Concerns from Vietnam

well you're very welcome to today's talk it's monday the 31st of may main thing i want to talk about today is the india variant in the uk and there seems to be a new highly transmissible variant in vietnam so we'll have a look at that let's just start off though with a quick review of the english beacon countries as we often do um now this is uh this sharp decline here that's the canada line so canada's come down quite quickly this is ireland here a more gradual decline then the united states still going down and unmistakably the united kingdom going up there's been a few cases actually in australia we're going to do an update on that later on and new zealand uh essentially flat as far as i'm aware at the moment but the uk going up there and of course that's due to the spread of the india variant combined with the recent uh opening up where people can mix within each other's houses in in the uk so um quick review from the states first though dr fauci uh we don't want to declare victory prematurely as we still have a ways to go which of course we agree with despite the cases are going down we'll see why it's concerned as well but the more and more people that can get vaccinated as a community the community will be safer and safer vaccination rates in the states are not really where we would like them to be at the moment and the rates of new disease are still relatively high and certainly they're in unvaccinated population and his concerns are there is more global cases in 2021 than 2020. so there's still lots of coronavirus out there that can possibly of course be imported into the states and that's what it says there's always a danger of variance emerging and diminishing somewhat not entirely somewhat we believe the effectiveness of our vaccines so that is his concern there i think really unvaccinated people within the united states and the risk of a new variant being imported and it's not impossible as we'll see this vietnamese variant could become the world's dominant variant which could be really quite a significant problem depending on um well we'll look at the data from vietnam in a minute now quite a few people have been asking about the indianapolis speedway 135 000 spectators only 40 of capacity evidence of vaccination required so it's outdoors so i'm not too worried about that what i would be more worried about is the bars around about the speedway that the public toilets around about the uh the racetrack i'd be more worried about and even although it said evidence of vaccination is required to go um 90 000 people were given vaccines at the meeting which is a bit strange good that 90 000 people are vaccinated but if they already need to be vaccinated to go why were they being vaccinated again so um curious one there don't quite know the answer to that now let's look at the uk first of all now and think about the india variant now people testing positive 3240 in the 24 hours the last seven days it was 22 474 testing positive that's an increase of 26.8 percent now it's an increase on relatively low numbers i know but it's still a rapid increase and about 80 percent of these new positives are the b1 617.2 the india variant now this is the increase of the india event in the uk now this is from the sangha institute working with nhs england and it really is quite uh staggering this is the increase from the 24th of april it has gone up exponentially to now being 80 of the cases in the uk i mean look at that just incredible level of uh increase now to be fair we warned about this a couple of months ago on this channel advice wasn't taken flights continued and uh this is the this is the this is the result uh that is the result rather it's okay um so admitted to hospital in the last uh yesterday 133 patients 870 over the week um up 23 and deaths up slightly as well now we we know this is going to cause increased cases in combined with the fact that we're now allowed more indoor mixing um but i'm hopeful it's not going to cause a great increase in death because the the relationship between deaths and cases has largely been broken by the vaccine but we are told that this will cause an ongoing increase in cases and there will be an increase in hospitalizations in those that have only had one vaccine those that haven't been vaccinated in younger groups and those that haven't accepted the vaccine especially at risk in the older groups and those with co-morbidities so um that is what we were warning about and that is exactly what has happened i'm not going to take time to get annoyed because it's now where we are at but um it was pretty obvious it was going to happen some time ago um and to confirm that um epidemiologist queen mary university london this was entirely predictable we agree india variant while at different frequencies in different regions was rapidly increasing across all of england so this is still clustered to a large extent but it is now abroad as it were in england all over the country and indeed scotland now we have a highly transmissible variant these are direct quotes of course they're in italics capable of a significant level of escape from vaccines especially after a single dose so people are going to become infected after they've had one dose of the vaccine a few after they've had two doses of vaccine far fewer um people at particular risk are going to