Vol.17 (2020/12/25) Latest trends in Japan / Elderly clusters / Latest vaccine trends (Pfizer-Moderna, Japan) / Mutation of the virus that emerged in the UK / Children's drawings of the coronavirus and more

[1] About antibody-positive patients at our clinic

At our clinic, we are conducting tests on people who do not have symptoms such as fever or cough (nor have they had any within the past two weeks), and the positive rate for coronavirus antibodies from November 2th to December 11th was 15% (12/14).
I'm curious to see what the positivity rate will be over the next month.

(Figure 1) Trends in antibody testing at our clinic

[2] Trends in infections in Japan

As you may have heard in the news, the current situation in Japan is that the number of cases is increasing rapidly. It is necessary to be especially careful around the New Year period.

(Figure 2) Number of positive cases

(Figure 3) Number of people requiring hospitalization

(Figure 4) Number of deaths (cumulative)

(Figure 5) Number of seriously ill patients

Source: Ministry of Health, Labor and Welfare, "What we can learn from data - COVID-2020 information" as of December 12, 24
https://covid19.mhlw.go.jp/

[3] Increase in mortality rate due to elderly clusters

Clusters of infections among the elderly increase the death rate. Iwate Prefecture, which should have a low number of infected people, has the highest death rate.

[Iwate] Mortality rate of 5.37%, the worst in the country, 18 deaths: Many hospital clusters
On the 20th, the prefecture and Morioka City announced that two people infected with the new coronavirus have died and five new cases have been confirmed. The total number of deaths in the prefecture is now 18, and the number of infected people is 335. The death rate for infected people is 5.37%, which is the highest among all prefectures as of 8:00 p.m. on the 20th, according to a summary by the Yomiuri Shimbun.
　The high death rate is due to the successive outbreaks of clusters of infections in hospitals frequented by elderly people. The next highest death rate is in Toyama Prefecture, at 5.26% (26 cases). The second highest in Tohoku is Aomori Prefecture, at 1.54% (6 cases). Tokyo is at 1.10% (566 cases).
The two deaths in the prefecture announced on the 20th were both elderly people over 65 years old and had underlying health conditions. The prefecture's Medical Policy Office said, "If the virus enters a medical institution where there are many elderly people and people with underlying health conditions, it will become a very serious situation. We would like young people in particular to be conscious of not bringing the virus into the country."

Source: Yomiuri Shimbun, Monday, December 2020, 12, "COVID-21 'death rate' is XNUMX%, Iwate Prefecture has the highest rate in the country"
https://www.yomiuri.co.jp/national/20201221-OYT1T50088/

[4] Latest vaccine trends 1: Pfizer, Moderna

The Pfizer and Moderna vaccines have begun to be used.

According to information from the FDA, as shown in the two figures below (graphs of the number of infected people after vaccination), both vaccines caused infections in people who received the vaccine for the first two weeks (the period until antibodies are produced after vaccination), but after two weeks, there were almost no new infections. In other words, this is a vaccine with unprecedented effectiveness.

Pfizer

The red increasing line is a placebo (an injection that is not a vaccine), and the blue non-increasing line is the real vaccine.

(Figure 6) Cumulative incidence curve of COVID-19 outbreak (Pfizer)

Source: Emergency Use Authorization for Pfizer-BioNTech COVID-19 Vaccine Review Memo (fda.gov)
https://www.fda.gov/media/144416/download

●Moderna

This is the opposite of Figure 6; the blue, increasing line is a placebo (an injection that is not a vaccine), and the red, non-increasing line is the real vaccine.

(Figure 7) Cumulative incidence curve of COVID-19 outbreak (Moderna)

Source: Vaccines and Related Biological Products Advisory Committee December 17, 2020 Meeting Briefing Document – ​​FDA
https://www.fda.gov/media/144434/download

[2] Latest vaccine trends XNUMX: Side effects of vaccines

There have been reports of severe anaphylactic shock in several people after receiving the Pfizer vaccine.
Anaphylactic reactions are known to occur, including to influenza vaccines. For this reason, the medical questionnaire always includes a section asking about past allergic reactions.
Generally speaking, people who have had severe allergic reactions in the past may be advised to refrain from getting the vaccine.

