employers.

The ruling provides a test case as vaccine mandate opponents gear up to fight plans by President Joe Biden’s administration to extend COVID-19 inoculation requirements to tens of millions of unvaccinated Americans.

Vaccines have become highly politicized in the United States, where only 66% of Americans are vaccinated, well short of the initial goals of the Biden administration.

Seventeen healthcare workers opposed to the mandate sued, saying the requirement violated their rights under the U.S. Constitution and a federal civil rights law requiring employers to reasonably accommodate employees’ religious beliefs.

Hurd agreed, saying the state’s order “clearly” conflicted with their right to seek religious accommodations.

“The court rightly recognized that yesterday’s ‘front line heroes’ in dealing with COVID cannot suddenly be treated as disease-carrying villains and kicked to the curb by the command of a state health bureaucracy,” said Christopher Ferrara, a lawyer for the workers at the conservative Thomas More Society.

New York Governor Kathy Hochul, a Democrat, vowed in a statement to fight the decision, saying her “responsibility as governor is to protect the people of this state, and requiring health care workers to get vaccinated accomplishes that.”

At least 24 states have imposed vaccine requirements on workers, usually in healthcare.

New York’s Department of Health on Aug. 26 ordered healthcare professionals to be vaccinated by Sept. 27 and the order did not allow for the customary religious exemptions.

Hurd issued a temporary restraining order on Sept. 14 in favor of the workers while he considered whether to issue a preliminary injunction.

(Reporting by Tom Hals in Wilmington, Delaware and Nate Raymond in Boston; Editing by Noeleen Walder and Peter Cooney)

Pfizer study to vaccinate whole Brazilian town against COVID-19

BRASILIA (Reuters) -Pfizer Inc will study the effectiveness of its vaccine against COVID-19 by inoculating the whole population over the age of 12 in a town in southern Brazil, the company said on Wednesday.

The study will be conducted in Toledo, population 143,000, in the west of Parana state, together with Brazil’s National Vaccination Program, local health authorities, a hospital and a federal university.

Pfizer said the purpose was to study transmission of the coronavirus in a “real-life scenario” after the population has been vaccinated.

“The initiative is the first and only of its kind to be undertaken in collaboration with the pharmaceutical company in a developing country,” Pfizer said.

A similar study was conducted by the Butantan Institute, one of Brazil’s leading biomedical research centers, in the smaller town of Serrana, in Sao Paulo state, to test the CoronaVac shot developed by China’s Sinovac Biotech Ltd.

In May, Butantan said mass vaccination had reduced COVID-19 death by 95% in the town with a population of 45,644 people. The institute is considering extending the study for a third dose.

“Here we believe in science and we lament the almost 600,000 deaths from COVID-19 in Brazil,” Toledo Mayor Beto Lunitti said at a news conference announcing the Pfizer study.

Regis Goulart, a researcher at Toledo’s Moinhos de Vento Hospital, said its aim was to validate the real-world efficacy and safety of the vaccine seen in clinical trials.

The observational study will also be an opportunity to do long-term monitoring for up to one year of participants and to answer lingering questions such as the duration of vaccine protection against COVID-19 and new variants, Goulart said.

(Reporting by Anthony Boadle; Editing by Jason Neely and Mark Porter)

Genes may add to ethnic COVID-19 disparities; sickest patients unwell a year later

By Nancy Lapid

(Reuters) – Here is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that have yet to be certified by peer review.

Genes may explain some ethnic differences in COVID-19 impact

The varying impacts of COVID-19 among ethnic groups might be partially due to genetic differences in the cell-surface protein the virus uses as a gateway, an international research team found. They analyzed genetic information from more than 85,000 volunteers, including 6,274 who were tested for the new coronavirus and 1,837 who tested positive. In the gene for ACE2 – the “receptor” protein through which the virus breaks into cells – they found rare variants that would alter the part of the protein to which the virus attaches itself. These variant genes “appear to vary in frequency between different ethnic groups,” said Jamal Nasir of the University of Northampton in the UK. Two were more common in Europeans than in East Asians, for example. Nasir and colleagues also found variants that appear to increase or decrease an individual’s ACE2 protein levels, which could affect vulnerability to infection, or severity. People who were not infected with the coronavirus were more likely to have a variant that decreases ACE2 levels, according to a report posted on Wednesday on medRxiv ahead of peer review. The next steps, Nasir said, are to confirm the findings by exposing human cells to the virus in lab experiments and to identify small molecules that can be used as drugs to block harmful genetic mutations’ effects.

