The World Health Organization (WHO) designated variant B.1.1.52, a variant of concern on November 26, 2021. The virus was named Omicron, on the advice of WHO’s Technical Advisory Group on Virus Evolution (TAG-VE). Factors that determine whether a variant is medically important include, the method or ease of spread, number of mutations, and severity of the disease caused. Scientists report that the Omicron variant spreads more easily than the original SARS-CoV-2 virus and infected persons can spread the virus to others, irrespective of their vaccination status or level of symptoms.
All COVID-19 variants, including Omicron, can be detected through current laboratory tests-
nucleic acid amplification tests (NAATs) and antigen tests. These tests only indicate the presence of an infection but does not specify the type of variant one is infected with. Additional and more complex tests are needed to determine which variant of concern is responsible for an infection. There are also self tests which are easy to do at home and produce rapid results. Evidence from studies suggest that there is an increased risk of reinfection with Omicron compared to the other variants of concern. Polymerase Chain Reaction (PCR) is a widely used tests which is effective in detecting COVID-19 infection, including infection with Omicron.
To protect against severe forms of illness, hospitalizations, and deaths due to Omicron infection, Centres for Disease Control and Prevention (CDC) recommends up to date vaccination. CDC also recommends that people aged 16 years and above get a booster shot about 6 months after the completion of their primary vaccination series. Vaccines have been the best public health approach and solution that protect people from COVID-19. Vaccines function by preventing or delaying viral transmission and potentially reducing the likelihood of the emergence of new variants. As with the previous variants, vaccines remain critical to reducing severe disease and death from Omicron and are still the most effective approach against life threatening complications. CDC’s recommendation is based on the fact that vaccines have remained effective for the previous variants, which are similar to Omicron in genetic make-up. Although the virus-specific genetic make-up of Omicron makes it non-responsive to some of the current treatments used for the previous variants, Corticosteroids and IL6 Receptor Blockers continue to be effective in the management managing patients with severe COVID-19.
It is important to note that all variants of COVID-19 are capable of causing severe disease or death, particularly for the most vulnerable people, and thus prevention is always the best option.
In addition to vaccines and boosters, masks- especially surgical masks, continue to provide a physical barrier against all variants. The wearing of masks in public spaces is a necessary protective strategy, irrespective of one’s vaccination status. Other effective ways to reduce the spread of the COVID-19 virus are: physical distance, avoiding poorly ventilated or crowded spaces, frequent hand washing and covering the mouth properly when coughing or sneezing.
It has been a long and rough ride with the CoVID-19 pandemic spanning over two years. As of January 2022, there have been over 364,191,494 confirmed cases of COVID-19 globally, including 5,631,457 deaths. A total of 9,854,237,363 vaccine doses have been administered.
For about two years now, COVID-19 has plagued the entire world, causing significant changes in the way we live and relate to one another. So far, several medically important strains of the virus, also called variants of concern, have been isolated and identified. Most recently on November 26 2021, the World Health Organization (WHO) designated a new variant of concern, the B.1.1.529. On the advice of WHO’s Technical Advisory Group on Virus Evolution (TAG-VE),, this variant was isolated and subsequently named Omicron,. Decisions on whether a variant should be of concern is based on the evidence presented to TAG-VE about the unique behaviour and characteristics of the virus such as transmissibility, mutative tendencies and severity of disease caused.
It was initially unclear whether Omicron is more transmissible than previously identified variants, including the Delta variant. Although South African researchers reported an increase in the number of people testing positive in parts of the country where the Omicron variant was dominant, epidemiological studies were needed to decipher if the increase was attributable to the new variant or as a result of other factors. In addition, the severity of the disease caused by Omicron was not fully understood, even though some data suggested an increase in the rate of hospitalization. The observed increase may not necessarily be due to infection with Omicron, hence, more research has been conducted in different parts of the world, as researchers continue to better understand the unique characteristics of the Omicron variant.
