Good I hope a fat woman knocks your whiny ass over. Fuck you10 things I hate about fat people
They whine about being fat but will unleash their wrath on you if you ever say the same to their face.
Mariam Tariq December 27, 2010
1. They think being fat is the sole reason for all their miseries in life — from acne to rejection from graduate school.
2. You can never go shopping with them because they won’t stop asking you questions like: “Does this shirt make me look fat?” “Do these shoes make me look fat?” “Does this room make me look fat?”
3. They always have their eyes on your food. There’s a reason why we give you leftovers. It’s not because we’re done eating; it’s because you stare us down until we choke on it or fear that we will.
4. They think they’re doing mankind a favour by going to the gym and walking on the treadmill — at minimum speed, mind you.
5. They whine about being fat but will unleash their wrath on you if you ever say the same to their face.
6. It’s perfectly okay for them to tease and bully the skinny kids, but if someone calls them by the ‘f’ word, it’s immoral and inhumane.
7. Since when did ‘fat’ become a dirty word?
8. They eat when they’re sad, they eat when they’re happy, they eat when they’re hungry, they eat because, why not? They take their breakfast, lunch and dinner and they still have room to binge because, hey! You’ve got to have a decent snack...right?
9. They ruin sleepovers because they snore like nobody’s business and the whole blanket rolls around their circumference, leaving the skinny ones shivering. But nobody should complain because Yokozuna there might feel left out.
10. They sweat profusely — all year round. Yeah, we all get hot flashes once in a while, but expecting people to turn on the air conditioner when its -1 degree Celsius outside is a little inconvenient.
Published in The Express Tribune, December 26th, 2010.
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COVID 19 vaccine successfully developed!!
- Thread starter vamjok
- Start date
It's not my fault you're fat, ugly and stupid.
Why are you really having your jab? Australia's coronavirus vaccine strategy explained
The Pfizer vaccine has a higher efficacy than AstraZeneca, but most will be getting the latter. Here, health experts explain why it's still important to be vaccinated and why you might be getting another jab next year anyway.
Vaccine strategy artwork
Vaccine strategy artwork Source: SBS News
A small group of people in Australia are among the lucky few who've now received their first doses of a coronavirus vaccine. By October, the government has said it hopes to have the entire adult population vaccinated.
But concerns have been raised about the efficacy of the vaccine that most people will receive - the AstraZeneca jab - and whether it’s sufficient to achieve herd immunity.
Here's why it’s still an important vaccine despite some questions surrounding it.
Advertisement
What are the concerns around the AstraZeneca vaccine?
Studies have shown it is about 62 per cent effective in preventing COVID-19. The Pfizer vaccine, which is being rolled out to mainly frontline workers and aged care residents, is about 95 per cent effective.
Novavax’s vaccine, which Australia has also secured agreements for but has yet to be approved, has an efficacy of 89 per cent.
Adrian Esterman, the chair of biostatistics and epidemiology at the University of South Australia, says the AstraZeneca vaccine also appears to have a lower chance of stopping transmission than the Pfizer BioNTech and Novavax jabs.
Read More
“The real issue is if the Novavax vaccine is very similar to Pfizer BioNTech in terms of its efficacy, why won't we use that instead of the AstraZeneca, when it comes?” he told SBS News.
So why is Australia continuing with this vaccine?
A spokesperson for the Department of Health told SBS News it disputes concerns about the AstraZeneca vaccine's efficacy and suggestion that it will give rise to an ineffective rollout.
"The Chief Medical Officer Professor Paul Kelly has directly refuted those suggestions, along with the Department Secretary Professor Brendan Murphy. A number of other key health professionals, including the Academy of Science have issued statements or responded in the media to counter those claims," they said.
Health experts, including Professor Esterman, also say there are several reasons why Australia should continue with the AstraZeneca jab.
If Pfizer is most effective why isn't Australia giving everyone that?
First of all, the AstraZeneca jab is safe, and it works.
“It's not as effective as Pfizer-BioNtech, but it works. And it works enough to protect people at risk. So that is the critical thing,” Professor Esterman said.
Recent trials have shown it is 100 per cent effective against severe disease, hospitalisation and death.
Read More
“If our main aim is to stop people getting very sick and dying, both vaccines [Pfizer and AstraZeneca] will achieve that,” said University of Sydney Associate Professor Nicholas Wood who leads the NSW Immunisation Specialist Service.
"In large scale Phase 3 clinical trials, the AstraZeneca vaccine was shown to be highly effective at preventing symptomatic COVID-19 and importantly, severe disease," the Department of Health spokesperson also said.
There’s also evidence that the longer you wait between the second required dose, the more effective it is.
Covid-19 vaccine in English
While earlier data showed it achieved a 62 per cent efficacy rate, recent studies show its effectiveness is boosted to 82 per cent if the second dose is given 12 weeks later.
Australian authorities have recommended a three-month wait between doses, so most people in Australia will likely be getting their second dose with that gap.
"Encouraging preliminary data released out of Scotland on 22 February suggests that four weeks after the first dose of the AstraZeneca vaccine, the risk of hospitalisation from COVID-19 fell by up to 94 per cent, and 85 per cent for the Pfizer vaccine," the Department of Health spokesperson said.
Read More
The AstraZeneca vaccine is also cheaper and can be locally produced. That’s important because Australia will not have to import it during a time when vaccine shortages have become a major issue around the world.
Moreover, Australia has an agreement for only 20 million doses of the Pfizer vaccine, so with two doses required it won’t cover the entire population.
The Pfizer vaccine is also imported from Europe and needs to be stored in a cold environment. The AstraZeneca vaccine can be transported and stored at normal refrigerated temperatures, which makes it easier to distribute it to people in remote and regional Australia.
“If it was just a matter of buying it, I'm sure the government would do it. But it's not; it’s a matter of supply,” Professor Esterman said.
“The thing about AstraZeneca is we can actually make it in Australia so there's no supply issues.”
The Department of Health spokesperson said provided the Novavax vaccine proves safe and effective, the first supply is expected to arrive from mid-2021.
There is no plan for a private market at this time, they added, meaning people in Australia won't be able to choose which vaccine they have.
"Vaccination is voluntary in Australia, and those who wish to be vaccinated will be able to for free in 2021 ... All vaccines that are coming into Australia are being used as part of the immunisation program," they said.
How will the vaccines work with the new stronger variants?
Pfizer says its vaccine still works well against the B117 variant that originated in the UK but may be less effective against the B1351 variant that was found in South Africa.
Although the AstraZeneca vaccine has shown some efficacy against the B117 variant, it's less effective against the B1351 variant, forcing the rollout of the vaccine in South Africa to be halted.