Severe COVID-19 still affects patients a year later

Among 1,276 COVID-19 patients hospitalized in China early in the pandemic, 49% still had at least one symptom 12 months after first becoming ill, researchers reported on Friday in The Lancet. Most common were fatigue or muscle weakness. About a third still had shortness of breath or other lung problems, especially those who had been the most severely ill. In some patients, doctors saw a reduced flow of oxygen from the lungs to the bloodstream. Roughly one in four survivors reported depression. Among patients who had been employed before they were hospitalized, 88% had returned to work by 12 months – but overall, the survivors were not as healthy as people from the community who had not been infected with the coronavirus. The study only looked at patients from one hospital, and not many of them had been sick enough to require intensive care. Nevertheless, the fact that some patients still had symptoms “should be taken into account when planning delivery of healthcare services post-pandemic,” coauthor Bin Cao from the China-Japan Friendship Hospital said in a statement.

Pfizer vaccine safe in small study of very sick kids

In adolescents with serious neurological conditions, the side effects of the Pfizer/BioNTech vaccine are likely to be mild to moderate and clear up quickly, a small study suggests. The 27 children in the study, ages 12 to 15, had muscular dystrophy, cerebral palsy, or other neurological diseases, plus other conditions such as heart defects and immune deficiency – all of which put them at very high risk for severe COVID-19. They would not have been included in the main trials of the vaccine because they were too sick, the researchers said. Eleven children had averse events after the first or second dose, such as mild rash, fever, headache, gastrointestinal upset, difficulty sleeping, and low blood sugar. Most problems resolved within 72 hours, and the rest cleared up within a week, according to a report published on Thursday in Archives of Disease in Childhood. Although the study involved only a few children, “these data are especially important as they are representative of the children who are most likely to benefit from vaccination, and parents and clinicians may have concerns regarding an increased risk of unexpected events,” the authors said.

(Reporting by Nancy Lapid; Editing by Tiffany Wu)

Factbox – Latest on the worldwide spread of the coronavirus

(Reuters) – The World Health Organization’s (WHO) pandemic program plans to ship 100 million doses of Sinovac and Sinopharm COVID-19 shots by the end of next month, mostly to Africa and Asia, in its first delivery of Chinese vaccines, a WHO document showed.

EUROPE

* Britain’s Health Department said it has not made any decision on COVID-19 vaccines for 12 to 15-year-olds after the Telegraph reported the National Health Service planned vaccinations from the first week children return to school in September.

* The British public’s view of the government’s management of the coronavirus crisis has turned negative for the first time since February and they are worried about the risk of a new wave of infections, according to a survey.

* Hundreds of Greek frontline health workers protested against a plan to make COVID-19 vaccinations mandatory for the care sector as infection rates remained high.

* Students and teachers who have not been inoculated against COVID-19 or recovered from the disease will have to take weekly tests, as infections in the country rose to their highest since May.

ASIA-PACIFIC

* Vilified by Indian Prime Minister Narendra Modi’s party for its high COVID-19 cases, Kerala’s apparent poor record may actually hold crucial lessons for the country in containing the outbreak as authorities brace for a possible third wave of infections.

* Vietnam will deploy troops to industrial Binh Duong province, a major manufacturing hub in the Southeast Asian country, to help contain an expected 50,000 additional coronavirus infections there over the next two weeks, the government said.

* Thailand is in talks with European countries to purchase millions of doses of COVID-19 vaccines.

AMERICAS

* Illinois will require all eligible students and school employees to be vaccinated and re-instituted an indoor mask mandate under an order announced by Governor J.B. Pritzker.

* Public support for stronger measures to require COVID vaccinations is strong, according to a new Reuters/IPSOS poll, but for Detroit automakers the debate over vaccination policy is far from over.

MIDDLE EAST AND AFRICA

* A third wave of COVID-19 infections in Africa has stabilized and the continent’s slow vaccination drive has picked up pace, the WHO said.

* Qatar is offering COVID-19 vaccines to evacuees from Afghanistan who are temporarily staying in the Gulf Arab state, which has been facilitating global evacuation efforts since the Taliban seized Kabul.

