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Omicron: England must act before Christmas to limit hospitalisations and deaths



People queue for vaccinations at St Thomas’ Hospital in London

Dan Kitwood/Getty Images

The world is facing a surge in hospitalisations and deaths from the omicron variant of the coronavirus that could be as bad as in previous waves. That is even if omicron is only a third as severe as the delta variant and so far, data from England doesn’t suggest it is any less severe, according to a team at Imperial College London.

What’s more, countries are fast running out of time to do anything to limit the impact. The UK is in a better position than most countries because it has already rolled out vaccine boosters to older people, but has less time left to act, says team member Neil Ferguson.

“Time is of the essence,” says Ferguson. “I think if we are going to have to make additional decisions, they probably will need to be made within the next week or two to have a substantial impact.”

“The key message coming from this is: countries need to prepare,” says team member Azra Ghani. That means rolling out boosters as fast as possible and implementing additional measures such as mask wearing and social distancing, she says.

Independent SAGE, a self-appointed group of experts that provides covid-19 advice aimed at the UK government, says a “circuit-breaker” should be implemented throughout the UK immediately to prevent omicron from spiralling out of control. It is calling for indoor hospitality to shut, no indoor gatherings between households, no outdoor gatherings of more than six people and a return to 10-day isolation for people who have come into close contact with cases. But the UK government has said that no further measures would be introduced.

The Imperial team used data from the UK and from lab studies to estimate how much less protection people have against omicron than delta, in terms of preventing infection, severe disease requiring hospitalisation and death.

There are many uncertainties, but the team concludes that people who had two vaccine doses or past infections have lost almost all protection against infection and a substantial amount of protection against severe disease and death.

Providing booster shots will therefore be vital, but that alone may not be enough, says Ghani. The team estimates that 60 days after having a Pfizer booster, protection against severe disease could be as low as 80 per cent for omicron, compared with 95 per cent with delta.

“With omicron and the reduced vaccine efficacy we are seeing, it’s very likely that most places will need booster doses,” she says. “But even with these in place, we could still see peaks [in deaths] that match previous peaks [of the pandemic].”

Despite this troubling data, we aren’t back to square one on vaccine coverage, says Danny Altmann at Imperial College London and Independent SAGE.

“[With just] two vaccine doses you’re really extremely susceptible,” he says. However, “I think for most people most of the time, a boost gets you into the protective zone, so we’re in danger, but not back to square one”.

Christina Pagel at University College London and Independent SAGE agrees. “Two doses of vaccine, whether AstraZeneca or Pfizer, do little to prevent omicron infection. A booster does help, it’s a lot better than two doses, but it’s still not as good as a booster would have been for delta. However, vaccines should still help significantly against severe disease.”

However, vaccine coverage is still quite low, says Pagel. London, which is the UK’s omicron hotspot, has the highest proportion of unvaccinated people (31 per cent) and the lowest proportion of boosted people (27 per cent) in England. And no part of the UK has over 50 per cent of people boosted, she says.

In separate research, an international team tested the effectiveness of six vaccines against omicron. It found that all of them – Pfizer, Moderna, AstraZeneca, Sinopharm, Johnson & Johnson and Sputnik – produced fewer antibodies against omicron than against the original coronavirus, and the latter three produced hardly any. The research has yet to be peer-reviewed.

The team says that UK figures so far don’t suggest the risk of becoming severely ill is any lower with omicron than with delta. However, this means the risk to people with no immunity, Ferguson made clear. Because most people do now have immunity, the proportion requiring hospitalisation should be lower than in previous waves, but this is factored into the modelling.

“People should not be complacent,” he says. “If you have enough cases per day, the resulting number of hospitalisations, we think, can still pose potentially major challenges for any health system.”

Reference: Report 48 from the MRC Centre for Global Infectious Disease Analysis

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Solar storms may cause up to 5500 heart-related deaths in a given year



In an approximate 11-year cycle, the sun blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field, which may disrupt our body clock and ultimately affect our heart


17 June 2022

A solar storm

Jurik Peter/Shutterstock

Solar storms that disrupt Earth’s magnetic field may cause up to 5500 heart-related deaths in the US in a given year.

The sun goes through cycles of high and low activity that repeat approximately every 11 years. During periods of high activity, it blasts out charged particles and magnetised plasma that can distort Earth’s magnetic field.