But the results from both vaccines against the variants came from small-scale trials and experiments, and experts say more data is needed before a definitive answer can be given about their effectiveness.
Read More
Dr Abrar Ahmad Chughtai, a lecturer in epidemiology at the University of New South Wales' School of Population Health, says we also need more data to see whether we’ll need a new vaccine shot yearly.
He says there's some data that antibody titers from the coronavirus vaccine wane after 10 months, and that while new variants may emerge, continuing vaccinations is vital.
“We just need to continue vaccinations and once a group of people are vaccinated, then you need to test them regularly to see the antibody level in their body … if the antibody level is sustained for one year or longer, then probably you don't need a booster.”
If we do need yearly shots, by that point we could have a better vaccine on the market.
“Don't forget there are about over 200 vaccines in trials at the moment,” Professor Esterman said.
“It is early days, and these first-off-the-block vaccines have been designed to stop severe infection and death. And they will all do that extremely well. But as more vaccines come on stream they're likely be more designed to stop transmission.”
Are we still aiming for herd immunity?
Many people are pinning their hopes on the rollout of the vaccines allowing life to return to normal. But without a high rate of vaccinations, much of that relies on not just the prevention of the virus, but also the transmission.
Infectious diseases epidemiologist Linda Selvey from the School of Public Health at the University of Queensland says herd immunity is a long way away for Australia.
Herd immunity refers to the process where a majority of a population is immune to a disease or virus, and for that to occur, 80 per cent of a population needs to be immunised.
Read More
“While we have some promising data from overseas, we still don't really know whether or not any of the vaccines actually prevent transmission of the virus, although I think there is some data suggesting the Pfizer vaccine may be doing that,” she said.
“But the whole concept of herd immunity can't be an aim of the vaccine at this point in time because we don't know whether or not the vaccine will achieve that anyway - any vaccine.”
People in Australia will be living with COVID-19 for years to come, but the health experts agree it will probably be more manageable due to the vaccine rollout, with fewer large-scale disruptions to life.
Share
Published 1 March 2021 at 7:22am
By Rashida Yosufzai
The Pfizer vaccine has a higher efficacy than AstraZeneca, but most will be getting the latter. Here, health experts explain why it's still important to be vaccinated and why you might be getting another jab next year anyway.
Vaccine strategy artwork
Vaccine strategy artwork Source: SBS News
A small group of people in Australia are among the lucky few who've now received their first doses of a coronavirus vaccine. By October, the government has said it hopes to have the entire adult population vaccinated.
But concerns have been raised about the efficacy of the vaccine that most people will receive - the AstraZeneca jab - and whether it’s sufficient to achieve herd immunity.
Here's why it’s still an important vaccine despite some questions surrounding it.
Advertisement
What are the concerns around the AstraZeneca vaccine?
Studies have shown it is about 62 per cent effective in preventing COVID-19. The Pfizer vaccine, which is being rolled out to mainly frontline workers and aged care residents, is about 95 per cent effective.
Novavax’s vaccine, which Australia has also secured agreements for but has yet to be approved, has an efficacy of 89 per cent.
Adrian Esterman, the chair of biostatistics and epidemiology at the University of South Australia, says the AstraZeneca vaccine also appears to have a lower chance of stopping transmission than the Pfizer BioNTech and Novavax jabs.
Read More
“The real issue is if the Novavax vaccine is very similar to Pfizer BioNTech in terms of its efficacy, why won't we use that instead of the AstraZeneca, when it comes?” he told SBS News.
So why is Australia continuing with this vaccine?
A spokesperson for the Department of Health told SBS News it disputes concerns about the AstraZeneca vaccine's efficacy and suggestion that it will give rise to an ineffective rollout.
"The Chief Medical Officer Professor Paul Kelly has directly refuted those suggestions, along with the Department Secretary Professor Brendan Murphy. A number of other key health professionals, including the Academy of Science have issued statements or responded in the media to counter those claims," they said.
Health experts, including Professor Esterman, also say there are several reasons why Australia should continue with the AstraZeneca jab.
If Pfizer is most effective why isn't Australia giving everyone that?
First of all, the AstraZeneca jab is safe, and it works.
“It's not as effective as Pfizer-BioNtech, but it works. And it works enough to protect people at risk. So that is the critical thing,” Professor Esterman said.
Recent trials have shown it is 100 per cent effective against severe disease, hospitalisation and death.
Read More
“If our main aim is to stop people getting very sick and dying, both vaccines [Pfizer and AstraZeneca] will achieve that,” said University of Sydney Associate Professor Nicholas Wood who leads the NSW Immunisation Specialist Service.
"In large scale Phase 3 clinical trials, the AstraZeneca vaccine was shown to be highly effective at preventing symptomatic COVID-19 and importantly, severe disease," the Department of Health spokesperson also said.
There’s also evidence that the longer you wait between the second required dose, the more effective it is.
Covid-19 vaccine in English
While earlier data showed it achieved a 62 per cent efficacy rate, recent studies show its effectiveness is boosted to 82 per cent if the second dose is given 12 weeks later.
Australian authorities have recommended a three-month wait between doses, so most people in Australia will likely be getting their second dose with that gap.
"Encouraging preliminary data released out of Scotland on 22 February suggests that four weeks after the first dose of the AstraZeneca vaccine, the risk of hospitalisation from COVID-19 fell by up to 94 per cent, and 85 per cent for the Pfizer vaccine," the Department of Health spokesperson said.
Read More
The AstraZeneca vaccine is also cheaper and can be locally produced. That’s important because Australia will not have to import it during a time when vaccine shortages have become a major issue around the world.
Moreover, Australia has an agreement for only 20 million doses of the Pfizer vaccine, so with two doses required it won’t cover the entire population.
The Pfizer vaccine is also imported from Europe and needs to be stored in a cold environment. The AstraZeneca vaccine can be transported and stored at normal refrigerated temperatures, which makes it easier to distribute it to people in remote and regional Australia.
“If it was just a matter of buying it, I'm sure the government would do it. But it's not; it’s a matter of supply,” Professor Esterman said.
“The thing about AstraZeneca is we can actually make it in Australia so there's no supply issues.”
The Department of Health spokesperson said provided the Novavax vaccine proves safe and effective, the first supply is expected to arrive from mid-2021.
There is no plan for a private market at this time, they added, meaning people in Australia won't be able to choose which vaccine they have.
"Vaccination is voluntary in Australia, and those who wish to be vaccinated will be able to for free in 2021 ... All vaccines that are coming into Australia are being used as part of the immunisation program," they said.
How will the vaccines work with the new stronger variants?
Pfizer says its vaccine still works well against the B117 variant that originated in the UK but may be less effective against the B1351 variant that was found in South Africa.
