Covid-19 News

Quote from JedRothwell

What does that mean? I do not understand this sentence. There is a limited supply of this drug. Putting in a purchase order does not magically make more appear. Because supplies are limited, it has to be rationed. It would not be fair to help more patients in Florida than other states.

The article FM1 linked to said Florida had to order monoclonal anti-bodies from another company:

"DeSantis said the first purchase was for 3,000 doses of the drug sotrovimab, which was given emergency-use authorization by the U.S. Food and Drug Administration in May.

The governor said last week that he would pursue a direct-purchasing agreement with GlaxoSmithKline, as the state is unable to directly buy doses of Regeneron’s monoclonal antibody treatment."

An In-Depth Examination of the Impact and Challenges Posed by the COVID-19 Pandemic in Pakistan

An In-Depth Examination of the Impact and Challenges Posed by the COVID-19 Pandemic in Pakistan

The general situation of healthcare in Pakistan is far from ideal. Lack of healthcare professionals, overburdened hospitals, and poor infrastructure do

trialsitenews.com

The general situation of healthcare in Pakistan is far from ideal. Lack of healthcare professionals, overburdened hospitals, and poor infrastructure do not paint an optimistic picture. While promises are made by politicians with regards to improving the healthcare system every election cycle, very few end up getting implemented. The COVID-19 pandemic has brought a lot of these discrepancies in the Pakistani healthcare system to the forefront.

The response of the Pakistani government to the Covid-19 pandemic has been erratic, exemplified by infrequent testing, shortages of drugs and ventilators, and now with the painstakingly slow vaccine rollout. This is not to say that the government has completely failed; it has been praised by some government proponents for controlling the positivity and death rates, as compared to rates in some of the other populous countries in the region such as India, Indonesia, and Iran. Despite this, the 31st highest confirmed cases (at approximately 1.2 million) and the 27th highest death toll (at approximately 27,566) in the world are hardly worth bragging about.

It is also a common sentiment that the impact of and the challenges posed by the COVID-19 pandemic in Pakistan—the 5th most populous country in the world—have seldom been addressed by the international media. This article aims to change that by surveying the COVID-19 situation in Pakistan, with a special focus on the impact of the pandemic, vaccine supply, challenges with vaccine hesitancy, and the overall response by the Pakistani healthcare system.

Impact of COVID-19 in Pakistan: The Pandemic in Numbers

The first case of the novel coronavirus was reported in Pakistan in February of 2020, when a Pakistani citizen studying at an Iranian university tested positive on his return to Karachi. At that time, despite Pakistan’s close proximity to China—where the virus originated—and Iran—the first major hotspot of the disease outside of China, the Pakistani government did little to cordon of its northeastern border (with China) and its western border (with Iran). Soon thereafter in March of 2020, Pakistan witnessed its first wave of COVID-19. The first wave, the root cause of which was returning travelers from abroad, was characterized by a high positivity rate but a low death rate. The highest single day (June 21, 2020) rise in the number of coronavirus cases of the first wave stood at 6,604. The first wave subsided in July of 2020, with confirmed cases at the end of that month standing at 277,300 and the death toll at 5,919.

The second wave of the coronavirus was relatively short-lived, starting with a rising number of confirmed cases in November of 2020 and peaking in December of 2020. Pakistan had 479,715 coronavirus cases and 10,105 deaths at the end of the second wave, marked roughly at the end of 2020 (December 31, 2020). The Pakistani province of Sindh was hit hardest by the second wave, with most deaths occurring in the population centers of Karachi and Hyderabad. The third wave started in March of 2021 and peaked in April of the same year. It largely affected the eastern province of Punjab—mainly the urban centers of Lahore, Rawalpindi, and Faisalabad—and the northern province of Khyber Pakhtunkhwa. Since June of 2021, the coronavirus cases have largely been under control, with average increase of 3000-3500 per day, which is way down from the exponential highs of the first wave.

