welcome back if you've watched the first
video on the update and the situation in
the
uk in the united states that's good and
this kind of helps put it into context a
bit because what we're looking at here
is the spread of the new variant
the n501 variant that we are concerned
about
but coming up on the good news side
we've got the vaccination program which
i'm
i'm expecting to kick in quite big time
quite soon i'm going to tell you more
about that
but in the meantime we've got to carry
on with the hands face space ventilate
and we have to recognize if we are
getting sick
from covid19 so we can isolate or advise
others to do so so i'm going to look at
some
symptoms of what we can really call the
coverage syndrome because this condition
can present in so many ways
and we want to be able to recognize all
of them so we can get tested and
self-isolate till we're tested
so some more symptoms from the coverage
symptom tracker app to look at
just to make sure we're familiar with
all the symptoms and again very
important for ourselves our family
but also for advising friends and those
around us we need this
high index of suspicion for sars
coronavirus 2 infection calling covered
19 disease
now just to start us off with this um
2012 this is the n501 uh sorry
the n 501
y mutation so it's the 501st proportion
of the amino 500 first amino acid in the
protein sequence
of the spike protein and the n form of
the amino acid
has been converted to the y form of the
amino acid so in the new
mutant in the new strain whatever you
want to call it
the the n is no longer present and the
501 position is occupied by the y
form amino acid that's what this means
now
i think i'm going to give you some what
i consider to be good news first of all
so so there's hundreds of amino acids
forming these polypeptides these
these small protein units that form this
spike protein
now the the n501 and the other mutations
in the virus
are probably only accounting for about
one percent of the proteins in the virus
and the antibodies
are made to the antigens the
t cells are are stimulated in response
to the antigen
and of course the antigen is the
totality of the proteome the proteins
that make up the virus
so if these mutations are making up
about one percent
of the virus now that means that 99 of
the virus is just the same as the old
one
and of course the antibodies are made up
to all of the proteins that comprise the
antigen
which is the virus so i am confident
and other scientists have read well
serious scientists
people that designed the vaccine who
actually know this in great detail
are confident that the the antibodies
and the
the uh sensitized uh cellular immunity
that has been generated by the uh the
old forms of the sars corona virus too
and indeed the vaccines will still be
able to recognize this new
form because 99 of the virus is the same
that's the key thing to grasp
so at the moment i'm not worried about
people who have previously been infected
being re-infected it can happen but i
don't expect them to get sick in the
vast majority of cases
and i'm not worried about the vaccine
working with the with the uk
501y n501y mutation
now for the south africa mutation which
is a different
independent evolutionary origin and a
different lineage but with a very
similar mutation pattern
at least the 501 is the same mutation
pattern
we know less about that i'm really
hoping that can be uh isolated
as we believe the mink mutation was
isolated in denmark
so that is quite concerning and i do
believe it's already spread in africa
but i'm not going to speculate because
we simply don't have the data
so here we're talking about the one that
i wrote what we could call the kent
mutation the one that
arose in kent now denmark
is the country in the world with the
highest
per capita uh genomic sequencing
so the uk does 45 of the world genomic
sequencing altogether
but denmark does the highest per capita
and denmark's identified 33 cases now i
do not believe its coincidence
that denmark having the highest level of
genomic surveillance has got the highest
number of cases
that the uk with the highest genomics
surveillance got the highest number of
cases
this is just too much of a coincidence i
believe that these countries are
identifying it
because it's being tested we're testing
more we believe this mutation
may be a rose in kent we don't know for
sure it could have come from somewhere
else
the epidemiological spread out from kent
does seem to be consistent
with the viral with a viral mutation
originating there
but we don't know for sure um
but denmark 33 cases of the new variant
what we're calling the 2012
variant been in denmark so it's spread
to there
as far as we know these are all being
isolated well obviously the ones that
have been identified are isolating
the question is how many are there that
have not been identified
the question is is community spread
already taking place
in denmark of the new mutation because
because if it is that this new lineage
we know that it out competes the older
forms of the virus and becomes the
the most common form of the virus it
basically becomes the pandemic
it replaces the old forms and we know
it's now more transmissible
so that would be a concern so we don't
really know is the answer
but we do know that 33 cases have been
identified
found between november the 14th and
december the 14th in four danish
locations now
this is four locations in denmark in
very different parts of the