Although the AstraZeneca vaccine has shown some efficacy against the B117 variant, it's less effective against the B1351 variant, forcing the rollout of the vaccine in South Africa to be halted.
But the results from both vaccines against the variants came from small-scale trials and experiments, and experts say more data is needed before a definitive answer can be given about their effectiveness.
Read More
Dr Abrar Ahmad Chughtai, a lecturer in epidemiology at the University of New South Wales' School of Population Health, says we also need more data to see whether we’ll need a new vaccine shot yearly.
He says there's some data that antibody titers from the coronavirus vaccine wane after 10 months, and that while new variants may emerge, continuing vaccinations is vital.
“We just need to continue vaccinations and once a group of people are vaccinated, then you need to test them regularly to see the antibody level in their body … if the antibody level is sustained for one year or longer, then probably you don't need a booster.”
If we do need yearly shots, by that point we could have a better vaccine on the market.
“Don't forget there are about over 200 vaccines in trials at the moment,” Professor Esterman said.
“It is early days, and these first-off-the-block vaccines have been designed to stop severe infection and death. And they will all do that extremely well. But as more vaccines come on stream they're likely be more designed to stop transmission.”
Are we still aiming for herd immunity?
Many people are pinning their hopes on the rollout of the vaccines allowing life to return to normal. But without a high rate of vaccinations, much of that relies on not just the prevention of the virus, but also the transmission.
Infectious diseases epidemiologist Linda Selvey from the School of Public Health at the University of Queensland says herd immunity is a long way away for Australia.
Herd immunity refers to the process where a majority of a population is immune to a disease or virus, and for that to occur, 80 per cent of a population needs to be immunised.
Read More
“While we have some promising data from overseas, we still don't really know whether or not any of the vaccines actually prevent transmission of the virus, although I think there is some data suggesting the Pfizer vaccine may be doing that,” she said.
“But the whole concept of herd immunity can't be an aim of the vaccine at this point in time because we don't know whether or not the vaccine will achieve that anyway - any vaccine.”
People in Australia will be living with COVID-19 for years to come, but the health experts agree it will probably be more manageable due to the vaccine rollout, with fewer large-scale disruptions to life.
Share
Published 1 March 2021 at 7:22am
By Rashida Yosufzai
Sad to say i am fat. But i am in the process of shedding it off. Man it's hard work.10 things I hate about fat people
They whine about being fat but will unleash their wrath on you if you ever say the same to their face.
Mariam Tariq December 27, 2010
1. They think being fat is the sole reason for all their miseries in life — from acne to rejection from graduate school.
2. You can never go shopping with them because they won’t stop asking you questions like: “Does this shirt make me look fat?” “Do these shoes make me look fat?” “Does this room make me look fat?”
3. They always have their eyes on your food. There’s a reason why we give you leftovers. It’s not because we’re done eating; it’s because you stare us down until we choke on it or fear that we will.
4. They think they’re doing mankind a favour by going to the gym and walking on the treadmill — at minimum speed, mind you.
5. They whine about being fat but will unleash their wrath on you if you ever say the same to their face.
6. It’s perfectly okay for them to tease and bully the skinny kids, but if someone calls them by the ‘f’ word, it’s immoral and inhumane.
7. Since when did ‘fat’ become a dirty word?
8. They eat when they’re sad, they eat when they’re happy, they eat when they’re hungry, they eat because, why not? They take their breakfast, lunch and dinner and they still have room to binge because, hey! You’ve got to have a decent snack...right?
9. They ruin sleepovers because they snore like nobody’s business and the whole blanket rolls around their circumference, leaving the skinny ones shivering. But nobody should complain because Yokozuna there might feel left out.
10. They sweat profusely — all year round. Yeah, we all get hot flashes once in a while, but expecting people to turn on the air conditioner when its -1 degree Celsius outside is a little inconvenient.
Published in The Express Tribune, December 26th, 2010.
He couldn’t lose weight on his own. Then he opted for surgery that’s gaining ground
Vasoo Kesevan went from being overweight to morbidly obese, and from being happy to being hurt until he came to a big decision. CNA Insider tracks his journey through bariatric surgery for over a year.
Hampered by chronic asthma and an old knee injury, Vasoo Kesevan needed help to lose weight.
Hampered by chronic asthma and an old knee injury, Vasoo Kesevan needed help to lose weight.
Bookmark
SINGAPORE: At his heaviest, Vasoo Kesevan weighed 212 kilogrammes. Even before he reached that point, he was hurting.
Whenever he took his children to the playground, he could see some of the parents looking at him, “as if they’d never seen a big-sized guy in their lives before”.
It was the kind of look he got wherever he went. Sometimes there was more, for example once when he was waiting for a taxi with his two children.
“A small boy — I think he must’ve been (in) Kindergarten Two or Primary One, somewhere around there — looked at me. He started to tell his mother, ‘Look at this fat man,’” recalled the 47-year-old. “The mother didn’t say anything.”
Vasoo Kesavan with his daughter, Priya, before he went for bariatric surgery to lose weight.
Vasoo with his daughter, Priya.
These are stories that one doctor has heard many times before. Tan Chun Hai, a consultant in Khoo Teck Puat Hospital’s (KTPH’s) department of general surgery, has seen many patients like Vasoo.
“They have difficulty fitting into the society. They take up more than one MRT seat (and) have difficulty getting on the bus,” he cited. “They walk around and people laugh at them. They (face) psychosocial stigmatisation of obesity.”
By the time most of his patients see him, they would have been obese “for a long period of time”. “They’d have tried 10 (to) 20 years of dietary-lifestyle modification,” he said.
When his patients see him, they would have realised they cannot lose weight on their own or sustain a durable weight loss over time.
Bariatric surgeon Tan Chun Hai is a consultant in KTPH's department of general surgery.
Dr Tan Chun Hai.
And he offers a solution that more Singaporeans are now becoming aware of: Bariatric and metabolic surgery, a treatment for not only their weight problems but also the accompanying health issues.
It was what Vasoo opted for after deciding that he had “better do something” and not “stay like this any more” — and CNA Insider tracked his journey for over a year, from pre-surgery to the outcome today.
WEIGHTY ISSUES
Since 2014, the number of people coming forward and qualifying for this surgery in KTPH has doubled, from 49 cases then to about 100 a year.
Vasoo was no ordinary patient, however, as he had a body mass index (BMI) of 70, which meant a high risk of serious health complications. For the Asian body, a BMI of more than 37.5 denotes morbid obesity.
WATCH: My weight loss surgery journey as a 212-kg man (12:18)
But it was not always like this for him. About seven to eight years ago, he weighed 120 kg; he had been overweight since his teenage years, but he felt “happy” and “light”.