As of 28th September 2021, Pakistan has had a total number of 1,241,825 confirmed coronavirus cases, and 27,638 confirmed deaths. Sindh has reported the most number of confirmed cases (456,343) followed by Punjab (cases: 429,081). The death toll, however, is the highest in Punjab (12,575) followed by Sindh (7,361). Two considerations are important to note here. First, the confirmed number of official COVID-19 cases in Pakistan are relatively low as compared to some of the other countries in the region, however, so are the number of tests conducted in Pakistan per million population. Pakistan has conducted a meager 85,068 tests/1M population, whereas the same figure stands at 404,086 in India, 373,523 in Iran, and 899,248 in Malaysia. Second, Pakistani provinces have witnessed consistently high positivity rates. For example, Punjab and its capital Lahore, observed a positivity rate of 14% and 21%, respectively, during the third wave. These figures, with regards to the positivity rate and testing, indicate that Pakistan’s relatively low number of confirmed COVID-19 cases should be treated with caution. Plausibly, frequent testing—on par with some of the developed countries in the world—would have meant more confirmed COVID-19 cases. It should be noted that most of the statistics used in this section are taken from the Government of Pakistan website, with useful information from Global Covid-19 Tracker and Wikipedia page detailing the COVID-19 pandemic in Pakistan.

Therapies and Drugs Used to Treat Coronavirus in Pakistan

Clinical management of COVID-19 in Pakistan—mandated by the National Command and Operation Centre—and implemented by individual hospitals—predominantly includes disease prevention and control measures, supportive care, and incorporation of supplemental oxygen and mechanical ventilatory support when needed. A combination of therapies and drugs has also been used in order to treat COVID-19.

One therapy employed (although not very extensively) in Pakistani hospitals is convalescent plasma therapy (CP). CP therapy involves the use of convalescent plasma from previously infected individuals (who have subsequently recovered), in order to passively transfer their antibodies to newly diagnosed patients. The majority of people who recover from coronavirus develop antibodies to SARS-COV-2 proteins as early as one to three weeks after infection. These antibodies in the shape of COVID-19 convalescent plasma can treat severe coronavirus symptoms in new patients. While CP therapy has been used in some Pakistani hospitals, there is little evidence to back its effectiveness, and the therapy itself can cause side effects such as febrile reactions, allergic reactions, transfusion-associated circulatory overload, and bronchospasm.

Additionally, a few drugs have also been authorized by the NCOC to treat COVID-19 patients in Pakistan. One such drug is tocilizumab—sold under the brand name Actemra. Tocilizumab, an injectable drug, was approved for use to treat coronavirus patients who develop lung complications and who have abnormal levels of IL-6 (a chemical which causes inflammation) in their blood. Another medication that has been extensively used to treat COVID-19 patients is dexamethasone, a corticosteroid renowned for its anti-inflammatory effects. The medication has previously been tested in a clinical trial in the United Kingdom and was found to be effective on critically ill patients. According to findings, dexamethasone was shown to reduce mortality by one-third in coronavirus patients on ventilators, and by one-fifth in patients requiring only oxygen.

The anti-influenza drug Favipiravir has also been extensively used to treat COVID-19 patients in Pakistan. The drug has shown considerable success in preventing severe disease and hospitalization. It has also been used in other countries such as India, Turkey, and Japan. Favipiravir has not only been imported from abroad, but various Pakistani pharmaceutical companies have started producing the drug under different brand names as well. It is also worth mentioning that the use of Ivermectin is still in a trial phase, and the medication is not fully approved for use in Pakistan.

Vaccine Rollout in Pakistan: Vaccination Rate and Supply of Vaccines

According to the official statistics released by the Government of Pakistan as of 28th September 2021, a total of 79,533,208 doses of the coronavirus vaccine have been administered in Pakistan. Out of these, 57,897,219 people have received the first dose of the vaccine, whereas 27,331,678 people have been fully vaccinated. This means that approximately 27% of the Pakistani population has been vaccinated, whereas 13% has been fully vaccinated. Pakistan is trailing other countries in the region with regards to the vaccination rate, as for example, 17% of the entire population is fully vaccinated in both India and Iran. Additionally, Pakistan is way behind some of the more developed countries in the Asia Pacific, with the full-vaccination rate standing at 79% in Singapore and 62% in Malaysia.

This article would touch on the reasons as to why Pakistan has a relatively low vaccination rate—discussing points such as challenges with hesitancy and breakthrough infections—later on. First, however, it is important to examine the supply-side of Pakistan’s vaccine rollout. Which vaccines are being used in Pakistan? From where is Pakistan getting its COVID-19 vaccines? Who is buying them? Have other countries or organizations donated vaccines to Pakistan? These are some of the pertinent questions that require attention. The Pakistani government has authorized seven vaccines for use in the country. These are:

Moderna

Pfizer/BioNTech

CanSino

Sputnik V

Oxford/AstraZeneca

Sinopharm

Sinovac (CoronaVac)

It can be seen that vaccines produced in a wide array of countries—such as the United States, United Kingdom, Russia—have been authorized for use in Pakistan. However, it is the Chinese vaccines (CanSino, Sinopharm, and Sinovac) that dominate the list.