It is important to note that all identified variants of concern are capable of causing severe disease or death, especially in vulnerable people. It is therefore essential to take all the necessary precautions even before more research is available. This may be the reason why the United Kingdom and Canada initiated restrictive travel guidelines and banned several African countries in early December as a measure to curtail the spread of the new variant. However, following some international backlash and in light of more information about the Omicron variant, the ban was lifted and travel regulations relaxed barely a week afterwards. This is because there is currently no evidence to show that symptoms associated with Omicron are more severe compared to those from other variants according to WHO and other international/governmental organizations.
Irrespective of the variant identified, vaccines remain indispensable in reducing severe disease and death. More so, PCR tests continue to be reliable in detecting infection, including infection with Omicron. WHO consistently coordinates with a large number of researchers on various topics around the any variant of concern including viral transmissibility, severity of infection, vaccine effectiveness, diagnostic testing and disease management. WHO encourages countries and hospitals to collect and report patients data as well as to enhance surveillance methods. Additionally, countries must continue implementing effective public health measures to reduce the spread of COVID-19.
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The Centre for Disease Control and Prevention (CDC) has recommended a booster shot for Covid-19, following the first and second doses. In the past, vaccine programs required years of post-marketing surveillance to determine the best time interval between vaccine doses and the number of doses necessary to sustain long-term protection. However, in the case of Covid-19 pandemic, there is no luxury of time or years for such long-term protocols to observed or followed. The virus, which causes serious health complications requires immediate and proactive approaches and decisions to be contained… hence, the recommendation for booster shots..
So, what is a booster shot? By definition, a booster shot is simply an extra or additional dose of a vaccine given to people following an observed decrease in the effectiveness and efficacy of an original dose(s). A decline in the strength of protection conferred by a vaccine is often expected, especially when the causative agent mutates and has various strains or variants as in the case of Covid-19. The aim of a booster shot is to restore protection that may have waned or decreased over a period of time to a level that is deemed insufficient to protect individuals who initially responded satisfactorily to the original vaccine doses. A booster shot is distinct from a third dose in that it is not considered a part of the standard primary vaccine doses. It is usually recommended on the side, when there is need to enhance immune response and establish adequate levels of protection for individuals who have developed no or sub-optimal immune response to an original dose(s).
A booster, in general, is designed to help the population retain the highest level of immunity and for the longest possible time. Typically, individuals are encouraged to get a booster after the immunity from the initial dose(s) have naturally begun to to diminish.
The CDC recommends a COVID-19 boosters for individuals who are 18 years or older, and have received the first and second doses. Boosters are readily available in many vaccine outlets across the world including retail pharmacies, mobile vaccination clinics and state or local vaccination sites. As with most vaccines, temporary side effects and symptoms similar to those of a flu shot are expected for a few days. These may include sore or swollen arm, fever, body aches, headaches, cold, general malaise and swollen lymph nodes. All Covid-19 booster shots are mRNA vaccines and can be interchangeable- either the same brand as the original doses or a different brand- the Moderna or Pfizer (mRNA) vaccine are readily available in the United States and Canada.
An additional dose- also known as a third dose, is given to people whose immune systems are moderately or severely compromised in order to improve their response to the initial doses. This is different from a booster dose in that the booster is given when a person has completed their vaccine doses, and protection against the virus has reduced over time. A third dose is especially recommended for Individuals who have cancer, underwent organ or stem cell transplant in the last two years, are taking immunosuppressive drugs, are diagnosed with HIV and have a high viral load or low CD4 count.
From all indications, COVID-19 does not seem to be backing down anytime soon; in fact, a new variant-omicron, has just been identified. Despite all precautions by individuals, organizations and governments, the pandemic has persisted. However, we must not lose hope- we must continue to follow appropriate guidelines and recommendations by governments and health authorities. As always, BlessWorld Foundation continues to provide information to keep the community updated about COVID-19 through her online blogs.