His weight started climbing after he had changed jobs, from driving a tipper truck to driving a coach. His work became “too relaxed”, and he started snacking a lot, especially with the irregular hours of his new job.
“You drive, you eat, you sit down,” he said. “There’s no exercise.”
The first thing he noticed was his clothes getting tighter. After some time, his friends also sounded a note of caution.
“What happened to you? Why are you putting on so much weight?” he related. “You better be careful … Do some walking, because you have two kids.”
His weight gain began to affect him in “a lot of ways”. When he fell at home once, he realised he could not pick himself up. “I tried getting up, turning here and there,” he recalled. “I couldn’t.”
His young daughter was at home, crying and “afraid” for him. So he finally “forced” himself up.
Vasoo Kesavan's children have been a key motivating factor in his weight loss journey.
His children have been a key motivating factor in his weight loss journey.
Then there was the time he dropped some coins from his pocket. He could not bend to pick them up. “An old man came and helped me. (He said), ‘I understand, you don’t worry,’” recounted Vasoo.
“He picked up all the coins and gave them to me. Then I held his hand and said, ‘Thank you very much, uncle. I’m very sorry.’”
Eventually, his weight affected his career too. His stomach had got so big that it reached the steering wheel. And his employer called into question his driving ability. He went from driving full-time to being a relief driver.
UPHILL STRUGGLE
Losing the weight he gained was not easy for Vasoo.
He has chronic asthma, which makes exercising difficult for him, although he tried. “(I’d) just take a slow walk, then wait for five minutes, (another) slow walk, (then) wait for five minutes,” he cited.
It did not take much for Vasoo to be short of breath.
It did not take much for Vasoo to be short of breath.
He also has an old knee injury, which makes it doubly difficult. Chun Hai noted: “At his weight, he’d be at risk of … injuring (himself) and having a fall during exercise.”
Vasoo tried diet pills for a few months but found them to be “very expensive”, at more than S$100 a month. And he said that whenever he stopped taking the pills, he gained more weight.
He also went to KTPH’s Integrated Care for Obesity and Diabetes clinic — where Chun Hai is a consultant — for several rounds of weight management through dietary and lifestyle modification. His lack of success can be explained medically.
“Obesity now has been classified by the World Health Organisation as a chronic relapsing disease … which means you may have some success in losing weight initially but (it) may come back at a later date,” said Chun Hai.
Bariatric surgery patient Vasoo Kesavan consults Dr Tan Chun Hai in Khoo Teck Puat Hospital.
Vasoo consults the good doctor.
For those who are “just overweight” or have Class I obesity (with an Asian BMI of less than 32.5), a change in lifestyle and diet can be effective. But those who are more obese are likely to need more help.
“The longer that you stay in the obese category, the more likely that you’ll have cardiovascular or cardiorespiratory incidents, a risk of stroke, heart attack, obesity-related cancer and comorbidities such as diabetes,” said the doctor.
For this category of patients, which Vasoo fell into, “the most effective” solution with long-term results is surgery.
In fact, his wife had been nudging him to consider this for a few years, but he was concerned about the cost. He did not think he could afford the time either.
Bariatric surgery patient Vasoo Kesavan at a check-up in Khoo Teck Puat Hospital.
At a check-up.
It was only after his sister went for the same operation, and received help from the medical social worker, that he decided to go for it, “for a better life, a better future”.
A SIX-WEEK PLAN
In September 2019, Vasoo secured a referral to see Chun Hai, KTPH’s bariatric and metabolic surgeon, who recommended a sleeve gastrectomy. This involves removing more than 60 to 70 per cent of the stomach.
What is left of the stomach would look like a “curved banana”, which restricts the volume of food intake to “about 20 to 25 per cent of what a normal person would eat”.
The part that is removed is also the production centre of the appetite hormone, so its removal would lessen the patient’s hunger.
It is the most common bariatric surgery performed in Singapore and globally, said the doctor. And normally, this keyhole surgery requires the patient to stay in the hospital for a day or two.
A keyhole surgery allows for faster patient recovery compared to more invasive surgeries.
A keyhole surgery allows for faster patient recovery compared to more invasive surgeries.
But because of Vasoo’s BMI, he had to get his weight down to 180 kg, to reduce the surgical risks. Cases like his, requiring pre-surgery weight loss, make up 10 to 20 per cent of KTPH’s bariatric caseload.
A six-week plan was devised for him involving a team that included endocrinologists, a dietitian, a nurse co-ordinator, a physiotherapist, a psychologist and a medical social worker.
Vasoo was given an exercise regime and a low-caloric diet, i.e. meal replacement shakes, to follow at home for the first three weeks. He struggled with the calorie reduction, noted KTPH senior dietitian Hedy Cheng.
“Usually (in) the first few days, there’d be a drop in energy level because there’s a drastic change from eating to not eating (as much),” she said. “However, after that, your body kind of adapts.”
Khoo Teck Puat Hospital senior dietitian Hedy Cheng advising bariatric surgery patient Vasoo Kesavan
Hedy Cheng advising Vasoo.
Sessions were also scheduled to “teach him how to practise healthy eating”. She explained: “After the surgery, (patients) still need to know how to … make the correct food choices.”
In the second three weeks, Vasoo was hospitalised to step up his customised care plan and ensure his weight loss, and for the various specialists to assess him.
Said Chun Hai: “For high-grade obesity, your risk of cardiorespiratory complications from surgery is higher, which is the reason we get the cardiologist and respiratory medicine and an anaesthetist to come on board, to optimise the patient for surgery.”
And in Vasoo’s case, their assessments showed that he had a heart condition, which needed stabilising and monitoring first. So his surgery — scheduled for December 2019 — was postponed.
Detecting bariatric surgery patient Vasoo Kesavan's accelerated heart rate in KTPH.
Detecting Vasoo's accelerated heart rate.
‘A LIFELONG COMMITMENT’
Vasoo was re-admitted to hospital in February last year to prepare for surgery for a second time. This time, COVID-19 scuppered his hopes as hospital resources were re-allocated to tackle the outbreak.
At this point, he almost gave up, with all the uncertainty caused by the novel coronavirus. But he soon received unexpected news.
“I was really down (and) I was looking for a job. Then (Dr Tan) suddenly called me, and he told me, ‘I’ve got good news for you. I’ve already made an appointment for your operation,’” he recounted.
A window had opened when the COVID-19 cases were tapering, before the surge in infections emerged in the foreign worker dormitories. March 11 was set as the date.
Bariatric surgery patient Vasoo Kesavan doing wall push-ups as part of his pre-op physiotherapy.
Doing wall push-ups as part of his pre-operation physiotherapy.
Special arrangements had to be made for his surgery: Longer instruments were needed to reach his stomach; and the operating table was extended at the sides to support his weight.