According to data, Pakistan has purchased 85.61 million vaccines from China, of which 55.13 million have already been delivered. China has also donated 3.5 million vaccines to Pakistan—taking the delivered total to 58.63 million (with additional 26.98 million Chinese vaccines in the pipeline). Additionally, Pakistan has received 25.5 million vaccines—predominantly Pfizer/BioNTech, Oxford/AstraZeneca and Moderna—under the Covax scheme. The Covax scheme, which is being collectively run by international organizations (including the World Health Organization), was designed to ensure that low or medium-income countries are not left behind in the global vaccination drive. Lastly, the Pakistani government has also purchased Sputnik V from Russia, although its use in the country is not very common. A million doses of Sputnik V reached Pakistan in September 2021.

As far as the financial aspect of the procurement of these vaccines is concerned, almost all the money has been allocated by the government of Pakistan. The Pakistani government has allocated $1 billion to purchase COVID-19 vaccines until now, with part of the allocation coming in the shape of a $500 million loan from the Asian Development Bank (ADB). In the initial phases of the vaccine rollout, a few Pakistani private hospitals and pharmaceutical companies did acquire vaccines on a private basis for commercial sale. Some 50,000 doses of the Russian Sputnik V were procured, which were then given at the price of 12,000 Pakistani Rupees ($75) for two doses. However, as the government’s vaccination drive gained steam, the private firms stopped importing vaccines, calling the private sale and purchase of COVID-19 vaccines a commercially inviable business.

Challenges with Hesitancy and Breakthrough Infections

In the previous section, it was seen that—although Pakistan has initiated a sufficiently robust vaccination drive—the vaccination rates are still low as compared to other countries in the region. Why is that? The answer lies in vaccine hesitancy. There are several reasons as to why Pakistanis are hesitant of getting a COVID vaccine. First, quite a few Pakistanis are refusing to get COVID-19 vaccines because they believe vaccines are not safe. The illiteracy rate within Pakistan is high and a lot of people cannot assess the scientific data with regards to the efficacy of vaccines. These people are instead content to believe in rumors and fake news on social media.

Pakistanis are indeed fearful of getting vaccinated due to safety concerns. However, another reason for vaccine hesitancy is that the Pakistani health officials have not done an effective job of detailing the benefits (and risks) of vaccines to the mass population. The situation is exacerbated by mistrust between the population and the government concerning healthcare. In a country where the general healthcare situation is far from ideal, people are not willing to trust the government on issues pertaining to their health. Some Pakistanis are also hesitant to get vaccines due to religious and political reasons. As far as religious grounds are concerned, strictly religious people in Pakistan believe that vaccines are ‘haram’ (unlawful) in Islam. Political reasons usually revolve around the conception that vaccines are foreign-funded, and thus are part of the larger imperial goals of the foreign governments to get a stronghold in Pakistan.

In addition to vaccine hesitancy, breakthrough infections are another concern for the Pakistani government. Pakistan, due to its proximity and friendly ties with China, has excessively relied on Chinese vaccines. Some of these vaccines, however, specifically (Sinovac, Sinopharm, and CanSino) have had a worrying track record with regards to breakthrough infections. Thailand and Indonesia, for example, have overly relied on Chinese vaccines, with both countries witnessing mass reinfections and outbreaks. Although Pakistan has not observed breakthrough infections on the same scale as those witnessed in Thailand and Indonesia, some worrying signs are starting to emerge. According to one study conducted by the Health Department of Punjab in August of 2021, the breakthrough infection rate in the province stood at 10%. Most of the affected patients, as stated in the study, were healthcare professionals employed in public hospitals.

COVID-19 Pandemic and the Pakistani Healthcare System

So, what has been learned about the Pakistani healthcare system from the pandemic? First, the COVID-19 pandemic has highlighted that the Pakistani healthcare system is heavily underfunded. A large portion of Pakistan’s budget is allocated on defense, which means pertinent sectors such as education and healthcare remain underfunded. This became apparent during the pandemic when Pakistan’s hospitals had frequent shortages of medicines, healthcare professionals, and ventilators.

Second, the pandemic has made it clear that a lot of what the Pakistani government does—including in healthcare—is dependent on regional politics. Pakistan, for example, could have coordinated a collaborative plan with neighboring India to combat COVID-19. However, Pakistan did not do so due to hostile relations with India. In addition, Pakistan secured the most vaccines from its closest partner in the region, China. Although both Thailand and Indonesia have moved to abandon their use of Chinese vaccines owing to mass breakthrough infections, there is no indication Pakistan would do the same.