MEDICAL DEVELOPMENTS

* Inovio Pharmaceuticals Inc said it would start a large study for its experimental COVID-19 vaccine in the next few weeks, after the drugmaker received authorization from Brazil’s regulatory agency.

* Pfizer Inc and BioNTech signed on Brazil’s Eurofarma Laboratorios as a manufacturer of their COVID-19 vaccine doses for Latin America.

* Pfizer said a booster dose of its two-shot COVID-19 vaccine spurs a more than threefold increase in antibodies against the coronavirus, as the company seeks U.S. regulatory approval for a third injection.

ECONOMIC IMPACT

* Global equity markets slipped while U.S. Treasury yields rose to two-week highs on Thursday after two hawkish Federal Reserve officials called for the U.S. central bank to start ending its bond-buying program ahead of a key speech by Fed Chair Jerome Powell.

(Compiled by Aditya Soni and Krishna Chandra Eluri; Editing by Subhranshu Sahu and Arun Koyyur)

U.S. to begin offering COVID-19 vaccine booster shots in September

By Carl O’Donnell and Ahmed Aboulenein

(Reuters) -The U.S. government said on Wednesday it plans to make COVID-19 vaccine booster shots widely available starting on Sept. 20 as infections rise from the coronavirus Delta variant, citing data indicating diminishing protection from the vaccines over time.

U.S. officials are prepared to offer a third shot to Americans who completed their initial inoculation in two-dose COVID-19 vaccines made by Moderna Inc and by Pfizer Inc and BioNTech AG at least eight months ago, the Department of Health and Human Services said in a statement.

Initial booster doses will be given to Americans who received the two-dose vaccines, but U.S. health officials said they anticipate that people who received the single-dose Johnson & Johnson shot, the other COVID-19 vaccine approved in the United States, will also need boosters. The United States did not begin administering J&J shots until March.

The booster shots initially will focus upon healthcare workers, nursing home residents and older people, among the first groups to be vaccinated in late 2020 and early 2021, top U.S. health officials said in a joint statement.

There is mounting evidence that protection from the vaccines wanes after six or more months, particularly in older people with underlying health conditions. The officials cited this in their decision on boosters, but stressed that the U.S.-approved shots have proven “remarkably effective” in reducing the risk of severe disease, hospitalizations and deaths.

The officials included President Joe Biden’s chief medical adviser Anthony Fauci as well as the heads of the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the National Institutes of Health.

“The available data make very clear that protection against SARS-CoV-2 infection begins to decrease over time … and in association with the dominance of the Delta variant, we are starting to see evidence of reduced protection against mild and moderate disease,” the officials said.

“We conclude that a booster shot will be needed to maximize vaccine-induced protection and prolong its durability,” they added.

U.S. officials previously authorized a third dose of the vaccines from Pfizer/BioNTech and Moderna for people with weak immune systems.

In recent weeks, several other countries also have decided to offer booster shots to older adults as well as people with weak immune systems, including Israel, France and Germany.

DELTA VARIANT CONCERNS

Vaccinations have been widely available in the United States, unlike many other countries, but the highly infectious Delta variant has caused what experts describe as a pandemic of the unvaccinated as a significant number of people choose not to get inoculated.

The United States leads the world in reported COVID-19 cases and deaths. Daily U.S. cases soared from fewer than 10,000 in early July to more than 150,000 in August as the Delta variant took hold. The new cases include some vaccinated people, though they are far less likely to experience severe disease or death than the unvaccinated.

According to CDC data, more than 72% of Americans 18 and older have received at least one vaccine dose and nearly 62% are fully vaccinated. Of the total population, the CDC said 59.9% have received at least one dose and 50.9% are fully vaccinated.

More than a million Americans independently sought an extra vaccine dose before the official decision on boosters was announced, according to federal data.

A study by an Israeli healthcare provider released on Wednesday found that a third dose of the Pfizer/BioNTech shot is 86% effective in people over age 60.

It followed another Israeli study released this week that showed evidence of waning immunity from COVID-19 vaccines in the months after inoculation, raising the risk of serious infection among the elderly and people with compromised immune systems.

“The surprise factor is the vaccine vulnerability – people who are vaccinated became vulnerable much earlier than expected,” Dr. Eric Topol, a cardiologist and director of the Scripps Research Translational Institute in California, said about the study.

“The whole dynamic of boosters is being rewritten,” Topol added.