For his part, he had dropped his weight to 188 kg, close to the target of 180 kg.
“He has shown great strength and mentality in persevering through these setbacks,” remarked Chun Hai. “We didn’t have any hiccups … (The surgery) went according to plan.”
The operation took one to two hours, and Vasoo was discharged a few days later. But it was not the end of his weight-loss journey.
He had to subsist on a liquid diet for the first fortnight and then pureed food for the next fortnight, before progressing to soft food.
Even now that he is back on regular food, he cannot eat regular portions. If he overeats or eats too fast, without chewing his food well, he risks vomiting.
The part of the stomach that was removed from bariatric surgery patient Vasoo Kesavan.
The part of the stomach that was removed.
He misses his mee pok “so much” — if he buys a packet of wonton mee, two to three forkfuls are enough to fill him up. “You must get used to it,” he said. “I must just continue this way.”
There is, as Chun Hai noted, no “magic pill” for weight loss without continual efforts. “Bariatric and metabolic surgery isn’t the easy way out of obesity, but it’s a lifelong commitment to a healthier lifestyle,” he said.
At the same time, he wants those with higher-grade obesity to come forward earlier for treatment. “Patients shouldn’t consider the surgical option as the last treatment option,” he stressed.
“The longer you wait … the longer you risk getting your comorbidities, such as diabetes, hypertension, fatty liver and obstructive sleep apnoea.”
Vasoo’s sleep apnoea has improved, for example, so he no longer feels tired in the day. And he is back to driving a bus full-time without facing any problems.
Bariatric patient Vasoo Kesavan is in better shape today, almost a year after his surgery in KTPH.
In better shape today.
“I go to bed fresh, I wake up in the morning fresh,” he said. “It’s a lot of difference.”
He gets his exercise by washing the bus and also does housework, which he could not do when his weight ballooned previously. He also gets to play more with his son and daughter, aged seven and 11 respectively.
At 162 kg, he has shed nearly a quarter of his total weight. It is still a work in progress, but he no longer feels “scared to go out”.
“Right now, (people) look at me (as) a normal person. I feel happy,” he said.
Bariatric patient Vasoo Kesavan is not just sitting at home any more after his surgery.
He's not just sitting at home any more.
Source: CNA/dp
It's very easy to shed fat. Just burn more calories than you eat. It works for me every single time.
My target weight is 60kg. I weigh myself monthly. When I find that my weight has crept up eg 60.5kg to 61kg I'll up my exercise volume by 50% ie 2 hour bike ride instead of the usual 1.5 hours and 5 days a week instead of 4 days.
When I weigh myself again it has always been back to 60kg or less.
I keep my intake constant.
However if I cannot ride for some reason ie on holiday or down with a fever I'll cut my food intake by 50% and this will achieve the same result.
Everything follows the simple laws of physics ie that you cannot create matter from nothing. Fat is stored energy and you have to consume that energy via food for fat to be deposited.
Not tat easy. Obesity genes etc play a big part. I know of ppl who eat like pigs n still remain slim. I know also of ppl who watch wat they eat. Exercise etc n still fat. For me i changed my eating habits. I have 1 main meal a day tat is Brunch. N dinner is fruits n meal replacement shakes. I buy the atas low sugar ones n protein bars. Also exercise. 10 km walk in the evening. N i can only maintain my weight. Cant reduce it. But it is what it is.
Genes play a part but only when it comes to establishing your metabolic rate.
I put on weight very easily if I am not disciplined. That's why I have to keep a watchful eye on my intake vs calories burned.
Well said. Once i retire. I will eat n enjoy n hope for a quick death. At least i enjoyed myself in my final days
Novavax COVID-19 shot could be cleared for US use by May: CEO
FILE PHOTO: A Novavax logo is reflected in a drop on a syringe needle in this illustration taken November 9, 2020. REUTERS/Dado Ruvic/Illustration/File Photo
02 Mar 2021 05:25AM (Updated: 02 Mar 2021 08:51AM)
Bookmark
MARYLAND: Novavax's COVID-19 vaccine could be cleared for use in the United States as soon as May if US regulators authorise it based on data from the company's British trial, which could be completed "in the coming weeks", its chief executive said on Monday (Mar 1).
However, chief executive Stanley Erck added that talks with the US Food and Drug Administration are ongoing and the agency may require Novavax to submit data from its US trial, which could take an additional two months to complete, pushing back US clearance to mid-summer.
Novavax shares were off 5.6 per cent at US$226.85 in extended trading after initially rising following the release of its quarterly results. The shares have soared about 2,400 per cent from US$9.82 on Jan 21, 2020, when the company announced it was developing a vaccine against the coronavirus.
Preliminary data from its UK trial released in January showed the vaccine to be around 96 per cent effective against the original version of the coronavirus and around 86 per cent effective against the now widely circulating variant first discovered in Britain.
Novavax can already manufacture its shots at scale and will be able to have tens of millions of doses stockpiled and ready to ship in the United States when it receives authorisation, Erck said.
"It will be substantial – in the many tens of millions or a hundred million," Erck said in an interview.
READ: Fauci urges Americans to get any of the 3 COVID-19 vaccines available
READ: US authorises Johnson & Johnson's single-shot COVID-19 vaccine
Novavax had promised to deliver 110 million doses to the US government by the end of the third quarter. That could happen as early as July, Erck said.
Novavax's vaccine production plants should all be fully functional by April, said Novavax research chief Gregory Glenn on a conference call after the company reported quarterly results.
"In April, May, June, we should be finishing filling and finishing product in advance of regulatory approvals," Glenn said.
In late January, Erck said he expected it would take several weeks for Novavax to file UK trial data with regulators in the United Kingdom, Europe and elsewhere. Novavax could produce up to 150 million doses per month by May or June, he had added in January in an interview.
The Novavax shot, if authorised, would add to the vaccine options for millions of Americans awaiting immunization against the coronavirus.
Johnson & Johnson's one-dose vaccine on Saturday become the third to win US emergency use authorisation (EUA). Vaccines produced by Pfizer with partner BioNTech and Moderna received EUAs in December.
Novavax's vaccine is a two-dose regimen like Pfizer's and Moderna's, but is easier to ship as it can be stored at refrigerator temperatures, rather than frozen.
Novavax promised to deliver doses to the United States after the Trump administration awarded it US$1.6 billion to help finance research, development and production of a COVID-19 vaccine.
Novavax completed enrollment of its 30,000-subject US-based trial in February.
FILE PHOTO: A Novavax logo is reflected in a drop on a syringe needle in this illustration taken November 9, 2020. REUTERS/Dado Ruvic/Illustration/File Photo
02 Mar 2021 05:25AM (Updated: 02 Mar 2021 08:51AM)
Bookmark
MARYLAND: Novavax's COVID-19 vaccine could be cleared for use in the United States as soon as May if US regulators authorise it based on data from the company's British trial, which could be completed "in the coming weeks", its chief executive said on Monday (Mar 1).