Malaria vaccine is a long awaited, ground breaking invention and breakthrough in medical science.. Since time immemorial, malaria has persisted in sub-Saharan Africa, causing significant health challenges, personal suffering, loss of life and economic drawbacks. The continent, and world at large, has long hoped and looked forward to the birth of an effective malaria vaccine. Now, for the first time ever, the dreams of many have come true- a malaria vaccine recommended for widespread use has been approved by World Health Organization (WHO). This great progress increases the hope that someday, the menace and misfortune caused by malaria, mostly in Africa- the continent with the heaviest burden of malaria, and other continents, will be history.
Based on the results of an ongoing pilot program from 2019 in Ghana, Kenya and Malawi, WHO has recommended a widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine- schedule of 4 doses in children from 5 months of age, in sub-Saharan Africa and in other regions. These regions are considered to have moderate to high Plasmodium falciparum malaria transmission.. The program has currently reached over 800,000 children since it’s onset in 2019. It is projected that the vaccine, in addition to other existing malaria prevention tools, could save tens of thousands of lives annually.
Clearly, the benefits of inventing and administering the malaria vaccine are extensive given that malaria is the primary cause of childhood illness and death in sub-Saharan Africa. Approximately, two hundred and sixty thousand (260,000) African children below five years of age die yearly from malaria. Findings from the pilot program mentioned above have continued to inform WHO’s decisions regarding the malaria vaccine. Established facts and benefits of the vaccine include:
Feasibility: The malaria vaccine administration is very feasible as it follows four scheduled doses
Accessibility: Vaccines are funded by international organizations and are available in countries where malaria cases and incidents are high
Positive and strong safety profile: The vaccine has not been associated with any side effect and is considered safe.
Cost effectiveness: Given the economic impact of malaria, vaccination which reduces the incident of malaria is a cost-effective practice
Significant reduction in number of cases: Up to 30% reduction in the number of malaria cases have been recorded in some countries and regions where the vaccine has been introduced
According to CDC, malaria is a critical, potentially fatal disease caused by the parasite, Plasmodium falciparum- which feeds on human blood. Symptoms of malaria are typically similar to the flu with high fevers, chills, and headache. Although there are other plasmodium species that cause malaria, P. falciparum causes symptoms that may most likely result in severe cases and possibly death, if not promptly treated. Generally, illness and death from malaria can usually be prevented.
About 2,000 malaria cases are diagnosed in the United States annually, majority which are travellers and immigrants returning from parts of the world where malaria transmission occurs, particularly sub-Saharan Africa and South Asia. Worldwide, millions of malaria cases occur clinically causing hundreds of thousands of deaths. Malaria transmission occurs when people are bitten by infective female Anopheles mosquitoes- the only mosquitoes that transmit malaria, and they must have been infected by a P. falciparum through a previous blood meal from an infected person. Malaria can also be transmitted through blood transfusion, organ transplant or the shared use of needles or syringes contaminated with blood because the malaria parasite is found in red blood cells of an infected person. Malaria may also be transmitted from a mother to her unborn infant before or during delivery, known as congenital malaria. Malaria is not spread from person to person, and it cannot be sexually transmitted.
Scientists have been working hard to find a vaccine for malaria, however, a completely effective vaccine is not yet available. Currently, there are several vaccines under development- these vaccine candidates target the blood-stage of the parasite’s life cycle but that has not been sufficient. Consequently, several potential vaccines targeting the pre-erythrocytic stage are being developed.
So far, R21/Matrix-M, with 77% efficacy shown in clinical trials is the most effective malaria vaccine. It meets the World Health Organization’s goal of a malaria vaccine with a requirement of at least 75% efficacy. The vaccine was developed following a collaboration of various institutions including Oxford University, Kenya Medical Research Institute, London Hygiene and Tropical Medicine, Serum Institute of India amongst others. Further clinical trials are needed to approve the vaccine, which has an expected annual production of 200million doses.