be those that have developed a poor immunological response such as those with purely controlled diabetes or those with cancers or on immunosuppressing drugs would be particularly at risk if they haven't responded well to the vaccine leading to an exponential rising cases in many areas i'm afraid currently the fully vaccinated figure is 38.1 in the uk this could be a start of a third wave hopefully not severe because of the vaccination status now the opening up that was due to happen on the 21st of june it wears out well-thumbed road map here it is step four is supposed to be on the 21st of june potentially see all legal limits on social contact remove nightclubs opening rest restrictions on weddings funerals will also be abolished after the further liberalizations or the previous liberalizations on the 17th of may so there's now no question really in my mind that is going to have to be put back so there's not a question mark it will be put back i think it has to be put back the final decision is on the 14th of june but with the increase in the india variant i can't see that that will not be put back unfortunately here's the data from the uk now just to show that these are relatively low levels they're the increasing cases there so we see it still at relatively low levels but the variant is increasing likewise with healthcare still at fairly low levels but there is unfortunately uh an increase that's the total number of people in hospital so that looks about the same but the number of people being admitted has slightly increased okay nothing like where we were but we really don't want a third wave so it is definitely a concern now other countries are concerned as well um france for example um fans for example where are we there we go transfer from from today non-eu nationals not allowed into france and of course that includes people from the uk unless they have compelling reasons if they have compelling reasons pcr tests in the past 48 hours uh travelers would like to self-isolate for seven days because of concerns over the india variant so france closing down actually is legally as much as it can as quickly as it can really because of the european regulations but closing down to all non-eu residents and even then these requirements for anyone else of course people from other eu countries could go without these these stipulations so um i think that means that the india variant will get to france because of the mixing within the european union italy uh extended travel ban from india bangladesh and sri lanka of course they're worried about it as well and just to show that we forget how well on we are with the vaccinations in the uk and the us but spain for example king felipe aged 55 had his first doses of vaccine yesterday now obviously pleased to see that king felipe is taking his vaccine with his age group cohort in madrid but it just shows that they're not really quite um well nothing like as far ahead as we are in the uk so uh the potential for things to go a bit wrong in europe with more cases spread of the uh india variant and because they have a lower proportion of people vaccinated than potentially more cases hospitalizations and unfortunately deaths in europe with a new variant now talking about new variants the most concerning one at the moment seems to be vietnam now we don't have full data on this yet but the vietnamese data appears to have the worst characteristics of the uk b117 variant and the worst characteristics of the india b1 uh six what is it six one seven point two variant now it's not a hybrid of the both it's not the viruses don't breed they don't reproduce sexually in that way but it seems to have the worst combinations of both now the question in my mind is vietnam has had very low cases for a lot of time so where does this come from that really is a bit of a mystery now if you had millions and millions of people who are infected and millions and millions of viral replications in each person of the millions and millions that's affected um then there's a great opportunity a greater opportunity for mutation to take place but because the rates were so low in vietnam you really wouldn't have expected a mutation to arisen there because of the relatively low viral numbers and yet this seems to be where it has emerged and it's not looking good from what we know from the vietnamese data now uh background here is early 2020 vietnam and closed the boards extent returning citizens quarantined and tested everyone who entered the country with a great deal of efficiency it has to be said um and i'll give you the evidence for that in a minute widespread contract tracing and testing so vietnam actually did an excellent job in early 2020 way better than the uk or the united states or europe a really good they did a really good job in the early stages of this pandemic they were proactive as we were yelling for people to be at the time we weren't they were and things went well so overall in the pandemic seven thousand cases 47 deaths but most of these seventh half of these 7 000 cases have been very recently and here we are now um so february uh 2020 up to the present time so we see okay a few cases there small amount there very low levels there a little bit there but now i'm afraid with this new i suppose what we must call the vietnamese variant sharp rise in cases now to be fair they're