However, chief executive Stanley Erck added that talks with the US Food and Drug Administration are ongoing and the agency may require Novavax to submit data from its US trial, which could take an additional two months to complete, pushing back US clearance to mid-summer.
Novavax shares were off 5.6 per cent at US$226.85 in extended trading after initially rising following the release of its quarterly results. The shares have soared about 2,400 per cent from US$9.82 on Jan 21, 2020, when the company announced it was developing a vaccine against the coronavirus.
Preliminary data from its UK trial released in January showed the vaccine to be around 96 per cent effective against the original version of the coronavirus and around 86 per cent effective against the now widely circulating variant first discovered in Britain.
Novavax can already manufacture its shots at scale and will be able to have tens of millions of doses stockpiled and ready to ship in the United States when it receives authorisation, Erck said.
"It will be substantial – in the many tens of millions or a hundred million," Erck said in an interview.
READ: Fauci urges Americans to get any of the 3 COVID-19 vaccines available
READ: US authorises Johnson & Johnson's single-shot COVID-19 vaccine
Novavax had promised to deliver 110 million doses to the US government by the end of the third quarter. That could happen as early as July, Erck said.
Novavax's vaccine production plants should all be fully functional by April, said Novavax research chief Gregory Glenn on a conference call after the company reported quarterly results.
"In April, May, June, we should be finishing filling and finishing product in advance of regulatory approvals," Glenn said.
In late January, Erck said he expected it would take several weeks for Novavax to file UK trial data with regulators in the United Kingdom, Europe and elsewhere. Novavax could produce up to 150 million doses per month by May or June, he had added in January in an interview.
The Novavax shot, if authorised, would add to the vaccine options for millions of Americans awaiting immunization against the coronavirus.
Johnson & Johnson's one-dose vaccine on Saturday become the third to win US emergency use authorisation (EUA). Vaccines produced by Pfizer with partner BioNTech and Moderna received EUAs in December.
Novavax's vaccine is a two-dose regimen like Pfizer's and Moderna's, but is easier to ship as it can be stored at refrigerator temperatures, rather than frozen.
Novavax promised to deliver doses to the United States after the Trump administration awarded it US$1.6 billion to help finance research, development and production of a COVID-19 vaccine.
Novavax completed enrollment of its 30,000-subject US-based trial in February.
How well does the AstraZeneca vaccine work? An expert reviews the current evidence
By early March only one-third of Germany’s stocks of the Oxford/AstraZeneca vaccine had been used – possibly because of misinformation about its effects. Sean Gallup/EPA-EFESarah Pitt, University of Brighton
March 4, 2021 5.16pm GMT
When the Oxford/AstraZeneca vaccine was first authorised by the UK Medicines and Healthcare products Regulatory Agency, it was hailed as a milestone in turning the tide on the coronavirus.
But in the time since, this highly efficacious vaccine has suffered a lot of reputational damage. In January, the German press and French president Emmanuel Macron falsely claimed that it is largely ineffective in people over 65, despite there being no evidence to support this.
Yet concrete evidence on how protective the vaccine is in older people has been lacking, leading some European countries to restrict the vaccine to under-65s. Together, these factors appear to have created high levels of scepticism in Europe and low levels of uptake.
Thankfully, though, more information on how well the vaccine works is arriving all of the time – and seeing the vaccine’s positive effects, some countries are now reversing their restrictions on giving it to over-65s. Here’s what we know so far about the vaccine’s effects.
Is the Oxford/AstraZeneca vaccine as protective as the others?
Trials suggested it’s a bit less protective than other vaccines. Pfizer’s, for example, prevented symptomatic disease 95% of the time in testing, whereas the Oxford/AstraZeneca vaccine did so 70% of the time.
But recent real-world data from the UK suggests that the Oxford/AstraZeneca vaccine might actually be a bit better than Pfizer’s at preventing serious disease and hospitalisation. However, these studies haven’t been set up to avoid outside biases affecting results. For example, the Pfizer vaccine was rolled out first, so might have been given disproportionately to more vulnerable people. Also, these studies are preprints, meaning they haven’t been checked by other scientists yet.
So whether the Oxford/AstraZeneca vaccine is more or less effective than others at preventing COVID-19 isn’t clear yet. The important thing to remember is that all the authorised vaccines are safe and offer very good levels of protection against COVID-19. If you’re offered any vaccine, you should take it.
Does the vaccine work in older people?
An early stage of testing – a combined phase 1 and 2 trial – strongly suggested that the Oxford/AstraZeneca vaccine would offer protection to older people. It showed the vaccine generated just as strong an immune response in older participants as younger ones.
However, as we don’t know to what extent different parts of the immune response act against the virus, this alone didn’t prove that the vaccine would be effective in this age group. And in the final phase of testing – phase 3 trials – which are designed to prove that a vaccine is protective, there weren’t enough people over 55 to give a reliable estimate of protection for this group.
Several billion doses may be distributed this year. Fighting misinformation will be key to ensuring they have the greatest impact. Sean Gallup/EPA-EFE
Exactly how protective the vaccine is in older people remains uncertain. But a recent preprint suggests it works very well. A single shot of the Oxford/AstraZeneca vaccine appears to reduce the chances of people being admitted to hospital with COVID-19 by 80% after the first dose.
Does the vaccine protect against new variants of the virus?
It depends on the variant. A preprint suggests that the vaccine may be as effective against B117, the variant that has arisen in the UK, as it was against the earlier forms of the coronavirus.
But against the variant circulating in South Africa, B1351, a preprint suggests it may be much less effective at preventing mild to moderate disease than it was against previous forms of the virus. It’s believed this is because of a mutation called E484K, which changes the virus’s exterior so that existing antibodies to SARS-CoV-2 are less able to bind to it.
Sarah Gilbert, lead researcher on the Oxford Vaccine Development Programme, believes that the Oxford/AstraZeneca vaccine will still protect against severe disease when facing these variants. However, this has yet to be proven.
Variants circulating in New York (B1526) and Brazil (P1) also have this E484K mutation. We don’t yet have data on how well the vaccine works against these variants, but it’s plausible that it may struggle against them too.
In the meantime, the vaccine’s developers have confirmed that they can tweak it to handle these mutations. They estimate an updated booster could be ready by autumn.
The Oxford vaccine is already being widely deployed: doses made in India are now being administered in Egypt, for example. Khaled Elfiqi/EPA-EFEWill the vaccine will give me bad side-effects?
