COVID19 update, December 30, 2020: Oxford-AstraZeneca vaccine approved in the UK; more updates from Israel; link between viral load and severity of disease; Rapid CRISPR-based tests coming

(1) The Oxford-AstraZeneca vaccine is now approved for use in the UK. This is good news in a number of respects: it can be manufactured cheaply in the UK itself and only requires conventional refrigerators (not even freezers). [Addendum: this makes it especially attractive for countries like India, that not just couldn’t afford to acquire Pfizer or Moderna vaccines in the quantities required, but can’t realistically deploying the low-temperature supply chain required.]

The immunisation campaign will now shift to giving as many people as possible their first dose of vaccine with a second dose following within that period.

When the Pfizer-BioNTech jab rollout began, the aim was to give the second dose after three weeks.

But based on advice from the Joint Committee on Vaccination and Immunisation, the aim now is to give as many vulnerable people some protection from Covid-19, irrespective of the jab they are given.

The Oxford vaccine is easier to store and distribute, as it can be kept at normal fridge temperature unlike the Pfizer-BioNTech jab that has to be kept at -70C.

There is also more confidence about supply as it is UK-made, whereas the Pfizer-BioNTech jab has to be shipped in from Belgium.

The article also explains that in effect, it seems the UK will be trying to maximize the number of people that will get at least one dose of the vaccine, the idea being that more will be available a few months down the line. A source in Belgium told me they are planning the same thing there.

Below is the UK priority schedule:

(2) A few more updates from Israel, which appears to be vaccinating about 150,000 people per day now (that’s several % per day of the eligible groups)

  • Times of Israel editor-in-chief David Horowitz movingly describes the experiences of himself and his parents getting vaccinated (in Jerusalem)
  • An insider told me that some time ago, the TEVA pharmaceutical company built a somewhat grandiose logistical center in Shoham, pretty much next door to the airport. This includes a large capacity in REVCO low-temperature storage, much of it sitting empty. Right now, this turns out to be serendipitous, as this facility is now the national distribution hub for the vaccines.
  • A man age 88, “with multiple complex health issues”, collapsed hours after receiving the vaccine. Doctors are confident the vaccine was not the culprit, however.
  • Veteran Arab affairs correspondent Khaled Abu Toameh reports that in many Arab locales, people are wary of the vaccine — and as a result, vaccination rate in the Arab sector is much lower than in the Jewish sector. Nevertheless, there are exceptions — such as the town of Umm al-Fahm, whose mayor Umm al-Fahem “Mayor Samir Mahamed said that rumors circulating on social media and WhatsApp have scared many Arabs. ‘Unfortunately, some people are posting incorrect information and fake news about the vaccination,’ he told the Post, noting that 55% of Umm el-Fahm residents over the age of 60 have received the vaccine. ‘They are scaring the people, and that’s why we are waging a campaign to raise awareness regarding the importance of receiving the vaccine.'” Galilee Medical Center director. Prof. Masad Barḥoum, points out that vaccination centers in many Arab communities are empty — and hence Jews travel to Arab villages to get vaccinated without a wait.
  • While in some locations, the commonsense decision was made to use leftover defrosted vaccine shots also for not-yet-eligible person rather than discard them (Pfizer mRNA vaccines have to be used within 6 hours, as the mRNA vaccine is so temperature-sensitive), in other places, several hundred of the precious doses were discarded unused

I would suggest that anybody sitting on the fence about the effectiveness of the vaccine watch very carefully the news coming out of Israel over the next weeks, as we are likely to become the first country where most of the vulnerable population groups will have been vaccinated. If the vaccine is as effective on the ‘battlefield’ as it was doing clinical trials, we should see a precipitous drop in COVID19 mortality 3-4 weeks from now.

(3) More evidence that viral load associated with severity of disease from these two papers:

https://doi.org/10.1093/ofid/ofaa535 and http://doi.org/10.7555/JBR.34.20200110

From a NYTimes write-up in popular language: ““A [RT-PCR] test is performed in “cycles,” each doubling the amount of viral genetic material originally drawn from the patient’s sample. The higher the initial viral load, the fewer cycles the test needs to find genetic material and produce a signal.[…] the Nevada Department of Public Health found an average Ct value of 23.4 in people who died from Covid-19, compared with 27.5 in those who survived their illnesses. People who were asymptomatic had an average value of 29.6, suggesting they carried much less virus than the other two groups. […] Most manufacturers conservatively set their machine’s thresholds for diagnosis from 35 to 40 […]”

(4) Miscellaneous updates:

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