More so, RTS,S- developed by PATH Malaria Vaccine Initiative (MVP) and GlaxoSmithKline (GSK), and supported by Bill and Melinda Gates Foundation is a recent recombinant vaccine which comprises of the P. falciparum circumsporozoite protein (CSP) from the pre-erythrocytic stage. The CSP antigen stimulates the production of antibodies capable of preventing the infection of blood cells as well as destroying already infected cells. The vaccine is commercially traded as Mosquirix, and requires four injections.
In July of 2015, Mosquirix was positively appraised by the European Medicines Agency (EMA) on the proposal for the vaccine to be used in children aged 6 weeks to 17 months outside the European Union. Subsequently, a pilot project for vaccination was launched in 2019 for children in Malawi, Ghana and Kenya. The vaccine was then endorsed by the World Health Organization in October 2021.
The major question on everyone’s lips remains “Can COVID-19 be treated?”
Well, governments, scientists and drug companies have been working very hard to find a cure. So far, Remdesivir, an antiviral agent, was the first drug to gain full FDA approval for the treatment of COVID-19 in October 2020. While many investigational treatments exist, only Remdesivir and Dexamethasone (a steroid medication) have been approved to lower death rate in hospitalized covid 19 patients.
Research has established that hospitals, although vital to health systems, have never been the solution to public health problems. Consequently, vaccination is regarded as the means to the end of COVID 19, through achieving herd immunity. This is why vaccination and the hope to attain herd immunity remains the cul de grace- a final trump card to bring an end to COVID-19. The vaccine rollout started as early as late December 2020 in countries like Israel but became very popular in other countries by April 2021, especially in countries that took big hits in terms of death rates like France, Italy, Portugal, Spain and the United Kingdom.
Different types of COVID vaccine include:
Protein Subunit: Novavax is working on a protein subunit COVID-19 vaccine
Viral Vector: The Janssen/Johnson & Johnson COVID-19 vaccine is a vector vaccine. AstraZeneca and the University of Oxford also have a vector COVID-19 vaccine
Nucleic Acid (RNA AND DNA): ThePfizer-BioNTech and the Moderna COVID-19 vaccines use mRNA.
Despite success with vaccine availability, reaching herd-immunity thresholds has been impossible because of factors such as vaccine hesitancy, emergence of new variants and the delayed arrival of vaccinations for children. In most countries, vaccine distribution is stratified by age, with priority given to older people, who are at the highest risk of dying from COVID-19. Therefore, some vulnerable groups are left out; for example, children (who have less developed active immunity) or adults that have medical conditions or are undergoing specific cancer treatment that cause them to produce few or no antibodies in response to a vaccine. With herd immunity, the spread of the virus in communities are reduced and most people are protected by default.
Currently, Pfizer–BioNTech and Moderna have now enrolled teens in clinical trials of their vaccines, and the Oxford–AstraZeneca and Sinovac Biotech vaccines are being tested in children as young as three. Vaccination rates have also been highly variable across regions in countries. In Canada for example, Yukon, Prince Edward Island and Nova Scotia have total fully vaccinated above 70% while Nunavut has only 52%. The situation in the United States is even more variable with Vermont at 68% and Alabama at 39%.
As of October 2021, 62.2% of the U.S. population have had at least one vaccine dose and 52.8% are fully vaccinated. Worldwide, only about 36.5% are fully vaccinated. These percentages are constantly changing.
Estimates from the United Kingdom show that two doses of the Pfizer vaccine are between 85% and 95% effective against symptomatic disease with the Alpha variant, while two doses of AstraZeneca are 70% to 85% effective. Overall, vaccine effectiveness appears to drop about 10% with the Delta variant. With the increase in variants, which may be more infectious and could potentially impact the effectiveness of vaccines, that percentage is now estimated to be higher—some say up to 85%.