country so given that it's been
identified in four
different geographical locations in
denmark
it wouldn't be surprising if it was in
the locations between
the specific locations where it has been
identified
it does indicate to me that it's already
spreading
in denmark and we we know that in the
past
month or two there's been an absolute
spike of cases
in denmark still going up in fact
dramatic increases in denmark could this
be part of the driver of that
insufficient data to tell but it is a
risk
um germany picks up a case from the uk
at frankfurt airport obviously being
isolated
so germany has identified one case even
in germany the genomic surveillance
robert institute and such people
nothing like as good as in denmark or
in the uk surprisingly i'm surprised
german is not
doing more sequencing but there you go
it's not
so that's the first known case in german
it won't confirm case in singapore
because we will insist in flying around
the world
france there's one confirmed case that's
from the uk
but as well as the one confirmed case in
france the uh
the the louis pasteur institute in paris
is examining
several other cases and i'm expecting
more cases to be diagnosed today
japan has had five cases um
all from the uk all identified for
travelers from the uk hopefully the
japanese authorities can
arrest that and we know there's been at
least one case in spain
with no further information available on
that at the moment
so um has this spread all around we
don't have the genomic data to answer
that yet
i'm hopeful that it hasn't and i'm
hopeful that it can be
contained because it's going to make the
containment measures
with this when this new variant becomes
the prevalent form
the containment measures that were
containing the virus no longer contain
it
we need more containment measures to
contain this more uh
it's not a more virulent form it doesn't
seem to be making people sicker but it
is spreading
a lot quicker and also the other
downside of this and
the reason it's concerning well another
several reasons it's concerning but
herd immunity is probably going to go
from 65 to 70 percent
with the old variety and we're probably
going to need 80
herd immunity to stop community
transmission of this
new strain of the vice because it's more
transmissible
so that's a concern no more news to
bring you on on the south africa variant
which is even more concerning than this
one
really hopeful it's being contained in
south africa really hopeful it's been
contained in south africa
and more travel restrictions are being
implemented now although there have been
flights
as we looked at a couple of days ago
the flights were only stopped to the uk
literally
two days ago i think the last one
arrived on the morning of the 23rd or
the 24th of december
so unfortunately there's been plenty of
time to spread the new
variant around the world let's hope it
hasn't happened
because there is some indications from
the south african authorities that the
south african
new variant does cause more severe
disease in younger people which would be
a bit of a worst case scenario really
but but no more speculation because we
simply don't know
we're keeping a close eye on it of
course
now better news global vaccination
progress
now the uk is only giving the fisa
vaccine at the moment
uh over half a million in england 56 000
in scotland
22 000 in wales 16 000 in northern
ireland so we made a start
and this data is more than this is this
is just this is the 24th of december
data i think
so well over 600 thousand so we've made
a good start
now the problem with the pfizer vaccine
as far as the united kingdom is
concerned is we're gonna run out in
january
and we're not gonna get new supplies
till march so um
good start but uh we'll look at what's
going to plug that gap in
or we hope it's going to plug that gap
in a minute but
um if if we're relying on the fisa
vaccine for the uk we're going to
vaccinate till january
and then all throughout the end of
january all throughout february and into
the beginning of march we won't be doing
any vaccines at all because we've run
out of the fires of supplies
um but let's come to the good news on
the oxford vaccine
in due time the united states giving out
pfizer and modern a vaccine
as of the 14th of december sorry from
the 14th of december
up until the 24th of december i think
this data goes to
uh well over well one quarter million
people have been vaccinated with the
first
dose good number of course
well over a million people vaccinated
but
that represents 0.39 percent of the
population of the united states
you see this herculean task we have
ahead of us it's a great start it's
fantastic
but it is only a start
we've got a good few months before any
significant herd immunity is going to
come along
wonderful that we're protecting
individuals wonderful that we're
protecting healthcare providers who are
not going to now spread it to their
patients we believe
we don't know that for sure but there's
good evidence to suggest that that is
more likely to be the case logically it
makes sense
do we have the trial data to prove that
it's going to prevent transmission no we
don't
but logically it makes a lot of sense
that it will
so very good stuff but a long way to go
now canada um data from canada
uh pfizer and modern vaccine both being
given out from the 24th
of december now um
i've got this little graphic here of the
situation in canada
of of of how we're going now this was as