Third, the pandemic has shown that there is a huge disparity between private and public hospitals of Pakistan. Private hospitals, where admission charges are extremely high, provide much better medical care to patients than public hospitals. However, it is impossible for an average Pakistani to afford such private care, leaving only the richest to utilize services of private hospitals. Fourth, there is growing mistrust between the Pakistan healthcare professionals and the general public, highlighted by the reluctance of some Pakistanis to heed professional advice and get vaccinated. This does not bode well for Pakistan’s other vaccination drives, especially with regards to the polio vaccination campaign.

It is apparent that Pakistani healthcare has shown some gains in the country’s response to the COVID-19 pandemic. The healthcare professionals and the Pakistani government have not allowed the COVID situation to get out of control. However, a lot has to change before the Pakistani healthcare system can get back on track.

Quote from JedRothwell

You will see that the vaccines work extremely well.

Tell this THHuxleynew. He wants a booster... Does not sound like working extremely well.

Quote from zorud

double vaccinated with Morderna and still feel fine :-

From today's point of view Moderna is vastly superior to the other gene therapies, that I never would recommend. Worst is Oxford-ASTRA, followed by Pfizer.

Moderna has no problem with unknown junk RNA that makes up about 30% in early decaying Pfizer RNA. The antibody response seems to be "much" broader with Moderna at least we here can talk about such an effect, despite some papers claim just a factor of 2 under lab conditions.

The vaccination side effects are more or less the same among all gene therapies. Outraging high and not in agreement with a long time "usable" vaccine.

So far we have no clean data for immune suppression with Moderna. Thanks to Israel we can very clearly see all the bad effects of Pfizer.

Quote from Wyttenbach

e also know from UK data that age class 40..80 gets more CoV-19 infection than unvaccinated...

No, we don't. 11th time. (but not a long explanation again).

Quote from Wyttenbach

Tell this THHuxleynew. He wants a booster... Does not sound like working extremely well.

A vaccine that provides excellent protection against symptomatic disease for 6 months works well, in the context of COVID, where if you are age 62 you do NOT want to get the disease unvaccinated.

Notwithstanding that I protect my 92 year old father, to some extent, by reducing my chances of transmitting the disease to him.

But what that comment shows is an emotional response to a medical intervention. A vaccine that is not perfect is no good? Why?

THH

Quote from zorud

Probably due to my non-native capabilities nobody did realize this Wyt-sarcasm...?

Poe's law! My fault.

Quote from Shane D.

The article FM1 linked to said Florida had to order monoclonal anti-bodies from another company:

"DeSantis said the first purchase was for 3,000 doses of the drug sotrovimab, which was given emergency-use authorization by the U.S. Food and Drug Administration in May.

Is this a one-for-one replacement? I don't see how it could be rationed in that case. Perhaps the supply from only one company is rationed. Maybe Uncle Sam has priority. Anyway, if they can get an equivalent from another supplier, what are they complaining about?

Quote from THHuxleynew

A vaccine that is not perfect is no good? Why?

For the same reason we should disband FAA air traffic control and remove all traffic lights and stop signs. Because they sometimes fail to prevent accidents.

A prenylated dsRNA sensor protects against severe COVID-19

AAAS

Abstract

Inherited genetic factors can influence the severity of COVID-19, but the molecular explanation underpinning a genetic association is often unclear. Intracellular antiviral defenses can inhibit the replication of viruses and reduce disease severity. To better understand the antiviral defenses relevant to COVID-19, we used interferon-stimulated gene (ISG) expression screening to reveal that OAS1, through RNase L, potently inhibits SARS-CoV-2. We show that a common splice-acceptor SNP (Rs10774671) governs whether people express prenylated OAS1 isoforms that are membrane-associated and sense specific regions of SARS-CoV-2 RNAs, or only express cytosolic, nonprenylated OAS1 that does not efficiently detect SARS-CoV-2. Importantly, in hospitalized patients, expression of prenylated OAS1 was associated with protection from severe COVID-19, suggesting this antiviral defense is a major component of a protective antiviral response.

It might be a good idea to stock up on vitamin d

A Network-Based Analysis Reveals the Mechanism Underlying Vitamin D in Suppressing Cytokine Storm and Virus in SARS-CoV-2 Infection

A Network-Based Analysis Reveals the Mechanism Underlying Vitamin D in Suppressing Cytokine Storm and Virus in SARS-CoV-2 Infection

SARS-CoV-2 causes ongoing pandemic coronavirus disease of 2019 (COVID-19), infects the cells of the lower respiratory tract that leads to a cytokine storm in a…

www.ncbi.nlm.nih.gov

Quote from THHuxleynew

But what that comment shows is an emotional response to a medical intervention.

