Latest knowledge on Covid-19

Dr Adrian Hyzler Chief Medical Officer at Healix International

Dr Adrian Hyzler
Chief Medical Officer

Developments from 19th February 2021

Covid infections across the world have fallen to their lowest levels since the middle of October. There are a number of reasons for this significant fall that in combination account for lower case numbers: there is likely to be a degree of seasonality both from the point of view of the virus and also behavioural aspects of the end of seasonal festivities towards the end of 2020; a proportion of the population is likely to have a degree of natural immunity to infection as a result of infection with COVID-19 and an increasing proportion of high income countries, where much of the case volume is concentrated, are beginning to roll out a number of highly effective vaccines. However, optimism over a straightforward path out of the pandemic crisis has been tempered by increasing numbers of variants of concern of the SARS-CoV-2 virus, raising fears about the efficacy of vaccines. Despite the variants’ predominance in a number of countries, non-pharmaceutical measures such as masking, physical distancing and isolation/quarantine, have resulted in rapidly falling numbers of infections.

There were just under 400,000 new infections reported worldwide yesterday on a seven-day average, the figure falling from 863,737 on Jan 7. There were 17,649 deaths on 26 January, falling to 11,561 yesterday. Africa’s total reported death toll from COVID-19 has just crossed the 100,000 mark, a fraction of those reported on other continents but rising fast as a second wave of infections has swamped hospitals across southern Africa. South Africa was ravaged by a second wave caused by the ‘501Y.V2’ variant that is more infectious than the wild type coronavirus as well as appearing to be less susceptible to the natural immunity from the first wave. The rise in deaths has also been more pronounced in countries near South Africa such as Zimbabwe, Mozambique and Malawi, where there is likely to be further spread of the variant. To date, 87 countries have begun vaccinating people for the coronavirus and have administered at least 193 million doses, but only Morocco, Egypt and Algeria in the north and South Africa have started rolling out vaccination campaigns across the continent.

New research suggests that the South African variant of the coronavirus may reduce antibody protection from the Pfizer/BioNTech vaccine by up to two-thirds, and it is not clear if the jab will be effective against the mutation, according to Pfizer. The study found the vaccine was still able to neutralise the virus and there is not yet evidence from human trials that the variant reduces vaccine protection. Nevertheless, they are making investments and talking to regulators about developing an updated version of their mRNA vaccine, or a booster shot, in case this is needed. This latest research backs up the data from the AstraZeneca/Oxford vaccine that suggests that their vaccine offers as little as 10% protection against the ‘501Y.V2’ variant first seen in South Africa, that led the country to halt its planned rollout of the jab and offer all remaining doses to the African Union for distribution in countries without a prevalence of the variant.

Pfizer and BioNTech have started an international study with 4,000 volunteers to evaluate the safety and effectiveness of their COVID-19 mRNA vaccine in healthy pregnant women. Pregnant women are at higher risk of developing severe COVID-19, and many public health officials have recommended some women in high-risk professions take coronavirus vaccines even without proof they are safe for them. Pregnant women were excluded from all the major international trials used to obtain emergency use authorisation of COVID-19 vaccines, though a number of volunteers became pregnant during the trials and no adverse events have been recorded. They expect to publish results by the fourth quarter of 2021.

In the UK children and young adults are being invited to take part in the first study to assess the safety and immune response to the COVID-19 vaccine in young people. The study, funded and supported by the UK National Institute of Health Research (NIHR), will be run by University of Oxford, together with three partner sites in London, Southampton and Bristol, looking at the Oxford/AstraZeneca coronavirus vaccine. Building on previous trials of the vaccine, which have shown that it is safe, produces strong immune system responses and has high efficacy in all adults, this trial will assess if children and young adults aged 6-17 years make a good immune response with the ChAdOx1 vaccine. Also in the UK, healthy, young volunteers will be infected with SARS-CoV-2 to test vaccines and treatments in the world’s first COVID-19 “human challenge” study. The study, which has received ethics approval, will start in the next few weeks and recruit 90 people aged 18-30. The volunteers will be exposed to the virus in a safe and controlled environment while medics monitor their health. The trials will help scientists work out the smallest amount of coronavirus needed to cause infection, and how the body’s immune system reacts to it. This will give researchers a better understanding of COVID-19 which will feed into the development of vaccines and treatments. The Human Challenge study is being delivered by a partnership between the UK government’s Vaccines Taskforce, Imperial College London, the Royal Free London and the company hVIVO, which has pioneered viral human challenge models.

