Here’s when vaccines will trigger global growth next year, says Goldman Sachs

 The world's advanced economies expect a vaccine to drop by mid December – that should also mean the start of the road to economic recovery in 2021, according to Goldman Sachs analysts.

Considering the data around immunisation timelines, some of which is uncertain, the analysts expect "widespread immunisation should drive a sharp pickup in global growth starting in Q2."

Analysts Daan Struyven and Sid Bhushan examined vaccine-related data to forecast the speed and challenges that large advanced economies – the UK, US, Canada, Japan, Australia and the European Union – might face when rolling out a vaccination programme. Their analysis considered global vaccine production, country vaccine supply, vaccine distribution capacity and country monthly vaccinations.

For both the US and Canada, vaccinations are expected to be initially scarce but supply should exceed demand by April.

The analysts say the UK is expected to vaccinate 50% of its population in March with the US and Canada following in April. They forecast that the EU, Japan, and Australia would reach this 50% threshold in May.

The US investment bank’s economic research, “Vaccinating the Population: A Timeline”, comes as doubts have surfaced surrounding one of the main vaccine candidates. The Oxford-AstraZeneca Covid-19 vaccine, which had announced on 23 November that under one of its dosing regimens it has a 90% efficacy rate, has faced heightened scrutiny after revelations that the half dose given during trials was a result of errors as well as the age groups of volunteers.

The UK government has asked the regulator, the Medicines and Healthcare products Regulatory Agency, to assess the vaccine for approval.

“The medium-run effects of the various vaccine candidates, their impact on transmission, vaccine supply, and especially vaccine demand remain quite uncertain and imply that risks are skewed to a later timeline,” the analysts noted in their November 26 note.

If two of the vaccines – AstraZenenca and Johnson & Johnson’s – do not succeed, vaccinations will be slower in Europe, a region that relies more on these developers, the analysts said.

https://www.fnlondon.com/articles/heres-when-vaccines-will-trigger-global-growth-next-year-says-goldman-sachs-20201130

Saving Lives of COVID-19 Patients by Using Existing Treatment Earlier

 The lives of patients hospitalized with COVID-19 are being saved by doctors who are using an existing medical treatment at an earlier stage.

Dr. Luigi Sedda of Lancaster University analyzed the results from the team at Wrightington, Wigan and Leigh Teaching Hospitals NHS Trust (WWL). Their research has now been published in the prestigious medical journal BMJ Respiratory Open.

He said: “We show that Continuous Positive Airway Pressure (CPAP) in the first days of hospitalization seems to save between 10% to 20% of patients. However, it is important to underline that this was a pilot study with a small sample size, although comforting evidence is starting to emerge elsewhere.”

According to NHS England, 96% of people who died with Covid had at least one serious health condition and the majority are over the age of 80.

The team led by Dr. Abdul Ashish used the CPAP machines on patients with COVID-19 admitted to the Royal Albert Edward Infirmary in Wigan.

In the case of patients with severe acute respiratory syndrome, COVID-19 may cause the lungs to swell and collapse. Using CPAP treatment, which is often used at home to help people with sleep problems, helps to keep the lungs open and makes breathing easier.

The research conducted by the team showed how CPAP treatment can be delivered effectively in a ward setting, with low resources both across the country and worldwide where intensive care bed availability is limited.

The research has so far helped almost a hundred patients at the Royal Albert Edward Infirmary.

Consultant Respiratory Physician Dr. Ashish said: “When you use CPAP early in the admission it stops the patient getting worse, therefore avoiding invasive ventilation techniques. As CPAP is readily available and can be used in a ward setting, we have demonstrated that, when used early, it can be very effective way of treating severe COVID-19 pneumonia.

“We are one of the early adopters of ward based CPAP in the North West and have developed local protocols and pathways by modifying our existing CPAP machines to deliver good outcomes for our patients.”

The researchers also found that the early use of CPAP potentially reduces lung damage during the worst of the COVID-19 infection and allows the patient to recover from the inflammatory effects. However, when used later, CPCP does not prevent lung damage thus leading to additional inflammation and a reduction in survival chances.

Dr. Martin Farrier, Associate Medical Director, said: “”We are at the forefront of developing care for COVID-19 patients and have developed a very effective treatment strategy for our population who develop lung failure following COVID-19 infection. The people of Wigan can be sure that they are going to get the best care at WWL because we have helped to develop the best care.”

He praised Dr. Luigi Sedda and his team at Lancaster University.

“This collaboration with Lancaster University has been remarkable and allowed us to deliver high quality research.

“The BMJ Respiratory Open is a very significant journal, but more than that, the results of the work are important in terms of our response to COVID-19 and for our organization. This is the most important publication on the use of CPAP in treating COVID-19 patients and shows a significant association with a fall in mortality. The way that we treat patients here in Wigan has been influential in the way that patients are now treated in other organizations.”