of the 24th of december
so we see british columbia just over 5
000
prairie states you can see the numbers
alberto saskatchewan
um i think that was that manitoba i
think that's
ontario quebec and we can see the
numbers um
so uh i guess that's nova scotia i guess
that's
uh prince edward island anyway
you've got the numbers um they've made a
good start
um across the southern states of canada
so that's encouraging and of course
canada has approved the pfizer
and the moderna vaccine and uh canada's
uh got enough supplies
of the fisa and madonna vaccine to
vaccinate
pretty well the the whole population so
um
and given that they've got good supplies
of both of those vaccines which in the
uk in the uk we're not getting the
modern a vaccine till march
so there's been no rush to approve it
really um
i think the regulators are flat out on
the oxford vaccine
so i'm not expecting to hear approval
for the moderna vaccine in the uk for
some weeks
but we're not getting it till march
anyway so it doesn't matter for the uk
but
great to see it's going out in the
united states and canada
so um good start two
to two weapons now in in the repertoire
which is
is really good news really really good
news
this is the beginning of the end but
it's going to be one heck of an end
because we've got
december january february march to get
through as as we've said so many times
mexico um population 126 million
now this kind of illustrates the problem
in lower middle income countries
mexico i guess is a middle income lower
lower income country
now they've got an additional dose of
125 000 doses of the fisa vaccine
and it's come from belgium
so they are not
getting the vaccine that's manufactured
in the united states this has come from
belgium and it's great to see that
pfizer vaccination
is beginning in mexico but 125 000 doses
for 126 million people it's
it's wonderful for the individuals
concerned but it's
it's it's barely even a start barely
even a start
it is somewhat tokenistic to be quite
honest but i'm glad it's happening i'm
not mocking it
so first jabs are on the 29th uh 26
today three days time
total fisa order is seven million but
when they're getting these is by no
means clear
um it's not clear at all
all healthcare workers are hoping to
vaccinate in there in mexico by
2021 for the first quarter so by about
what march april
so they must believe they're getting
supplies of vaccine from somewhere
um now mexico has agreed to buy 35
million doses from um
the the sinovac one the um the kansano
chinese vaccine and it's currently being
tested on 6 000
mexican volunteers which of course is is
excellent
um that's good
but it's not yet approved in mexico it's
important to
add and it's looking like now we don't
know
it's looking like the sinovac chinese
vaccine
has a relatively low efficacy
it's looking like it's a relatively low
efficacy about 50 percent
now we don't know that yet because the
data is not published
the efficacy data was scheduled to be
published for earlier in december
but it has not been published or it has
i certainly can't find it
so this trial ongoing in the mexican
situation is good
but from what we know and this is just
from basically leaks from press reports
the efficacy of the chinese vaccine
seems to be 50 now giving out a vaccine
that's 50
efficacious is absolutely worth doing
but it is looking lower than the other
ones
so very limited supply of uh
fires of vaccines in mexico at the
moment as an example of course
other other countries have no no no
physical vaccine at all or modern
vaccine at
all this this is the problem um
global distribution and uh people being
prepared to pay for it is going to be
the problem
but the oxford astrozenica vaccine
uh will offer 77 million doses to mexico
now that
is a difference
so if we believe they're getting seven
million total in pfizer but we don't
know when
but we do know they're getting uh 10
times that
of oxford astrozenica vaccine
and not only that the oxford astrozenica
vaccine is going to be produced in
mexico
for distribution to mexico and brazil
and other areas of south america
not only that the oxford astrazeneca
people
in an act of great humanity have agreed
to do this
in a non-profit basis for the duration
of the pandemic
that is a very very moving gesture from
the university of oxford
and from the astrazeneca uh foundation
and that 77 million could save
many many lives in in mexico so
um great that they've done that
more news on that in a minute it's good
it's the news is good
i'm not trying to make you to wait to
the end of the video i'll break now and
give you the bottom line on the on the
astrazeneca oxford vaccine
i'm expecting it to be approved in the
uk in fact i'm
pretty certain it's going to be improved
in the uk approved in the uk
on the 28th or the 29th of december
from from taking uh advice from quite a
lot of people that looks like it's the
case
and and once it's approved in the united
kingdom i would expect mexico to approve
it really quite quickly
therefore i would expect to take mexico
and brazil as examples
that the oxford vaccine will be given to
several million people in those
countries in january
this is the big hope for these
uh countries and as well as that we know
that the i mean you know if you're
transporting vaccines to
mexico and brazil and you've got to
maintain a minor 70 cold chain whereas
the astrazeneca
vaccine is transported at fridge
temperatures there's no there's no