What do we know about Covid-19?

Knowledge and advice relating to the disease is constantly evolving. To help support our clients, Healix’s Chief Medical Officer has produced a comprehensive reference guide, updated weekly, containing everything you need to know about COVID-19, as well as sharing our latest advice for travellers and employees.

What’s inside?

  • Overview
  • Transmission
  • Symptoms & Risk Groups
  • Treatment
  • Long Term Health Effects
  • Prevention
  • Vaccine Approval Chart
  • Testing
  • Latest Advice for Travellers
  • Country Bandings

To view our Coronavirus Pandemic Information Hub, click here.

Reference: Covid-19 country band categorisation

Extreme

>250 cases per 100,000 over 7 days

  • Albania ↑
  • Andorra
  • Bahrain
  • Czech Republic
  • Estonia
  • Israel
  • Latvia
  • Lebanon
  • Mayotte
  • Montenegro
  • San Marino
  • Seychelles
  • Slovakia
  • Slovenia
  • St Lucia
  • St Vincent & Grenadines
  • Turks & Caicos
  • USA – New Jersey, New York, N Carolina, Rhode Island, S Carolina, Tennessee ↑

Severe

>50-250 cases per 100,000 over 7 days

  • Antigua and Barbuda
  • Argentina
  • Aruba
  • Austria
  • Barbados
  • Belarus
  • Belgium
  • Bolivia
  • Bosnia & Herzegovina
  • Botswana
  • Brazil
  • Bulgaria
  • Cape Verde
  • Chile
  • Colombia
  • Costa Rica
  • Croatia
  • Cuba ↑
  • Cyprus
  • Dominican Republic
  • Falkland Islands
  • France
  • French Guiana ↑
  • Georgia
  • Germany
  • Gibraltar
  • Greece
  • Honduras
  • Hungary
  • Iran
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Jordan
  • Kosovo
  • Kuwait
  • Lebanon
  • Lithuania
  • Luxembourg
  • Malaysia
  • Maldives
  • Malta
  • Moldova
  • Monaco ↓
  • Netherlands
  • North Macedonia
  • Palestine Territories
  • Panama
  • Paraguay
  • Peru
  • Poland
  • Portugal ↓
  • Qatar
  • Romania
  • Russia
  • Saint Martin/Sint Maarten
  • Serbia
  • Slovakia
  • Spain
  • St Vincent & The Grenadines ↑
  • Sweden
  • Switzerland
  • Turkey
  • Ukraine
  • UAE
  • UK
  • Uruguay
  • USA – Alabama, Alaska, Arizona ↓, Arkansas ↓, California, Colorado, District of Colombia, Connecticut, Delaware ↓, Florida ↓, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky ↓, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada ↓ , New Hampshire, New Mexico, N Dakota, Ohio, Oklahoma ↓, Oregon, Pennsylvania, Vermont, Puerto Rico, S Dakota, Texas ↓, Utah ↓, Virgin Islands, Washington, West Virginia, Wisconsin, Wyoming

High

>20-50 cases per 100,000 over 7 days

  • Armenia
  • Bahamas ↑
  • Belize
  • Bermuda
  • British Virgin Islands ↓
  • Canada ↓
  • Comoros
  • Curacao ↑
  • Denmark ↓
  • Ecuador
  • El Salvador
  • Eswatini
  • Finland
  • French Polynesia
  • Gabon
  • Gambia
  • Guadeloupe
  • Guatemala
  • Guyana
  • Indonesia
  • Iraq
  • Kazakhstan
  • Lesotho
  • Libya ↓
  • Liechtenstein ↓
  • Mexico ↓
  • Montserrat ↓
  • Namibia
  • Norway
  • Oman
  • Reunion
  • South Africa
  • Sri Lanka
  • Suriname
  • Tunisia ↓
  • USA – Hawaii
  • Yemen
  • Zambia

We have recently reviewed how we classify countries, and we identify three distinct categories: Extreme, Severe and High. Extreme is >250 new cases per 100,000 over 7 days, Severe is >50-250 new cases per 100,000 over 7 days, and High is >20-50 new cases per 100,000 over 7 days. We include these categorisations in our communications to give an indication of country / regional risk rating and refine the categorisation using the following additional criteria:

  • Deaths per capita
  • Health care capacity
  • Prevalence of testing

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