Thankfully,, there has been massive support from international organizations like the WHO, UN and Gavi COVAX initiatives and even from non-profit organizations. In Canada, some bodies like the Canadian Red Cross society have increased funding to nonprofit organizations involved in COVID 19 relief in any way. A couple of Canadian nonprofit and charity organizations have been pooling resources together to help different communities manage the crisis. Bless world foundation international has also been engaging communities during this pandemic; specifically, the cradle2fame program aims to support and help with talent development.
Finally, there has been a truly gruesome journey but the world is adapting to this whole change.With up and downs to things returning back to status quo, the post covid era is taking longer than we thought
Covid 19 has firmly persisted in the spotlight and also remained in the news headlines all over the world. From the constant increase in the number of lives lost, to the broad range of economic and political issues it influences, there is no slowing down for this deadly virus. Even worse, just when the world is about to figure it out, it mutates and changes its characteristics producing novel strains. One would begin to wonder, for how much longer would this ingenious and very elusive virus continue to surprise our world…
Since the lockdown in 2020, the social aspects of human life including business, education, travel and entertainment have not been the same.
In Canada, the Public Health Agency of Canada (PHAC) continues to work with provincial and territorial partners and the Canadian COVID-19 Genomics Network (CanCOGeN) to sequence a percentage of all positive COVID-19 test result. So far, four variants of concern (VOC) have been detected in most provinces and territories:
B.1.1.7 (Alpha)
B.1.351 (Beta)
P.1 (Gamma)
B.1.617.2 (Delta)
The Alpha and Delta variants are the commonest variants of concern in Canada, especially Ontario, which has the highest rate of infection in the country. Infection leads to flu-like symptoms. Five most common symptoms according to recent research include fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). In addition, a very common and specific symptom is the loss of taste or smell. This symptom is reported in up to 80% of patients that test positive for COVID-19.
As proposed by World Health Organization experts; wearing masks, frequent hand washing, social distancing, avoiding crowds and contact with sick people, cleaning and disinfecting frequently touched surfaces and social distancing can help prevent coronavirus infections. These recommendations have been tested and trusted for months and even though they have proven to cut down infection rates, people have become numb to them and would not wait to get back to their normal lives. According to newer research, septic shock, cardio respiratory complications and multi organ failure were the most common immediate cause of death, often due to suppurative pulmonary infection.
It is also important to note that older patients and those with preexisting chronic health conditions are at an increased risk of fatal disease outcome.
Death is not the only result of COVID-19 infection, in-fact, quality of of life can be severely affected following infection. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after being infected. Some people who fall severely ill with COVID-19 experience multi-organ effects or autoimmune conditions over a longer time with symptoms lasting weeks or months even after the COVID-19 illness ends. Post-intensive care syndrome (PICS), which refers to health effects that begin when a person is in an intensive care unit (ICU), can remain after a person returns home. These effects can include severe weakness, problems with thinking and judgment, and post-traumatic stress disorder (PTSD). Concurrently, as more waves of COVID-19 hit an area consistently, with no sign of slowing down, hospitals become overcrowded and ICU beds are filled to maximum capacity causing more deaths.
Does COVID-19have any treatment options? Remdesivir, an antiviral agent, was the first drug to gain full FDA approval for treatment of COVID-19 in October 2020. While many investigational treatments exist, remdesivir and dexamethasone(a steroid medication) have been approved to lower death rate in hospitalized covid 19 patients.
Hospitals, although vital to health systems, have never been the solution to public health problems. Hence, the vaccine rollout started as early as late December 2020 in countries like Israel, and have become popular in most countries since April 2021 especially countries with high cases and deaths rates including France, Italy, Portugal, Spain and the United Kingdom.
To continue prioritizing global health research and monitoring of COVID-19, specific variants of Interest (VOIs) and Variants of Concern (VOCs) are frequently identified and characterized. This characterization- with reference to SARS-CoV-2, the virus that causes COVID-19- ultimately informs the ongoing response to the pandemic. Most viruses mutate and change with time- sometimes, the new variants have changes that make little or no difference in the properties of the virus. However, some changes are capable of altering the properties of the virus such as ease of spread, severity of symptoms, performance of vaccines, therapeutic drugs, diagnostic devices, or other social and public health markers.