You might experience some, but they shouldn’t be severe or last long. Common side-effects include a sore patch where the needle went into your arm, a temperature, aching, tiredness and feeling sick. These aren’t necessarily bad, because they’re a sign that your immune system has noticed the vaccine and is responding to it.
In France and Germany, reports of healthcare workers experiencing flu-like symptoms after receiving the vaccine – at rates of 40% of people or higher – have worried people. However, these effects were also seen in the vaccine’s combined phase 1 and 2 clinical trial. Researchers found that taking paracetamol helped, and that these effects had largely subsided after seven days.
Is delaying the second dose risky?
The intervals between doses have been a bit controversial, since the 12-week gap that’s being left between them in the UK is different from the dosing schedule that was submitted for regulatory approval by the manufacturer.
However, it looks like delaying the second dose to 12 weeks after the first is actually a good idea. The protection from the first injection seems to last, and if you have the second vaccine 12 weeks later, rather than four weeks as originally proposed, that seems to generate a stronger immune response.
March 4, 2021 5.16pm GMT
When the Oxford/AstraZeneca vaccine was first authorised by the UK Medicines and Healthcare products Regulatory Agency, it was hailed as a milestone in turning the tide on the coronavirus.
But in the time since, this highly efficacious vaccine has suffered a lot of reputational damage. In January, the German press and French president Emmanuel Macron falsely claimed that it is largely ineffective in people over 65, despite there being no evidence to support this.
Yet concrete evidence on how protective the vaccine is in older people has been lacking, leading some European countries to restrict the vaccine to under-65s. Together, these factors appear to have created high levels of scepticism in Europe and low levels of uptake.
Thankfully, though, more information on how well the vaccine works is arriving all of the time – and seeing the vaccine’s positive effects, some countries are now reversing their restrictions on giving it to over-65s. Here’s what we know so far about the vaccine’s effects.
Is the Oxford/AstraZeneca vaccine as protective as the others?
Trials suggested it’s a bit less protective than other vaccines. Pfizer’s, for example, prevented symptomatic disease 95% of the time in testing, whereas the Oxford/AstraZeneca vaccine did so 70% of the time.
But recent real-world data from the UK suggests that the Oxford/AstraZeneca vaccine might actually be a bit better than Pfizer’s at preventing serious disease and hospitalisation. However, these studies haven’t been set up to avoid outside biases affecting results. For example, the Pfizer vaccine was rolled out first, so might have been given disproportionately to more vulnerable people. Also, these studies are preprints, meaning they haven’t been checked by other scientists yet.
So whether the Oxford/AstraZeneca vaccine is more or less effective than others at preventing COVID-19 isn’t clear yet. The important thing to remember is that all the authorised vaccines are safe and offer very good levels of protection against COVID-19. If you’re offered any vaccine, you should take it.
Does the vaccine work in older people?
An early stage of testing – a combined phase 1 and 2 trial – strongly suggested that the Oxford/AstraZeneca vaccine would offer protection to older people. It showed the vaccine generated just as strong an immune response in older participants as younger ones.
However, as we don’t know to what extent different parts of the immune response act against the virus, this alone didn’t prove that the vaccine would be effective in this age group. And in the final phase of testing – phase 3 trials – which are designed to prove that a vaccine is protective, there weren’t enough people over 55 to give a reliable estimate of protection for this group.
Several billion doses may be distributed this year. Fighting misinformation will be key to ensuring they have the greatest impact. Sean Gallup/EPA-EFE
Exactly how protective the vaccine is in older people remains uncertain. But a recent preprint suggests it works very well. A single shot of the Oxford/AstraZeneca vaccine appears to reduce the chances of people being admitted to hospital with COVID-19 by 80% after the first dose.
Does the vaccine protect against new variants of the virus?
It depends on the variant. A preprint suggests that the vaccine may be as effective against B117, the variant that has arisen in the UK, as it was against the earlier forms of the coronavirus.
But against the variant circulating in South Africa, B1351, a preprint suggests it may be much less effective at preventing mild to moderate disease than it was against previous forms of the virus. It’s believed this is because of a mutation called E484K, which changes the virus’s exterior so that existing antibodies to SARS-CoV-2 are less able to bind to it.
Sarah Gilbert, lead researcher on the Oxford Vaccine Development Programme, believes that the Oxford/AstraZeneca vaccine will still protect against severe disease when facing these variants. However, this has yet to be proven.
Variants circulating in New York (B1526) and Brazil (P1) also have this E484K mutation. We don’t yet have data on how well the vaccine works against these variants, but it’s plausible that it may struggle against them too.
In the meantime, the vaccine’s developers have confirmed that they can tweak it to handle these mutations. They estimate an updated booster could be ready by autumn.
The Oxford vaccine is already being widely deployed: doses made in India are now being administered in Egypt, for example. Khaled Elfiqi/EPA-EFEWill the vaccine will give me bad side-effects?
You might experience some, but they shouldn’t be severe or last long. Common side-effects include a sore patch where the needle went into your arm, a temperature, aching, tiredness and feeling sick. These aren’t necessarily bad, because they’re a sign that your immune system has noticed the vaccine and is responding to it.
In France and Germany, reports of healthcare workers experiencing flu-like symptoms after receiving the vaccine – at rates of 40% of people or higher – have worried people. However, these effects were also seen in the vaccine’s combined phase 1 and 2 clinical trial. Researchers found that taking paracetamol helped, and that these effects had largely subsided after seven days.
Is delaying the second dose risky?
The intervals between doses have been a bit controversial, since the 12-week gap that’s being left between them in the UK is different from the dosing schedule that was submitted for regulatory approval by the manufacturer.
However, it looks like delaying the second dose to 12 weeks after the first is actually a good idea. The protection from the first injection seems to last, and if you have the second vaccine 12 weeks later, rather than four weeks as originally proposed, that seems to generate a stronger immune response.
Immune interference – why even 'updated' vaccines could struggle to keep up with emerging coronavirus strains
Nurse Natalie O'Connor loads syringes with the Moderna COVID-19 vaccine in February 2021. Joseph Prezioso/AFP via Getty ImagesMatthew Woodruff, Emory University
March 8, 2021 8.35am EST
Despite the success and optimism of the new COVID-19 vaccination campaigns being rolled out worldwide, the emergence of new viral strains threatens to undermine their effectiveness. Indeed, South Africa has been forced to rethink its strategy as its initial vaccine of choice failed to provide protection to an emerging, but now dominant, viral variant.
Hope is still high that the mRNA-based vaccines licensed in the U.S., with their spectacular efficacy, will continue to provide protection despite impaired targeting of new strains. The jury is still out on viral vector vaccines, like the new Johnson & Johnson vaccine, but early data showing a reduced effectiveness against the South African variant has raised alarms.
