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A Global Force to Handle COVID-19 with Flu Control Protocols is Required4
HSVG misson P.O. Box 206, Hagatna, GU 96932, USA
(January 21, 2021)Herd Immunity May Not the Goal COVID Vaccination Should PursueAfter COVID vaccines were finally available, some officials and experts started worrying about the percentage of people getting vaccinated. Their concerns are mainly related to herd immunity that most previous vaccination programs tried to achieve. However, COVID vaccination may need to pursue a different public health objective.According to the University of Oxford Vaccine Knowledge Project, when a high percentage of the population is vaccinated, it is difficult for infectious diseases to spread, because there are not many people who can be infected. For example, if someone with measles is surrounded by people who are vaccinated against measles, the disease cannot easily be passed on to anyone, and it will quickly disappear. This is called herd immunity.The governments that are distributing and administering COVID vaccines have to notice that herd immunity is not the only model to eradicate an pandemic. For example, the WHO (World Health Organization) was able to declare an end to the global 2009 influenza A (H1N1) pandemic on August 10, 2010, although, according to the report released by the US CDC (Center for Disease Control and Prevention), the overall vaccination coverage in the US was only 27%.The novel influenza A (H1N1) virus was identified in April 2009. On September 15 that year, four vaccine manufacturers received approval from the US FDA (Food and Drug Administration) for use of the specific monovalent (H1N1) pdm09 vaccine in the prevention of influenza caused by the 2009 pandemic influenza A (H1N1) virus. Since the pandemic was associated with a threefold higher level of hospitalizations and deaths among people aged less than 65 compared with previous influenza seasons, the vaccination program prioritized five target groups – pregnant women, people who live with or provide care for infants younger than 6 months, health–care and emergency medical services personnel, children and young adults aged 6 months to 24 years, and people aged 25 to 64 years who have medical conditions that put them at higher risk for influenza–related complications.The US CDC’s report showed that, from October 2009 through May 2010, there were 34.2% of people in the target groups getting vaccinated. Among people of non-target groups, the vaccination coverage for people aged 25 to 64 was 16.7% and for those aged over 65, 28.8%.In fact, in the University of Oxford’s press release regarding its COVID vaccine’s emergency use authorization, they mentioned the Joint Committee on Vaccination and Immunisation (JCVI) will “publish its latest advice for the priority groups to receive this vaccine, with this announcement indicating that the JCVI has advised the priority should be to give as many people in at-risk groups their first dose, rather than providing the required two doses in as short a time as possible. The second dose completes the course and is important for longer term protection, and everyone will still receive their second dose within 12 weeks of their first, an approach the JCVI believes will maximise the benefits of this vaccine, ensuring at-risk people are able to get meaningful protection and ease the pressure on the UK National Health Service.” They did not address herd immunity.Therefore, taking care of the at-risk people, once again, ought to be the main task after the COVID vaccines became available, instead of paying too much attention to the overall vaccination coverage rate and arguing with the anti-vaxxers. Once fewer at-risk people develop severe illness and hospitals are no longer overwhelmed, the whole world will see the light at the end of the tunnel.The COVID vaccines’ effectiveness data supporting the emergency use authorization actually show that vaccines are significantly effective in preventing symptomatic COVID-19 disease and severe illness among the clinical trial participants. Every regulatory body also reminds that data are not available to make a determination about how long the vaccine will provide protection, nor is there evidence that the vaccine prevents transmission of the coronavirus from person to person. It implies the most relevant goal of COVID vaccination for now should be to protect at-risk groups from sickness, instead of pursuing herd immunity.Since COVID’s highly contagious nature, it could be very difficult to achieve a containment goal and mitigation might be a better mindset to respond to the pandemic. Many countries had paid the price for inappropriate response strategies last year. Several conceptual errors are still keeping many governments trapped in this public health crisis. While COVID vaccines are finally available, governments of main countries really need to use vaccines as a powerful tool and do their best to convince and help at-risk people getting vaccination to bring the whole world to get through the pandemic as soon as possible. http://www.hsvg.org/hot_380070.html Herd Immunity May Not the Goal COVID Vaccination Should Pursue 2021-01-21 2022-01-21
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(March 16, 2020)


A Global Force to Handle COVID-19 with Flu Control Protocols is Required


As COVID-19 is becoming a global issue, most people seem too nervous to notice that the virus is actually showing its flu-like epidemic pattern while more countries reported more cases around the world. Based on the pattern observed, the epidemic could be ended if an international organization steps forward to coordinate a global force to thoroughly implement flu control protocols in most of countries as soon as possible.