A newly identified Delta variant of SARS-CoV-2, has gained popularity in recent times. The variant, which originated from India and was identified as a variant of concern in May 2021, is linked to the second wave of the COVID-19 pandemic and has now spread to over 100 countries. The Delta variant h as become the dominant strain globally as it continues to spread in various countries irrespective of vaccination coverage. In a matter of months after its identification, the virus was isolated in more than 98 countries, making it the most dominant variant globally particularly in India, Scotland, the U.K., Israel and the United States. Over 83% of COVID-19 cases being reported in the U.S. can now be attributed to the Delta variant. As a VOC, the Delta variant has significant changes that may influence it’s properties.
Fundamentally, three questions drive research around newly identified variants:
How contagious is the Delta variant?
Is the Delta variant more dangerous than other variants of concern?
Will vaccines remain protective against the Delta variant?
To answer the above questions, much research is underway while some facts have already been established through scientific observations including:
Transmission: The Delta variant has proven to be more contagious than other variants. The Centres for Disease Control and Prevention confirms that the Delta variant accounted for more than 80% of new cases in the United States in July 2021.
Symptoms: Good news here as the symptoms associated with the Delta variant are not more severe than the previously identified variants. In fact, the symptoms of the Delta variant appear to be the same as the first variant of COVID-19, even though the virus grows more rapidly and people get sick faster, especially younger people. According to surveys in the U.K., where the Delta variant accounts for most current COVID-19 cases, symptoms caused by the Delta variant appear a little different than other strains, but not necessarily more severe. Fever, headache, sore throat and runny nose are common, while cough and loss of smell are rare. Other surveys report more serious symptoms, including hearing impairment, severe gastrointestinal issues and blood clots leading to tissue death and gangrene. Research is ongoing to determine if infection with the Delta variant is associated with increased hospitalization and death.
Vaccination: Most vaccinated people are either asymptomatic or mildly symptomatic if infected with the Delta variant. Their symptoms are limited to those of a common cold, such as cough, fever or headache and loss of smell. On the other hand, unvaccinated people may suffer symptoms that lead to hospitalization if infected. By inference, vaccines are considered highly effective in preventing severe COVID-19 infection and disease, including that of the Delta variant. A research from the U.K. suggests that full vaccination with the Pfizer-BioNTech COVID-19 vaccine confers about 90% protection and prevents symptomatic infection and severe disease by the delta variant. Additionally, a Canadian research showed that one dose of the Moderna COVID-19 vaccine results in about 85% prevention against symptomatic COVID-19 virus infection and severe disease caused by the delta variant. Finally, data released by Johnson & Johnson, showed that the Janssen/Johnson & Johnson COVID-19 vaccine is 85% effective at preventing severe disease with the COVID-19 virus caused by the delta variant.
Although the Delta variant is currently the most prominent strain of COVID-19, the Lambda variant isolated in South America is also emerging. Health experts maintain that a significant portion of the population must be vaccinated to confer herd immunity and for things to completely go back to normal. As long as most people across the world are unvaccinated, new strains of the virus will continue to emerge and potentially create new problems.
Current strategies and measures recommended by WHO continue to protect against virus variants identified since the start of the pandemic. Evidence from multiple countries indicate that public health and social measures (PHSM), including infection prevention and control (IPC) measures, have remained effective in reducing COVID-19 cases, hospitalizations and deaths. National and local authorities are therefore encouraged to continue strengthening existing PHSM and IPC measures as well as surveillance and sequencing capacities.
Reducing transmission through effective disease control measures and avoiding infections in animal populations, are crucial aspects of the global strategy to reduce the prevalence of mutations that have negative public health implications. In collaboration with partners, expert networks, national authorities, institutions and researchers, World Health Organization continues to characterize, monitor and asses the evolution of SARS-CoV-2.