The Pfizer vaccine website above lists the frequency of serious side effects that occurred during clinical trials (ranging from redness, fever, pain, swelling to neurological findings).
Ages 16 to 55: vaccine 0.4% placebo 0.3%
   Age 56 and older: vaccine 0.8% placebo 0.6%
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[3] Latest vaccine trends XNUMX: When will they arrive in Japan?

Quoting NHK News.
Vaccinations may begin among medical staff at hospitals dealing with the coronavirus outbreak sometime in February.

(Figure 8) Approval Schedule Expected (NHK)

Source: NHK News, December 2020, 12 "Pfizer Coronavirus Vaccine Approval Application in Japan, Decision as early as February"
https://www3.nhk.or.jp/news/html/20201218/k10012770781000.html

●A predicted timetable for global vaccination and achieving herd immunity has been released.

As shown below, the United States and the United Kingdom are predicted to achieve herd immunity by mid-2021.
In Japan, it will be around April 2022.

(Figure 9) Timeline forecast for achieving herd immunity (airfinity)

Source: Airfinity: Snapshot COVID-19 data
https://www.ifpma.org/wp-content/uploads/2020/12/Airfinity_Slides_Final.pdf

[7] A mutated virus has emerged in the UK.

Originally, coronaviruses mutate once within a month, so this is not surprising. This mutated virus has been increasing in the UK since September, and it has recently increased by more than two-thirds. (Orange)

(Figure 10) Proportion of mutant viruses

Source: https://twitter.com/The_Soup_Dragon/status/1340349639946629120/photo/1

On the official website conducting a survey across the UK, the group at the top of the graph, which has been detected rapidly since September, represents this new mutant virus.

(Figure 11) Differences between the mutated virus discovered in the UK and viruses previously discovered around the world

Source: Preliminary genomic characterization of an emergent SARS-CoV-2 lineage in the UK defined by a novel set of spike mutations – SARS-CoV-2 coronavirus / nCoV-2019 Genomic Epidemiology – Virological
https://virological.org/t/preliminary-genomic-characterisation-of-an-emergent-sars-cov-2-lineage-in-the-uk-defined-by-a-novel-set-of-spike-mutations/563

The paper published on December 12th explains the matter as follows:

Sharon Peacock, director of COG-UK, told a Science Media Centre press conference: "We expect mutations to occur - this is a natural part of virus evolution. Thousands of mutations have already occurred but none have been found that have significantly changed the properties of the virus. However, this is important in order to quickly understand which variants are involved when new outbreaks occur."

Is this variant more dangerous than previous versions of the virus?

"We don't know that yet. There is no need to assume that an increase in infectivity necessarily means that the virus is more virulent. Numerous mutant strains have already been discovered in the UK, and the D614G mutant strain, for example, is thought to be more contagious, and in fact most of the COVID-XNUMX strains currently circulating in the UK are of this type. However, it is not thought to be more virulent than the initial strains."

Will the vaccine be effective against this mutated virus?

"This strain has mutated the spike protein that is targeted by the three previously approved vaccines.
However, these vaccines have the ability to produce antibodies that react to various parts of the spike protein, so it is unlikely that a single mutation will reduce the effectiveness of the vaccine.

If more mutations occur in the future, vaccine design may need to be revised. Such mutations are common in seasonal influenza every year."
"The new coronavirus does not mutate as quickly as the influenza virus. The vaccines that have been shown to be effective against the new coronavirus in this trial are designed to easily adapt to such mutations."

Source: The BMJ: Covid-19: New coronavirus variant is identified in UK
https://www.bmj.com/content/371/bmj.m4857
*Source of information for this and the next section: Dr. Michiyuki Matsuzaki, Dohoku Kinikyo Asahikawakita Hospital

[8] Christmas: Children's drawings of the coronavirus

This year, as a measure against infectious diseases, there was a period when children around the world were not able to attend school. After discussing with psychiatrists and psychologists, French pediatricians asked children to draw pictures of the coronavirus.

"Their drawings followed the same imagery of the virus that has been reported countless times before: round, mushroom-shaped, colorful, single or multiple, smiling, sad, but rarely sinister, although one depicted a goddess-like figure with snake-head hair."
The children's drawings are brilliant.

(Picture) 20 children drew their own images of the coronavirus without looking at anything.

Source: The BMJ: To each child their own coronavirus.
https://www.bmj.com/content/371/bmj.m4578