The U.S. announcement goes against guidance from the World Health Organization, whose chief scientist said on Wednesday current data does not indicate the need for booster shots. A WHO adviser said vaccine doses should first go to people in poorer countries who have not yet received an initial inoculation.

The decision represented a shift from the optimism of U.S. health authorities in May in curbing the pandemic when Biden set a goal to vaccinate 70% of American adults with at least one dose by July 4. That goal was achieved about a month late.

The U.S. booster plan is dependent on the FDA determining that a third dose of the two-dose vaccines is safe and effective, and a favorable recommendation from CDC advisers.

(Reporting by Carl O’Donnell in New York and Ahmed Aboulenein in Washington; Editing by Will Dunham and Grant McCool)

Factbox-Latest on the worldwide spread of the coronavirus

(Reuters) – The Tokyo Paralympics will take place generally without spectators, organizers said, as the government was set to prolong COVID-19 emergency measures in the capital and other regions that will run through the Games.

EUROPE

* The European Guarantee Fund, which is managed by the Investment Bank Group, secured European Union approval to provide guarantees on synthetic securitization tranches to help companies in 22 EU countries affected by the pandemic.

* Poland will send 650,000 doses of the AstraZeneca vaccine to Ukraine, the minister in charge of the Polish vaccination drive told state news agency PAP.

* North Macedonia has reimposed restrictions on access to cafes, restaurants and public events in a bid to subdue a fresh spike in infections and nudge citizens to get vaccinated, prompting public anger and protests.

* All 16- and 17-year-olds in England will be offered their first vaccine dose by Aug. 23, according to a target set by British Health Secretary Sajid Javid.

ASIA-PACIFIC

* Thailand, a regional manufacturer of AstraZeneca’s coronavirus shots, is seeking to borrow 150,000 doses of the same vaccine from the Himalayan kingdom of Bhutan, an official said, amid a Thai supply shortage.

* Indonesia extended its curbs though relaxed some measures in eight unspecified areas on the most populous islands of Java and Bali, as fewer infections have been reported in cities.

* Hong Kong’s government said it would upgrade 15 overseas places including the United States, Spain and France to “high risk” from “medium risk” by Aug. 20, meaning international arrivals from those countries will face lengthened quarantine due to a resurgence of the coronavirus.

* Taiwan has rejected an application for the emergency use of UBI Pharma’s vaccine candidate, the government said.

AMERICAS

* As the Delta variant of the virus sweeps through Mexico’s cities, more adults in their 30s and 40s are ending up in the hospital with polls showing vaccine hesitancy is rising in younger age groups.

MIDDLE EAST AND AFRICA

* Turkey is allowing people who were inoculated with Sinovac’s coronavirus vaccine to take an additional Pfizer dose as it looks to ease travel to countries that have not approved the Chinese shot, the health ministry said.

MEDICAL DEVELOPMENTS

* Europe’s drugs regulator said it was evaluating the use of Roche’s arthritis drug, Actemra, in hospitalized adults with severe COVID-19, its latest review of a potential coronavirus treatment.

* The UK’s health regulator said coronavirus vaccines did not raise the risk of miscarriage, and that it had not found any link between the shots and changes to menstrual periods.

* GlaxoSmithKline and CureVac said a study on macaque monkeys showed their jointly-developed vaccine candidate to be “strongly improved” in protecting against the virus compared with CureVac’s first attempt.

ECONOMIC IMPACT

* A surprisingly sharp slowdown in Chinese economic activity and a rapid Taliban takeover in Afghanistan helped drive global shares lower Monday.

* The initial success of Israel’s COVID-19 vaccination rollout that enabled an opening of the economy bolstered growth in the second quarter, official figures showed.

* Thailand’s economy unexpectedly grew in the second quarter from the first helped by exports and government spending, but spiking cases continue to batter domestic activity and tourism, restraining its fragile recovery.

(Compiled by Veronica Snoj and Federico Maccioni; Edited by Shounak Dasgupta)

WHO’s pandemic project faces cash crunch amid vaccine, oxygen shortages

By Francesco Guarascio

BRUSSELS (Reuters) – The World Health Organization (WHO) is seeking $11.5 billion in urgent funding to fight the more infectious Delta variant of the coronavirus, a draft report seen by Reuters shows, amid worries wealthy nations are partly bypassing its COVID-19 programs.