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In the end of January, Germany’s first two cases contracted the virus from a colleague who flew in from Shanghai to join the company’s workshop, and then another two colleagues who did not contact the Chinese visitor were tested positive as well soon. This cluster has preliminarily showed the human-to-human transmission of the virus could be very easy, and very similar to what the flu virus does. At the same time, those German patients’ very mild flu-like illness was noticed.



Singapore and Japan offered significant evidence of a larger scale in February. As of February 29, Singapore reported 93 cases, including five clusters and quite a number of patients whose source of infection is not known. It was showing that the spread of the virus could easily happen in the community, exactly like what the flu virus can do. And, just like those German cases, patients in Singapore were fighting with flu-like symptoms only, no severe cases reported.



Excluding the cruise line’s cases, Japan had found more than 250 cases in different cities and prefectures in February. Most of infected people had flu-like symptoms only and six elderly patients died from pneumonia. So, in Japan, the virus was also showing a flu-like epidemic, which usually brings senior people a higher risk of severity and fatality.



In addition, A BMJ, originally called British Medical Journal, article published on February 18 offers evidence from comparison of case fatality rate (CFR), which is the ratio of deaths from a certain disease to the total number of people diagnosed with this disease for a certain period of time representing a measure of disease severity. SARS had a CFR of around 10%. MERS killed 34%. COVID-19’s overall CFR was around 2%. A collaboration of Hong Kong University and Harvard University also estimated the CFR of COVID-19 is around 1.4%.



Therefore, the COVID-19 virus turns out to be mostly causing flu-like illness only. It does not seem to be a SARS-like or MERS-like super killing bug of the new decade. The scaring death toll number in China could be the result of a medical system collapse caused by too many patients rushing into hospitals, which is the scenario we usually saw during a flu pandemic. So, countries with increasing death tolls, such as Italy and Iran, need international aids.



Although The CFR number of COVID-19 mentioned above is lower than SARS’s and MERS’s, most experts agree the CFR of a seasonal flu is around 0.1% only. Therefore, we still have to take the virus seriously, most importantly, with a right strategy.



Based on its flu-like epidemic pattern, the goal of a global response to COVID-19 should change from containment to mitigation, for example, helping the elderly and people with underlying health conditions to avoid death tragedies. Don't waste resources on finding asymptomatic infections. Make sure that medical institutions are ready for a huge amount of patients. Remind Healthy people to wash hands more often and sick people to stay home. Besides these, Taiwan’s recent experience shows that wearing a mask is an effective extra precaution.



Excluding three small clusters with the index case contracting the virus in January, Taiwan did not report any new domestic case after January 31 until a local woman was tested positive on February 28. Besides washing hands, it is worth to notice that the majority of Taiwanese have been promptly wearing a mask since the epidemic started scaring people in the beginning of January, even though many experts claimed that wearing a mask is not necessary at that time. Although the shortage of surgical masks had caused chaos, the chaotic situation is believed to become a reminder of having most Taiwanese practice good personal hygiene all the time, which is the main preventive measure before we have vaccines and new drugs.



The researches on the virus take time and epidemic control can’t wait. It is necessary to find clues through the epidemiological analysis on the reported cases to help form the proper response strategy. The best solution for now is to follow flu control measures strictly, including public education of good personal hygiene, home or institutional quarantine on sick people, and a flu surveillance network that asks clinics and hospitals to report patients with flu-like symptoms for further virus testing and early advanced treatment, plus a few extra precautions, such as wearing a mask and maintaining healthy immune defense, to carry everybody through. The world's leading countries should drive a force to push flu control protocols and call for all countries to move forward in the same direction for a sooner ending of the epidemic.