COVID-19 Monthly Update

The insidious SAR-CoV-2 virus continues to wreak havoc worldwide. However, vaccinations are beginning to bring down the number of new cases in the United States and Europe.

There are, however, disturbing hot spots, particularly in India and Brazil where the number of new cases are breaking records. In India, hospitals are at a point of turning people away. Bodies are piling up and crematoriums cannot keep up. Many communities have resorted to pyres and burning the bodies outdoors.

Thousands of Indian Americans are struggling to support their relatives who must endure a catastrophic surge in cases in India. There were more than 400,000 new cases in India on Saturday, May 1, 2021, a world high. On April 27, 2021, India reported its sixth consecutive day with more than 300,000 new COVID-19 cases. Furthermore, the official death toll of nearly 200,000 is likely an undercount. Indeed, according to Ashish Jha, M.D., MPH, Dean of Brown University School of Public Health said it was “clearly an underestimate…the best estimates [are] 10 times that [number].”

Infectious disease expert Anthony S. Fauci likened the situation to a “war” and advocated for a temporary nationwide lockdown. Ironically, India is a leading exporter of vaccines and has been unable to ship doses since mid-April, hindering the global push for coronavirus vaccinations.

The Australian government threatened to fine or imprison anyone who returns to Australia from India. Critics say the punishments are racist, but Australian Prime Minister Scott Morrison contended the motivation was “about health” in an interview on Australian radio. The United States ceased flights from India effective May 3, 2021.

Brazil is not faring much better. According to data from Brazil's National Civil Registry, 615,329 deaths were reported in the country between January 1 and April 30, 2021. Of that number, 208,370 were related to COVID-19, according to Brazil's health ministry which represent approximately 33.9% of the nation's total. However, the reliability of this information is questionable as it does not appear to correlate with Johns Hopkins University data as well as other sources. Certainly, the coronavirus has surged with a vengeance in Brazil recently, fueled in part by the appearance of variants, as well as disregard to social distancing and similar guidelines. According to Johns Hopkins University, the total number of deaths in Brazil is not far behind that of the United States. While the United States is seeing a decline in cases and deaths, Brazil is still seeing a higher numbers.

As reported by The Washington Post on or about May 4, 2021 more than 3,217,000 people have died worldwide since counting began in February 2020. The total number of cases worldwide, a figure likely underestimated, are at least 154 million. Notwithstanding India and Brazil, the worldwide number of cases appears to be plateauing based on the seven day average as reported by Johns Hopkins University.

According to The Washington Post, out of the more than 100 million people who have been fully vaccinated against the coronavirus in the United States, a small number have still contracted COVID-19. However, the data indicated that most did not experience symptoms associated with the virus. According to the Centers for Disease Control and Prevention (CDC), approximately 9,200 (0.0092%) became infected. But the data shows that most of them were fine with many not even experiencing symptoms. Of the foregoing figure, 835 were hospitalized and 132 died.

According to Anthony S. Fauci, the nation's top infectious disease expert, the breakthrough cases were not unusual. It is understood that vaccines by nature are not a guarantee. The number of hospitalizations and deaths due to breakthrough infections is a very small number when compared with the population that was vaccinated. In several of these breakthrough cases, Fauci said the patients who died were elderly. He explained with elderly patients, particularly those with underlying health issues, they may not exhibit a strong immune response to the vaccine.

Based on clinical trial results, the Pfizer and Moderna vaccines, which use mRNA technology, were approximately 95 percent effective at preventing COVID-19. The Johnson & Johnson viral vector based vaccine was 72 percent effective at preventing moderate illness and at least 85 percent effective at protecting against severe cases. Based on early data from US vaccinations, the results are similar in that there appears to be 90 percent protection among those who took both doses of the mRNA vaccines. The risk/benefit ratio clearly indicates the need for more vaccination in the United States and the World.

Indeed, the White House aims to have administered at least one shot to 70 percent of U.S. adults by July 4. The goals is to have 55 million more people fully vaccinated during that timeframe. The challenge continues to be persuading those who are hesitant to get the vaccine. The White House, public health charities and researchers are using polls and focus groups to find the messages that appear to elicit a positive response. The White House is now considering waiving patent rights to the manufacture of these vaccines to improve the manufacturing output and getting more of the product into the hands of countries that need it.

While this pandemic is not over, we are in a far better position than we would have been had the year been 1918. Modern medicine, advances in healthcare in general, physical hygiene, nutrition, etc. have played a monumental role in keeping the death toll lower than what might have been.