These so-called solar storms can cause glitches in our power grids and bring down Earth-orbiting satellites. A handful of studies have also hinted that they increase the risk of …

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UK Covid infection rate rising, with more than a million cases in England | Coronavirus



Coronavirus infections are rising in the UK, figures have revealed, with experts noting the increase is probably down to the more transmissible BA.4 and BA.5 Omicron variants.

The figures from the Office for National Statistics (ONS), based on swabs collected from randomly selected households, reveal that in the week ending 11 June an estimated one in 50 people in the community in England are thought to have had Covid – around 1.13 million people.

The figure is even higher, at one in 45, in both Wales and Northern Ireland, while it was highest in Scotland where, in the week ending 10 June, one in 30 people are thought to have been infected.

While the figures remain below the peak levels of infection seen earlier this year, when around one in 13 people in England had Covid, the findings are a rise on the previous week where one in 70 people in England were thought to be infected. Furthermore, the data reveals increases in all regions of England, except the north-east, and across all age groups.

Experts say that a key factor in the increase is probably the rise of the Covid variants of concern BA.4 and BA.5.

“Infections have increased across all four UK nations, driven by rising numbers of people infected with the BA.4 and BA.5 Omicron variants,” said Kara Steel, senior statistician for the Covid-19 Infection Survey.

While Steel said it remained too early to say if this was the start of another wave, others have warned it may already have begun, with increased mixing and travelling among other factors fuelling a rise in cases.

Among concerns scientists have raised are that BA.4, BA.5 and another variant on the rise, BA.2.12.1, replicate more efficiently in human lung cells than BA.2.

Prof Azra Ghani, an epidemiologist at Imperial College London, said the latest figures were not surprising, and might rise further.

“This increase in infection prevalence is likely due to the growth of the BA.4 and BA.5 Omicron subvariants, which as we have seen elsewhere in Europe, appear to be able to escape immunity generated from previous Omicron subvariants,” she said.

“It is therefore possible that we will continue to see some growth in infection prevalence in the coming weeks and consequently an increase in hospitalisations, although these subvariants do not currently appear to result in any significantly changed severity profile. This does however serve as a reminder that the Covid-19 pandemic is not over.”

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NHS to offer women in England drug that cuts recurrence of breast cancer | Breast cancer



Thousands of women in England with breast cancer are to benefit from a new pill on the NHS which reduces the risk of the disease coming back.

The National Institute for Health and Care Excellence (Nice) has given the green light to abemaciclib, which cuts the chance of breast cancer returning after a patient has had surgery to remove a tumour.

Trials showed that patients who had the drug with hormone therapy had a more than 30% improved chance of their cancer not coming back after surgery, compared with hormone therapy alone.

“It’s fantastic thousands of women with this type of primary breast cancer will now have an additional treatment option available on the NHS to help further reduce the risk of the disease coming back,” said Delyth Morgan, the chief executive of charity Breast Cancer Now.

“The fear of breast cancer returning or spreading to other parts of their body and becoming incurable can cause considerable anxiety for so many women and their loved ones.

“New effective treatments such as abemaciclib, which can offer more women the chance to further reduce the risk of the disease recurring, are therefore extremely welcome and this is an important step change in the drug options available for this group of patients.”

The twice-a-day pill is suitable for women with hormone receptor-positive, HER2-negative, node-positive early breast cancer at high risk of recurrence who have had surgery. About 4,000 women will benefit initially, Nice said.

Helen Knight, the interim director of medicines evaluation at Nice, said the draft recommendation came less than a month after abemaciclib received its licence.

“The fact that we have been able to produce draft recommendations so quickly is testament to the success of our ambition to support patient access to clinically and cost effective treatments as early as possible,” said Knight. “Until now there have been no targeted treatments for people with this type of breast cancer.

“Abemaciclib with hormone therapy represents a significant improvement in how it is treated because being able to have a targeted treatment earlier after surgery will increase the chance of curing the disease and reduce the likelihood of developing incurable advanced disease.”

Abemaciclib works by targeting and inhibiting proteins in cancer cells which allow the cancer to divide and grow. It normally costs £2,950 for a packet of 56 150mg-tablets, but the manufacturer, Eli Lilly, has agreed an undisclosed discounted price for NHS England.

“Thanks in part to this latest deal struck by NHS England, NHS patients will be able to access another new targeted drug for a common and aggressive form of breast cancer,” said Prof Peter Johnson, the cancer director of NHS England.

“Abemaciclib, when used alongside a hormone therapy, offers a new, doubly targeted, treatment option, helping to increase the chances of beating the cancer for good, as well as meeting the NHS’s commitment to delivering improved cancer care under our long-term plan.”

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