only up to about 400 a day that's the 400 a day line so it's still at a low level but the vietnamese authorities are concerned the vietnamese authorities are competent therefore i am concerned mass chess testing in ho chi minh plan to test all nine million people hundred thousand a day don't take me don't doesn't doesn't need a mathematician to work out that's 90 days three months to get through the whole population that's going to be too late basically so they are focusing their testing around about a particular cluster that we believe has occurred there the authorities are saying it's a very dangerous hybrid when they say hybrid it's not cross-bred it's got the worst characteristics there was you understand of the india and the uk variant and uh i'm afraid i've kept the worst news till last the vietnamese authorities are saying easily transmissible by air so from what we can tell from the vietnamese authorities this looks like the most contagious variant that has so far come along unfortunately um new social distancing 15 days starting today and then for 15 days mostly staying at home shopping restaurants clothes religious activities suspended incoming international flights to the capital hanoi and ho chi minh city that used to be called saigon suspended vaccinations only one percent of the whole population of vietnam vaccinated about a million people the vaccines are the oxford astrozenica vaccine and the sputnik v vaccine the oxford astrozenica vaccine that they're using is manufactured under license in south korea biosciences by sk biosciences inside south korea so the reason they're getting any vaccines at all largely through the kovacs program is because oxford has licensed out production to many facilities around the world and they've got relatively local production there pity other vaccine manufacturers are not doing that as much as the oxford astrazeneca are so the question is will the vietnamese contain this well if it's just this cluster that we know about in hanoi the answer's probably yes because they're very good at containing it if it's already spread like if it's been imported from somewhere else and has already spread to other areas then because it's more transmissible than the india variant and the uk variant that means that will be rapidly become the most common variant in vietnam and um it will it will greatly increase the amount of cases in vietnam and having got away with uh essentially no cases all the way through the pandemic the last the next months which is going to be the hopefully the last month in their months in their pandemic could be really quite bad for vietnam so that is a bit of a concern also if that variant escapes in vietnam it could become the global variant in the world that's quite possible if it's as contagious as the vietnamese authorities are indicating that it may well be right that's all from me today the last thing is the report from australia now i know a lot of you like dr susan oliver i do very much and now i haven't actually listened to this yet so i'm going to listen to it with you make a few notes and uh let's see what's going on in australia she did email me to say that she did say there was 40 cases in the talk that's now up to 51 but i'm not quite sure what cases it is but let's listen to dr susan oliver thank you as always susan of course hello this is vaccinated susan we have a coveted update from australia so in my last two updates i talked about the growing complacencies towards cova that we have been seeing in australia unfortunately i now have to report that we are seeing some of the consequences of that complacency we have gone from zero local cases last week to so far 40 local cases this week and one case announced today is an aged care worker which is very concerning now most of the cases have been linked to each other by genomic sequencing and it is one of the variants that originated in india although not the same lineage as as being as is spreading across the uk it is one of the others but the whole of victoria is now in day three of a seven day lockdown so how did it happen well the index case was a return traveler who unknowingly caught covered whilst in cave whilst in hotel quarantine now this has happened a few times now and i think it is worth mentioning because these transmissions occurred between people who never had any face-to-face contact but were just staying on the same floor of a quarantined hotel if you think about how many people in the world live in shared buildings you know flats units apartments condominiums etc that's a lot of people who could still catch covert even though they are taking precautions whenever they leave home now obviously the risk of catching covert from someone living in the flat next door is a lot less than catching cover from going to the pub but the risk is still there now back to the index case he did the right thing and came forward for testing when he developed symptoms and he worked with contact tracers to identify where he had been in the time he was likely likely infectious so all would say far unfortunately when the contact traces went to the venues to get the names of everyone who had been there at the same time the lists were uncomplete and this is just complacency all round complacency of people not bothering to check into the venues which incidentally takes about 30 seconds