no contest in terms of logistics the
logistics of the
the oxford vaccine is so so much easier
it's logistics we've been doing for
years and years and years that we know
well
chile costa rica also began
administration of the fires of bioentech
but again as far as we know small
amounts
now argentina's interesting um
i suspect they'll be changing to the
oxford astrozenica vaccine when they can
um and unless the sputnik
vaccine turns out to be brilliant we
we're not really sure yet
but the sputnik 5 has been chosen by
argentina in its initial phase
and it's been flown directly from moscow
so interesting vaccines
flying directly from moscow to
argentina and i suspect you political
people that are listening are
your ears are probably picking up even
more than the normal at that
um as far as this channel is concerned
it's good if the vaccine has efficacy
and is safe because it means the people
will start getting vaccinated
wish we knew more about it so the
argentinian authorities though appear to
be happy so that they've given emergency
authorization which is great news
and the the next few days 300 000 doses
is arriving are arriving from moscow
so 300 000 doses arriving from
moscow as of today i would think from
about now
and the president of argentina is to
receive his vaccination
publicly which is excellent always great
to see
political leaders leading by example
uh just one other country maybe look at
but brazil
due to start vaccinating mid-february
pretty late
now i'm optimistic they could get some
i'm optimistic they could get some
oxford vaccine before that if it's
produced in brazil and mexico
so i'm hopeful they'll get it before
that
president bolsonaro is not planning to
get a jab because he believes he has
immunity already
now on this channel we haven't agreed
with everything president bolsonaro has
said
but i given that he's had the infection
i do believe he will be immune
so you could argue it would be a waste
of a vaccine to give him one
uh but there again the the the
leadership and
the the um the gesture of receiving the
public vaccine would be
would be the vaccine publicly would be
would be high
as most politicians around the world are
doing or planning to do we're going to
see a complete uh stream of
politicians elbowing to get
public vaccination first i'm sure
and that's a good thing very good thing
germany france italy starting their
vaccination programs
tomorrow 27th of december
had it not been for the pressure on the
european veterans agency they wouldn't
even be meeting till the 29th
but they met on the 21st and now
individual member states are starting to
authorize it
so germany france italy if they're not
starting tomorrow it will be the day
after
literally tomorrow or the day after
so the european vaccine with pfizer has
started they haven't approved the
moderna they have not approved the
oxford let's hope they are more
proactive than they were with the
fisa vaccine because they've got 300
million doses of the oxford astrozenica
vaccine
booked and that is enough to transform
europe
now oxford astrozenica vaccine medicines
in healthcare products regulatory
authority
mhra i've been fast track
rolling review of the vaccine since
november
so two things to notice they've been
doing this since november they haven't
waited to be particularly asked
they've been working on it all the time
it's fast tracked
they're flat out on it they're going
through all the normal procedures that
they normally go through
but they're doing as quickly as they can
and it's a rolling review so the data
that we have
three peer-reviewed papers we've looked
at three peer-reviewed publications
on this channel about the oxford
astrazeneca vaccine as well as the press
release
but the hmr are getting data every day
or certainly every couple of days i
believe it's every day
so they are bang up to date they've got
all the data they need
to make this decision and i'm expecting
that decision to be positive
and i'm expecting it to be next monday
or
tuesday 28th or the 29th
so next monday or tuesday i feel excited
already about it
i'm hoping to be able to announce a
complete game changer
this is going to be absolutely
massive absolutely
huge
because of the large numbers of doses
that are available and i am expecting it
to be approved
why am i expecting it to be approved
because i've read all the peer-reviewed
papers
and it looks like it's safe and the
efficacy is
we don't know 62 to 90 percent
um and it seems that no one
who had the oxford astrozenica vaccine
has been hospitalized
so stopping people getting very sick and
we also know
there's good evidence that is stopping
asymptomatic
infection as well and we're going to be
rolling this out by the million
100 million doses for the uk 300 million
doses for the european union can't
remember two or three hundred million
doses
for the united states 300 million doses
for poorer countries initially
being produced in australia and mexico
being produced all around the world
it's it's it's not for profit it's this
is what's going to do the job
monday or tuesday i believe that will be
confirmed positively
given the data we have the only way it's
not going to be confirmed
is if the hmra has got rolling review
data that we don't know about that's bad
so i can't pretend not to be nervous
about that but
we have to wait but monday or tuesday
now in the meantime we have to be very
aware of the symptoms of covid19
so i just want to do a bit of an update
from the um