A large portion of the cash being requested from the WHO’s partners is needed to buy tests, oxygen and face masks in poorer nations, says the document which is expected to be released this week. And a quarter of it would be to buy hundreds of millions of vaccines for them that would otherwise go elsewhere.

The paper, still subject to changes, outlines the results and financial needs of the Access to COVID-19 Tools Accelerator (ACT-A), the program co-led by the WHO to distribute fairly COVID-19 vaccines, drugs and tests across the world.

The program, set up at the start of the pandemic, remains vastly underfunded, and its coordinators are now acknowledging it will remain so as many governments look to address global COVID needs “differently,” an ACT-A official told Reuters, speaking on condition of anonymity.

As a result, it has cut by nearly $5 billion its total request for funds, the document shows. But it still needs $16.8 billion, almost as much as what has been raised so far, and $7.7 billion is required urgently.

The document also calls for a further $3.8 billion, on top of the $7.7 billion, to take up options for 760 million doses of COVID-19 vaccines that would be delivered next year.

“These options to buy need to be exercised in the coming months or vaccine doses will be lost,” the document warns.

WHO Director-General Tedros Adhanom Ghebreyesus last week said that $7.7 billion were urgently needed, but did not give a breakdown of planned spending, and did not say how much extra money was needed for vaccines.

The WHO was not immediately available to comment.

The latest cash crunch will underscore concerns about the long-term future of the program, which has struggled to secure supplies and equipment to tame a pandemic that has killed more than 4.2 million.

The vaccine portion of the project, called COVAX, is increasingly reliant on donations from wealthy nations, rather than its own supplies, after key manufacturer India restricted exports of shots to boost domestic vaccinations.

But the United States, European Union and Japan have also donated vaccines directly to countries as part of their vaccine diplomacy drives. Japan has also said it’s a quicker process than going through COVAX.

Some countries have provided equipment directly to others too. Last month, Australia said it would donate oxygen-related equipment, antigen test-kits as well as vaccines to Indonesia.

The plea for cash comes as a review of the ACT-A gets under way, with France, Germany and Canada among the countries steering the process. A report on the program’s results and shortcomings is expected in September by consultancy Dalberg Global Development Advisors, the ACT-A official said.

OXYGEN NEEDS

Among ACT-A’s immediate needs are $1.2 billion for oxygen to treat seriously ill COVID-19 patients in poorer countries where supplies are low, the report says.

Oxygen has moved up the priority list given vaccines are not available, the ACT-A official said, highlighting the repercussions from the shortage of shots as the Delta variant spreads to 132 countries.

COVAX has delivered about 180 million vaccines, far short of its 2 billion target by the end of this year.

Oxygen is needed to “control the exponential death surges caused by the Delta variant,” the document says.

Global demand for medical oxygen is currently more than a dozen times greater than before the pandemic, the document says, but many countries are struggling to access sufficient supplies.

The urgent need for the most basic treatment against COVID-19 one and a half years into the pandemic shows how little has been done to combat the virus in most of the world, the ACT-A official said, noting: “There hasn’t been much progress. What was urgent three months ago is still urgent now.”

“Inequity in access to life-saving COVID-19 tools has never been more apparent,” the document says.

In rich nations, most people have already been vaccinated, including the younger who are less at risk from COVID-19, whereas in poorer nations the most vulnerable are still waiting for a first dose and there is a lack of basic materials, such as face masks and other personal protective equipment (PPE).

“Avoidable death and unsustainable pressure on health systems is mounting in many countries due to insufficient access to oxygen and PPE,” the document says.

At least $1.7 billion are urgently needed to buy protective devices for healthcare workers in poorer nations, the document says, and another $2.4 billion are needed to boost testing in low-income countries.

(Reporting by Francesco Guarascio @fraguarascio; Editing by Josephine Mason and Mark Potter)

Britain’s COVID-19 cases up by nearly 41% over past week

LONDON (Reuters) – Britain has reported 46,558 new cases of COVID-19, government data showed on Tuesday, meaning the rise in cases between July 14 and July 20 stood at 40.7% compared with the previous seven days.

A further 96 people were reported as having died within 28 days of a positive test for COVID-19.

A total of 46.35 million people had received a first dose of a vaccine against coronavirus by July 19 and 36.24 million people had received a second dose.