complacency of the venues in not checking that their customers had checked in and complacency of authorities in not doing anything to ensure compliance but it gets worse someone who developed symptoms didn't get tested and instead just carried on with their plans and look prior to this pandemic that was what you did i mean i remember once working for about a week with a partially collapsed lung rather silly really but you know that was behaviour that was considered acceptable but it's not considered acceptable anymore anyway luckily one of the people that they infected did get tested when they developed symptoms but by then it was already spreading and sadly the effects of vaccine complacency have also been demonstrated by this outbreak now a lot of people infected in this outbreak weren't eligible to be vaccinated but some of them were and hadn't yet got vaccinated um one of these people is now in intensive care on a ventilator so that's complacency but some people have taken it further and are exhibiting downright selfishness people have been filmed dancing in a packed nightclub in contravention of the restrictions and yesterday hundreds of massless people descended on melbourne to protest the lockdown i mean how stupid can you get if you don't want to lock down engaging in activities that are likely to spread the virus isn't really the smartest move but every cloud has a silver lining and one positive to come from this outbreak is complacency around getting vaccinated has all but disappeared people are now cueing up to be vaccinated and both victoria and new south wales have experienced their biggest days ever in terms of number of vaccinations now we're up to over in fact well over 4 million vaccinations i haven't got the exact number because i haven't released the latest numbers yet for yesterday but that is over 20 of the adult population and i'm one of them and actually little julie here also got vaccinated this week although admittedly not not for covered anyway i had my only had my sick my vaccine six days ago so i don't really have any protection yet but i'm still excited because i'm just that type of person now i was warned by a few people before my vaccination that i could have quite bad side effects and in fact one of my friends at work was asking me all day to go home because she was worried that i was going to get stuck on the bus with these bad side effects anyway i i left work at my normal time and managed to get home without incidents but i did get some mild side effects later i had a slight fever although i probably wouldn't have known about if i hadn't actually checked my temperature but i also had a mild headache and i definitely knew about that so how does that compare with other people in australia who have been vaccinated we don't have an equivalent to the zoe app but the government is sending out a survey to a selection of people getting covered vaccines to monitor typical side effects so for the astrazeneca vaccine which is the one that i got after the first dose um 57.2 of people reported some sort of adverse event with fatigue being the most common at 44.5 and headache next at 37 also 18.5 reported that they needed to sort of miss work or study or routine duties for a short period of time now obviously not all symptoms will be caused by the vaccine because these are the types of symptoms that people suffer from every day but they are certainly more prevalent in people following vaccination after the second dose of the astrazeneca vaccine side effects were lower with 38.1 percent reporting any adverse event and only 9.7 missing work study or routine activities so how does pfizer compare only 37.8 reported any adverse event following the first dose which is you know quite a bit lower than the 57.2 following the first dose of astaxenica and only 6.3 reported missing work study or routine duties and the most common adverse event was in fact just injection site pain at 30.5 percent and fatigue at 21.2 now after the second dose things are a bit different with 59.7 reporting an adverse event and 23.1 missing work or study so in a nutshell side effects are more likely after the first days if you get the astrazeneca vaccine and more likely after the second days if you get the fisa vaccine and this seems to be consistent with what is seen in other countries so thank you for listening and stay safe everyone thank you [Music] susan thank you so much another excellent update as usual i agree i share your concern the india variant seems to have spread in the air in quarantine hotels so 51 local cases now um victoria has got good experience of closing these kind of outbreaks down so let's hope they can close this one down but of course we don't know till they actually hopefully succeed in doing that but that was an excellent uh update you had me going there for a minute with julie the dog getting vaccinated but it wasn't covered it wasn't a covered fact imagine he was getting his kendall coffin as distemper she was getting a kennecoff and distention just 10 percent no offense julie so um good news for both of you and uh thanks again for that update absolutely excellent and thank you of course for watching you

Channel: Dr. John Campbell

Views: 172,219

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: uyZOoFBjc3c

Length: 24min 19sec (1459 seconds)

Published: Mon May 31 2021