It seems that the incidence of Covid began to grow again (only this was not enough). Is it true? Do I need to make another vaccine more likely?

We answer as short as possible - and a little more

The World Health Organization stated in mid-July that Covid still remains a global threat, and called on world governments to use “proven methods” of pandemia, including mandatory wearing masks. "Medusa" understands how dangerous a new surge is and that each of us can take now.

The most important thing is as short as possible

• If you have not vaccinated over the past six months, make a booster vaccination - that vaccine that is available in your country.
• In Russia there are only two effective vaccines: “satellite V” and “Light satellite”; In Ukraine and other countries, American and British drugs are available, but it should be borne in mind that inactivated vaccines (Sinovac, Sinopharm, Bharat Biotech) are ineffective against existing coronavirus options, they should not be chosen.
• Updated Western vaccines aimed at new coronavirus options, it makes no sense to wait - it is unlikely that they will appear widely before six months later.
• But some surge in the incidence during this time may well happen. However, as before, no one can reliably predict how large -scale it will be.
• The increase in incidence in Moscow and St. Petersburg (where bursts usually began in Russia) has not yet been recorded.

The same, a little more details

Will there be a new wave?

Since the Omicron version was discovered in November 2021, a large -scale wave of incidence was swept around the world, the peak of which came in February 2022. From this moment, two significant events occurred.

• Firstly, new options appeared inside the Omicron line (first Ba.2, then Ba.4/Ba.5 and others), which are even more efficient to move away from vaccine and natural immunity than the initial Omicron BA.1.
• Secondly, about six months have passed after the peak of incidence-a time sufficient to significant reduction in immunity to the disease.

In combination with each other, these facts allow us to expect some surge in the near future - in the summer and especially in early autumn, when the children return to schools, and adults will spend more time in the premises. In fact, in some countries a new wave is already rising (Japan), somewhere managed to reach the plateau (Germany) or even went to the decline (Italy, South Africa). The fact that growth in a number of countries began several weeks ago, in the midst of the summer period, once again shows that Covid (so far) has not acquired seasonality, and its distribution depends primarily on the unpredictable processes of evolution, and not on the temperature outside the window.

In Russia, knowledge of the dynamics of incidence, as before, rests on the quality of official statistics, which is not possible to trust. So far, according to, for example, according to hospitalization data (they are a little more reliable than all other metrics), the increase in incidence in Moscow and St. Petersburg has not begun.

Is it to wait for new restrictions?

So far, the number of hospitalized ones does not exceed the limits of the throughput of hospitals, most countries are not going to return restrictive measures. In the United States, for example, we have now switched to a three -level system of restrictive measures, the severity of which depends on the spread of infection in a particular area. At the same time, in areas where the spread is threateningly large, the maximum requirement is to wear a mask in a closed room and vaccinated in accordance with the recommendations.

In Russia, against the background of a multi -month incidence of incidence, the introduction of new restrictive measures has not yet been publicly discussed. According to the two sources of Medusa, close to the presidential administration, the Kremlin fears social discontent with such measures and, as a possible option, with a significant increase in incidence in the fall, is considered only the introduction of mandatory masks as well as the return of the ban on mass events.

What is known about the new variants of coronavirus?

So far, all the SARS-COV-2 options that appeared since November 2021 and had some important clinical importance for the dynamics of the epidemic, belonged to one large group-they were different lines inside the same Omicron option. The first of them was widespread by Omicron Ba.1 - in South Africa. Then, in the same place, and then almost everywhere, this line was replaced by a very different nursing line - Ba.2. It turned out to be significantly more contagious, but not thanks to the care of immunity, but primarily due to the best interaction of the protein-the “spike” of the virus with its “entrance gate” on the surface of the cells-the ACE2 receptor. From the point of view of the effectiveness of vaccines between BA.1 and Ba.2, no significant differences were found.

By the end of spring in the UK, and in general in Europe, two, different from BA.1, but similar lines: Ba.4 and Ba.5, began to spread widely in Europe. From the earlier options for Omicron, they were distinguished by a rather large number of mutations in the S-Belya , but not only in it, but also in other areas of the virus genome.

To date, it is known that Ba.4 and Ba.5 have significantly increased infection - that is, they spread much faster than competitive lines BA.1 and even BA.2. In addition, there are preliminary, so far not very reliable data that the infection of BA.5 more often leads to hospitalization, that is, this option may turn out to be a slightly more virulent strain compared to other omicrons. So far, however, it is unclear why-laboratory studies do not show significant differences in the mechanism of propagation of the virus.

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How effective are vaccines against new options?

If we talk about all the lines inside the Omicron option, it has long been well known that the vaccines have lost a significant part of their effectiveness against the disease.

So, with the introduction of two doses of Pfizer or Moderna vaccines, the effectiveness against infection with any omicron first reaches 65–70%, and then quickly falls and goes naught by about the 25th week after the second dose. Over time, the effectiveness of booster vaccinations also falls - according to the same British data, 2–4 weeks after a booster dose (Pfizer or Moderna), efficiency varies from 60 to 75%, and then decreases almost to the complete absence of the effect 20+ weeks after revaccination.

As for the specifically options BA.4 and BA.5, even British data is not yet enough to draw reliable conclusions about the degree of fall in the effectiveness of vaccines. From laboratory studies , we can assume that BA.5 should get away from immunity well. Nevertheless, the British doctors still note that the preliminary comparison of the vaccination status of Omcron, infected with new and old lines, shows that "protection provided by vaccines is probably comparable to the one that was observed earlier."

If some difference in effectiveness is found, it can be assumed that it will not be too big-otherwise it would be seen already in the available data. It can be expected that this question will be clear in early August, when a new detailed analysis of the effectiveness of vaccines in the United Kingdom comes out.

For all the lines of Omicron, the effectiveness against hospitalization and death decreases over time, but it is very important to emphasize that this decrease is much more slow, and the fall comes from completely different, significantly higher indicators. So, according to the age group of 50+, the effectiveness against death in the UK even against Omcron reaches 93.6%, and in 10 weeks falls only to 87.6% .

When will the vaccines already update?

The updated production vaccines Pfizer and Moderna should appear by mid -autumn, but not one of the companies has yet called specific supplies. In any case, new vaccines will first be available only for people in risk groups and, of course, primarily in the USA. As for Europe, Pfizer has only submitted documents for registering new vaccines on July 19. There are no decisions of the European Center for Prevention and Control of Diseases on this issue.

Alexander Ershov