Reference: “CPAP management of COVID-19 respiratory failure: a first quantitative analysis from an inpatient service evaluation” by Abdul Ashish, Alison Unsworth, Jane Martindale, Ram Sundar, Kanishka Kavuri, Luigi Sedda and Martin Farrier, 4 November 2020, BMJ Open Respiratory Research.
DOI: 10.1136/bmjresp-2020-000692

https://scitechdaily.com/doctors-save-the-lives-of-covid-19-patients-by-using-existing-treatment-earlier/

Up to 30% in US may be infected with coronavirus by year-end: Gottlieb

 Dr. Scott Gottlieb told CNBC on Monday that nearly one-third of U.S. residents could ultimately be infected by the coronavirus at the end of 2020.

The significant level of prior infections is likely to have implications for transmission of the virus in 2021, when there is the potential for Covid-19 vaccines to be deployed across the country, according to the former Food and Drug Administration commissioner.

“We’re going to probably have by the end of this year, 30% of the U.S. population infected,” Gottlieb said on “Squawk Box.” The country has roughly 330 million people. “You look at states like North Dakota and South Dakota, it’s probably 30%, 35%. Maybe as high as 50%,” he added.

There are roughly 13.4 million confirmed coronavirus infections in America so far this year, according to data compiled by Johns Hopkins University. New daily U.S. cases recently reached single-day records around 200,000.

However, Gottlieb has stressed throughout the pandemic that the actual number of infections is likely higher than that because not everyone who contracts the virus is tested and ultimately diagnosed. In early November, for example, when the country’s daily cases were around 121,000, Gottlieb suggested the actual case number was much higher.

“We’re probably, at best, diagnosing 1 in 5 cases right now, maybe a little bit less than that, so this is at least half a million cases a day, probably more in terms of actual numbers of infection,” Gottlieb said Nov. 6.

The nation’s Covid-19 outbreak has intensified since those remarks. The U.S. seven-day average of new coronavirus cases is nearly 162,400, according to a CNBC analysis of Johns Hopkins data. While that’s down almost 5% compared with a week ago, inconsistent data reporting due to the Thanksgiving holiday makes the numbers challenging to interpret.

Nonetheless, Gottlieb said the scale of the coronavirus outbreak over the course of 2020 could help limit the spread of the virus early next year if vaccinations begin. Gottlieb is a board member of Pfizer, which was the first company to apply for emergency use authorization with the FDA for its Covid-19 vaccine. His remarks came before Moderna announced its intentions to apply for the same authorization Monday after it announced new data that confirmed its vaccine was more than 94% effective and safe.

“You combine a lot of infection around the country with vaccinating 20% of the population [and] you’re getting to levels where this virus is not going to circulate as readily, once you get to those levels of prior immunity,” Gottlieb said.

To get to so-called heard immunity, however, health experts estimate between 60% to 80% of a population must be vaccinated or have natural antibodies, allowing them to fight off the virus and significantly curtail its spread in a population. 

Earlier this month, Gottlieb urged Americans to take seriously coronavirus precautions around the holiday season, saying the country was facing “really one last surge of infection” and “I do believe 2021 is going to be better.” He added, “We have to get through the next two or three months, and so this is going to be, really, a temporary pain.”

https://www.cnbc.com/2020/11/30/dr-scott-gottlieb-30percent-of-us-may-get-covid-19-by-year-end.html

Dietary supplements during the COVID-19 pandemic: insights from 1.4M user study

  

View ORCID ProfilePanayiotis Louca,  View ORCID ProfileBenjamin Murray,  View ORCID ProfileKerstin Klaser,  View ORCID ProfileMark S Graham,  View ORCID ProfileMohsen Mazidi,  View ORCID ProfileEmily R Leeming,  View ORCID ProfileEllen J Thompson,  View ORCID ProfileRuth Bowyer,  View ORCID ProfileDavid Alden Drew,  View ORCID ProfileLong Alden Nguyen,  View ORCID ProfileJordi Merino,  View ORCID ProfileMaria F Gomez,  View ORCID ProfileOlatz Mompeo,  View ORCID ProfileRicardo Costeira,  View ORCID ProfileCarole H Sudre,  View ORCID ProfileRachel Gibson,  View ORCID ProfileClaire Steves,  View ORCID ProfileJonathan Wolf,  View ORCID ProfilePaul W Franks,  View ORCID ProfileSebastien Ourselin,  View ORCID ProfileAndrew T Chan,  View ORCID ProfileSarah E Berry,  View ORCID ProfileAna Valdes,  View ORCID ProfilePhilip Calder,  View ORCID ProfileTim D Spector,  View ORCID ProfileCristina Menni

doi: https://doi.org/10.1101/2020.11.27.20239087

This article is a preprint and has not been certified by peer review [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