(Writing by William Schomberg)

Living with COVID-19: Israel changes strategy as Delta variant hits

By Maayan Lubell

JERUSALEM (Reuters) – Four weeks ago, Israel was celebrating a return to normal life in its battle with COVID-19.

After a rapid vaccination drive that had driven down coronavirus infections and deaths, Israelis had stopped wearing face masks and abandoned all social-distancing rules.

Then came the more infectious Delta variant, and a surge in cases that has forced Prime Minister Naftali Bennett to reimpose some COVID-19 restrictions and rethink strategy.

Under what he calls a policy of “soft suppression,” the government wants Israelis to learn to live with the virus – involving the fewest possible restrictions and avoiding a fourth national lockdown that could do further harm to the economy.

As most Israelis in risk groups have now been vaccinated against COVID-19, Bennett is counting on fewer people than before falling seriously ill when infections rise.

“Implementing the strategy will entail taking certain risks but in the overall consideration, including economic factors, this is the necessary balance,” Bennett said last week.

The main indicator guiding the move is the number of severe COVID-19 cases in hospital, currently around 45. Implementation will entail monitoring infections, encouraging vaccinations, rapid testing and information campaigns about face masks.

The strategy has drawn comparisons with the British government’s plans to reopen England’s economy from lockdown, though Israel is in the process of reinstating some curbs while London is lifting restrictions.

The curbs that have been reinstated include the mandatory wearing of face masks indoors and quarantine for all people arriving in Israel.

Bennett’s strategy, like that of the British government, has been questioned by some scientists.

Israel’s Health Ministry advocates more of a push for stemming infections, Sharon Alroy-Preis, head of public health at Israel’s Health Ministry, told Kan Radio on Sunday.

“It’s possible that there won’t be a big rise in the severely ill but the price of making such a mistake is what’s worrying us,” she said.

But many other scientists are supportive.

“I am very much in favor of Israel’s approach,” said Nadav Davidovitch, director of the school of public health at Israel’s Ben Gurion University, describing it as a “golden path” between Britain’s easing of restrictions and countries such as Australia that take a tougher line.

THE VIRUS ‘WON’T STOP’

Israel’s last lockdown was enforced in December, about a week after the start of what has been one of the world’s fastest vaccination programs.

New daily COVID-19 infections are running at about 450. The Delta variant, first identified in India, now makes up about 90% of cases.

“We estimate that we won’t reach high waves of severe cases like in previous waves,” the health ministry’s director-general, Nachman Ash, said last week. “But if we see that the number and increase rate of severe cases are endangering the (health) system, then we will have to take further steps.”

Around 60% of Israel’s 9.3 million population have received at least one shot of the Pfizer/BioNtech vaccine. On Sunday, the government began offering a third shot to people with a compromised immune system.

Ran Balicer, chair of the government’s expert panel on COVID-19, said Israel had on average had about five severe cases of the virus and one death per day in the last week, after two weeks of zero deaths related to COVID-19.

Noting the impact of the Delta variant, he said the panel was advising caution over the removal of restrictions.

“We do not have enough data from our local outbreak to be able to predict with accuracy what would happen if we let go,” Balicer said.

Some studies have shown that though high, the Pfizer/BioNTech vaccine’s effectiveness against the Delta variant is lower than against other coronavirus strains.

Drawing criticism from some scientists, Pfizer and BioNTech SE have said they will ask U.S. and European regulators to authorize booster shots to head off increased risk of infection six months after inoculation.

Israel is in no rush to approve public booster shots, saying there is no unequivocal data yet showing they are necessary. It is offering approval only to people with weak immune systems on a case-by-case basis.

Authorities are also considering allowing children under 12 to take the vaccine on a case-by-case basis if they suffer from health conditions that put them at high risk of serious complications if they were to catch the virus.

Only “a few hundred” of the 5.5 million people who have been vaccinated in Israel have later been infected with COVID-19, Ash said.

Before the Delta variant arrived, Israel had estimated 75% of the population would need to be vaccinated to reach “herd immunity” – the level at which enough of a population are immunized to be able to effectively stop a disease spreading. The estimated threshold is now 80%.

Such data ensure doctors remain concerned.

“…the virus won’t stop. It is evolving, it’s its nature. But our nature is to survive,” said Dr. Gadi Segal, head of the coronavirus ward at Sheba Medical Centre near Tel Aviv.

(Writing by Maayan Lubell; Editing by Jeffrey Heller and Timothy Heritage)