You again mix facts with emotion, that shows your bias as a spin doctor.

I know no other vaccine that requires boosters every six months. This is a kind of wellness therapy only. I protected my uncle (90) by giving him all the medication he did need in advance.

Quote from zorud

(double vaccinated with Morderna and still feel fine :-)).

I like that typo. Subliminal truth?

Mord - Wikipedia

Mord Urn ya

My wife reluctantly had her second Moderna shot on Saturday mid afternoon. She came home impressed with the young lady administering the vaccine, much better than the first experience.

However about six hours later she was starting to shiver. Soon she was fevered. Very hot to the touch. She doesn't think she slept at all that night, and I can attest to that. Her breathing all night was laboured, fast and shallow. Her head hurt. Her eyes hurt. Her ribs hurt. Her energy was gone. Finally, after a day an a half of convalescing and suffering, her fever broke, and her blankets were wet with sweat. Thankfully she had Monday off work so she could more fully recover. This is a lady who has never taken a day off work sick that I recall. I've never seen her so sick.

One of my kids, 19, still has swollen lymph nodes in his left armpit two weeks after getting jabbed.

I can see how this vaccine could take out those with an already compromised constitution. Even those in apparently good health are suffering the consequences of the Prick. Expect to hear of more and more accounts of people collapsing due to heart failure, or dying unexpectedly after a 'short illness'.

Canada has just announced it is recommending Pfizer rather than the Moderna vaccine to young adults 19 to 24 years of age. They've found that 1 in 5,000 in that age group have a diagnosis of pericarditis or myocarditis after their second dose, about 5 times higher than with the Pfizer vaccine.

Quote from Wyttenbach

I know no other vaccine that requires boosters every six months.

More emotional response. Why are you comparing different vaccines? Surely what matters is the risk/benefit trade-off from using what we have?

Also a Wyttenfact: Flu vaccines are similarly transient in effect or we would not need them each year.

Quote from Mark U

My wife reluctantly had her second Moderna shot on Saturday mid afternoon. She came home impressed with the young lady administering the vaccine, much better than the first experience.

However about six hours later she was starting to shiver. Soon she was fevered. Very hot to the touch. She doesn't think she slept at all that night, and I can attest to that. Her breathing all night was laboured, fast and shallow. Her head hurt. Her eyes hurt. Her ribs hurt. Her energy was gone. Finally, after a day an a half of convalescing and suffering, her fever broke, and her blankets were wet with sweat. Thankfully she had Monday off work so she could more fully recover. This is a lady who has never taken a day off work sick that I recall. I've never seen her so sick.

From what you say that record remains. Good on her.

I'm glad though that I did not have your summary around me when I last had a fever: all those symptoms I have suffered and they are typical, but somehow they seem so much worse when described by you.

You know, of course, that fever is a common and expected side effect of vaccination? The point being that 24 hours of fever is preferable to COVID.

Quote from THHuxleynew

No, we don't. 11th time. (but not a long explanation again).

You never did show your claimed huge correction for the age class 40..50- So you only prove your ability to spread FUD...

Quote from THHuxleynew

You know, of course, that fever is a common and expected side effect of vaccination? The point being that 24 hours of fever is preferable to COVID.

75% of all infected with CoV-19 do not even notice it. Why you prefer to have a cancer cure instead of an early treatment of cold like illness only shows that you have not even the slightest clue of health & medicine.

Quote from Mark U

One of my kids, 19, still has swollen lymph nodes in his left armpit two weeks after getting jabbed.

This is very odd. No healthy person age <30 ever die of CoV-19. Frequent Long-Covid among kids is just a fake invention of big pharma marketing. So I cannot understand why the younger want a jab just to get a new fake freedom that ends after 6 months.

People are just nuts I believe. Flu is much more deadly for most younger people!!

An interesting read on how Uttar Pradesh managed the Covid-19 situation, with a lot of information, links and comments...

India's Ivermectin Blackout - Part V: The Secret Revealed

On May 7, 2021, during the peak of India's Delta Surge, The World Health Organization reported, "Uttar Pradesh (is) going the last mile to stop COVID-19."

www.thedesertreview.com

Anyone child or adult of any sex or gender with a malfunctioning immune system will die from COVID infection. Full Stop...whatever else is there to say????