PDF: https://www.medrxiv.org/content/10.1101/2020.11.27.20239087v1.full.pdf

Abstract

Objectives: Dietary supplements may provide nutrients of relevance to ameliorate SARS-CoV-2 infection, although scientific evidence to support a role is lacking. We investigate whether the regular use of dietary supplements can reduce the risk of testing positive for SARS-CoV-2 infection in around 1.4M users of the COVID Symptom Study App who completed a supplement use questionnaire. Design: Longitudinal app-based community survey and nested case control study. Setting: Subscribers to an app that was launched to enable self-reported information related to SARS-CoV-2 infection for use in the general population in three countries. Main Exposure: Self-reported regular dietary supplement usage since the beginning of the pandemic. Main Outcome Measures: SARS-CoV-2 infection confirmed by viral RNA polymerase chain reaction test (RT-PCR) or serology test. A secondary outcome was new-onset anosmia. Results: In an analysis including 327,720 UK participants, the use of probiotics, omega-3 fatty acids, multivitamins or vitamin D was associated with a lower risk of SARS-CoV-2 infection by 14%(95%CI: [8%,19%]), 12%(95%CI: [8%,16%]), 13%(95%CI: [10%,16%]) and 9%(95%CI: [6%,12%]), respectively, after adjusting for potential confounders. No effect was observed for vitamin C, zinc or garlic supplements. When analyses were stratified by sex, age and body mass index (BMI), the protective associations for probiotics, omega-3 fatty acids, multivitamins and vitamin D were observed in females across all ages and BMI groups, but were not seen in men. The same overall pattern of association was observed in both the US and Swedish cohorts. Results were further confirmed in a sub-analysis of 993,365 regular app users who were not tested for SARS-CoV-2 with cases (n= 126,556) defined as those with new onset anosmia (the strongest COVID-19 predictor). Conclusion: We observed a modest but significant association between use of probiotics, omega-3 fatty acid, multivitamin or vitamin D supplements and lower risk of testing positive for SARS-CoV-2 in women. No clear benefits for men were observed nor any effect of vitamin C, garlic or zinc for men or women. Randomised controlled trials of selected supplements would be required to confirm these observational findings before any therapeutic recommendations can be made.

Competing Interest Statement

TDS, AMV, ERL and SEB are consultants to Zoe Global Ltd (Zoe). JW is an employee of Zoe Global Limited. PCC has research funding from BASF AS and Bayer Consumer Care; is an advisor/consultant to BASF AS, DSM, Danone/Nutricia, Cargill, Smartfish, Nutrileads, Bayer Consumer Care, and Pfizer (now GSK) Consumer Healthcare; and has received travel reimbursement/speaking fees from Danone, Fresenius Kabi, Pfizer (now GSK) Consumer Healthcare, Smartfish, Biogredia and the California Walnut Commission. ATC has received consulting fees from Bayer Pharma AG, Pfizer, Inc. and Boehringer Ingelheim. Other authors have no conflict of interest to declare.

Funding Statement

This work was supported by Zoe Global Limited. The Dept of Twin Research receives grant support from the Wellcome Trust (212904/Z/18/Z) and the Medical Research Council (MRC)/British Heart Foundation Ancestry and Biological Informative Markers for Stratification of Hypertension (AIMHY; MR/M016560/1), European Union, Chronic Disease Research Foundation (CDRF), Zoe Global Ltd, NIH and the National Institute for Health Research (NIHR)-funded BioResource, Clinical Research Facility and Biomedical Research Centre based at Guys and St Thomas NHS Foundation Trust in partnership with Kings College London. PL is funded by the Chronic Disease Research Foundation; AMV is supported by the National Institute for Health Research Nottingham Biomedical Research Centre. CHS is an Alzheimers Society Junior Fellowship AS-JF-17-011; SO is funded by the Wellcome/EPSRC Centre for Medical Engineering (WT203148/Z/16/Z), Wellcome Flagship Programme (WT213038/Z/18/Z). ATC is the Stuart and Suzanne Steele MGH Research Scholar and is a Team Leader for the Stand Up to Cancer Foundation. ATC, LHN, JAM, and DAD are supported by the Massachusetts Consortium on Pathogen Readiness (MassCPR). CM is funded by the Chronic Disease Research Foundation and by the MRC Aim-Hy project grant. PCC is supported by the National Institute for Health Research Southampton Biomedical Research Centre. MSG is supported by the Wellcome Flagship Programme (WT213038/Z/18/Z). MSG is supported by the Wellcome Flagship Programme (WT213038/Z/18/Z). MFG and PWF receive support from the Swedish Research Council, Swedish Heart-Lung Foundation and the Swedish Foundation for Strategic Research (LUDC-IRC 15-0067).MSG is supported by the Wellcome Flagship Programme (WT213038/Z/18/Z). MFG and PWF receive support from the Swedish Research Council, Swedish Heart-Lung Foundation and the Swedish Foundation for Strategic Research (LUDC-IRC 15-0067).

https://www.medrxiv.org/content/10.1101/2020.11.27.20239087v1