from the covered symptom tracker app on
this um
now i've called this the coverage
syndrome now a syndrome
this is not i've just made this up i
don't know if anyone else is using this
term
but to me well what a syndrome is not
just to me a syndrome
is a group of clinical features so a
sign is something you see a symptom is
something the patient reports
clinical features combine both of those
and a syndrome is a range of signs and
symptoms clinical features altogether
like like uh ages acquired
immunodeficiency syndrome aids is a
syndrome
so the infection can present in the
injuries it can affect
the gi tract it can affect the lungs it
can affect anyway can affect the nervous
system
so it can it can manifest itself in many
ways
and kovid 19 is turning out to be a bit
like that
so uh the classic triad we know
persistent cough fever
uh loss of the sense of smell smell the
coffee jar every morning see if you can
smell
um get all your family to smell every
morning why not it's a simple test it's
dead easy to do
now um still one of these symptoms is
needed to get an nhs covered test
showing the nhs is a bit out of date
here
now 25 people who have antibodies do not
have one of the classic
triads so 75 of people from this data
will get one of these features
persistent cough
or fever or loss of smell or a
combination of those
most people will but not all a
significant chunk 25
who've had the infection don't have one
of the classic triad
so yes we expect these but only in three
quarters of cases
i think that's the key thing to to get
across these are not
diagnostic um
at all very useful 75
but not everyone most common two
features that people got headaches and
fatigue
so pretty well everyone 82 percent of
people who get covered infection get
headache
72 get fatigue but of course
put your hand up if you've never had
headache or fatigue there's a lot of
false positives
so so headache or fatigue doesn't mean
so you've necessarily got covered it can
raise your index of suspicion of course
but it doesn't mean say you've got it
because you're going to get a lot of
false positives because these are very
common
these are very common clinical features
but the majority of people who get
covered have these
also as well so people that get copied
normally
have headache and or fatigue people that
get headache and or fatigue do not
necessarily have coverage although they
may
is the way to describe it so just using
those features alone they can give false
positives but these figures for headache
and fatigue are true in all age groups
it's turned out uh uh the the
and the the highly non-specific so they
can give false positives is what that is
saying
now other symptoms from the copper
symptom tracker app
shortness of breath muscle pains
diarrhea that's the english spelling
loose
stools running to the toilet to to poo
to pass to pass feces anorexia means
loss of appetite you don't feel like
eating
confusion confusion typically manifests
itself as disorientation
for time you don't know when it is
for place you don't know where you are
and for person you can get people
mixed up in that order that's more
severe confusion
and this is primarily a feature in the
elderly
so some elderly people just become
confused that can be the only clinical
feature they get at least initially
so confusion have a high index of
suspicion for covered
in your elderly relatives who become
acutely confused
skin rashes as we looked at before in
this video on this series
eight percent of people who get covered
also get skin rashes
sore throat horse voice
pains in the chest diarrhea everybody
said abdominal pains
and it's estimated that only 20 of
people
get completely asymptomatic infection
so many people have minimal symptoms
many people don't develop symptoms till
later on in the illness
but only about 20 of those that are
infected have a genuine
asymptomatic course of the disease
so 80 percent of us when we get this
hopefully most of us won't get this but
if we do get this
because we'll be vaccinated but um
80 will get some clinical features
albeit potentially mild for most cases
some getting sick some getting critical
and some of course
tragically are not going to make it
they're going to die from it
now the other thing that covers symptom
tracker applied that is very useful
hallmarks of more severe infection so
the confusion
indicates more severe infection that can
deteriorate the abdominal pain can be
a warning sign and the shortness of
breath is as well
of course the shortness of breath can
develop onto the form of shortness of
breath
caused by the acute respiratory distress
syndrome
with fluid in the lungs
and the other thing they came up with
most people who require breathing
support
whether it's additional oxygen cpap
that's pressurized
oxygen and air going in or ventilation
most people who require breathing
support come to hospital around 13 days
after their first symptoms
13-day delay
so i'm going to post all of those in the
description
very important to to have a high index
of suspicion
for other clinical features which could
be covered 19
if any of these come along we're
suspicious then
self-isolate isolate contacts
organize the testing as soon as
possible and that way we will
curtail the spread more
okay i don't think i've got any more
pictures to show you at the moment i
think that's
i've got somebody on the other computer
obviously so
i think that's us for now so um thank
you for watching of course as
always