RNA viruses, like coronaviruses, are known for their ability to mutate. With continued widespread infection, the opportunity for the virus to mutate and evade ongoing vaccination efforts remains high. Many in the scientific community have felt comfortable in the knowledge that mRNA-based vaccines can be quickly modified and redeployed. If the our current vaccines fail, we revaccinate individuals with obsolete immunity against the new strains, and play global whack-a-mole as the virus evolves.
But it may not be that easy.
As an immunologist who studies how antibody responses choose their targets, I am concerned that these “vaccine updates” may be less effective in patients that have already received their original shots. Immunological memory, the very thing that offers continued protection against a virus long after vaccination, can sometimes negatively interfere with the development of slightly updated immune responses. The scientific community needs to get ahead of this emerging problem and investigate vaccine approaches known to reduce the potential for viral escape.
Vaccines are designed to generate immune memory
In simplest terms, vaccines are a way to give your immune system a sneak peek at a pathogen. There are different ways to do this. One way is to inject inactivated versions of a virus, as has been done with polio. Another is to use noninfectious viral components such as the proteins used for flu vaccines. And most recently, scientists have found ways to deliver mRNA “instructions” that tell your body how to make those noninfectious viral components, as has been done with the Moderna and Pfizer vaccines against COVID-19. These vaccines all train your immune system to identify and respond against critical components of a potential invader. An important part of that response is to get your body to produce antibodies that will hopefully prevent future infections, breaking the cycle of person-to-person transmission.
However, it takes time for your immune system to generate those protective responses. Your immune system is immensely powerful – capable of destroying dangerous pathogens as well as your own tissue. The risk of accidentally producing antibodies that attack your own body is both very real, and potentially catastrophic.
To prevent this, your immune system rigorously tests immune cells that produce antibodies – called B cells – to make sure that they are responding with high specificity to the pathogen and not your own tissue. This process can take weeks. Rushing it carries risks, and may be an important component of the manifestations of severe COVID-19.
Vaccination gives your body the time to safely carry out that process – generating antibodies against the pathogen that pose no risk to your own cells. The antibodies you produce in that time will last months, and your immune system also remembers how to make them. The establishment of immune memory is a critical component of vaccines. The ability to remember what your immune system has responded against in the past gives it a significant edge when it encounters the same pathogen in the future.
But what happens when the virus evolves, and that memory becomes “obsolete”?
The specter of ‘original antigenic sin’
During a response to a pathogen, such as a virus, your immune system produces large amounts of a limited set of antibodies. Think of a virus as a car trying to run you over. You might produce one kind of antibody against the hood, one against the bumper, and one against the hubcaps that prevents the wheels from turning. You have produced three kinds of antibodies that are specific to the car, but only the hubcap antibodies will slow the car down. Your immune system will remember how to produce all three, and doesn’t distinguish between them.
Now the virus-car mutates. It changes the changes the shape of the hubcaps, changes the material, or removes them altogether. Your immune system will remember the car – but not the hubcaps. The system doesn’t know that targeting the hubcap was the only important part, so it will ramp up its attack on the hood and bumper – minimizing the importance of all other responses. It may “tweak” its hubcap response, or perhaps even develop a new one from scratch, but that process will be slow and certainly of lower priority.
In ignoring the new hubcap response, the immune system’s memory of the original car is not only obsolete, but actively interfering with the response necessary to target the new car’s wheels. This is what immunologists call ‘original antigenic sin’ – ineffective immune memory that hampers desired responses to new pathogen strains. This phenomenon is well documented in influenza where seasonal variants and repeat vaccinations dominate the landscape. However, this sort of interference is extraordinarily difficult to quantify making it hard to routinely study.
Scientists and public health officials cannot ignore this threat in COVID-19, and must get out front of the virus. Fortunately, there is a path forward.
[Get the best of The Conversation, every weekend. Sign up for our weekly newsletter.]
Multiple-strain vaccinations offer hope
To combat this problem, significant efforts are being made to prioritize the pursuit of a single-shot flu vaccine, or a universal vaccine. The goal is to make a vaccine capable of neutralizing many different viral strains at once.
To this end, researchers have begun making headway in the development and use of complex multi-strain vaccines, capitalizing on emerging research showing that if your immune system is presented with multiple versions of the same pathogen, it will tend to choose targets that are shared between them.
Presented with a Model-T, Ford F150, and electric Mustang all at once, your immune system will often choose to ignore differences between the targets. Instead of focusing on the hood, or even the easily modified hubcaps, your immune system might recognize the shape and rubber on the tires. This altered response would not only interfere with the function of all three vehicles, but it would be targeting a region of the vehicle that is generalized. You have not created a vaccine against Mustangs, you have created a vaccine against road-based vehicles that use tires.
The recent knowledge gains in influenza vaccination must be immediately applied to SARS-CoV-2. I am hopeful that the current class of mRNA vaccines will continue to provide protection against emerging strains, but this pandemic has taught us that hoping is not enough.
Over the last year, governments around the world have stepped up to provide resources into the basic investigation of immune responses to COVID-19, and ongoing vaccination efforts. They had the foresight and courage to fund a new mRNA-based vaccination technology that has ushered in a new era in vaccination. Let’s build on that momentum and prioritize research into truly innovative approaches to vaccination that stand to benefit billions of people across the globe.
March 8, 2021 8.35am EST
Despite the success and optimism of the new COVID-19 vaccination campaigns being rolled out worldwide, the emergence of new viral strains threatens to undermine their effectiveness. Indeed, South Africa has been forced to rethink its strategy as its initial vaccine of choice failed to provide protection to an emerging, but now dominant, viral variant.
Hope is still high that the mRNA-based vaccines licensed in the U.S., with their spectacular efficacy, will continue to provide protection despite impaired targeting of new strains. The jury is still out on viral vector vaccines, like the new Johnson & Johnson vaccine, but early data showing a reduced effectiveness against the South African variant has raised alarms.
RNA viruses, like coronaviruses, are known for their ability to mutate. With continued widespread infection, the opportunity for the virus to mutate and evade ongoing vaccination efforts remains high. Many in the scientific community have felt comfortable in the knowledge that mRNA-based vaccines can be quickly modified and redeployed. If the our current vaccines fail, we revaccinate individuals with obsolete immunity against the new strains, and play global whack-a-mole as the virus evolves.
But it may not be that easy.
As an immunologist who studies how antibody responses choose their targets, I am concerned that these “vaccine updates” may be less effective in patients that have already received their original shots. Immunological memory, the very thing that offers continued protection against a virus long after vaccination, can sometimes negatively interfere with the development of slightly updated immune responses. The scientific community needs to get ahead of this emerging problem and investigate vaccine approaches known to reduce the potential for viral escape.
In simplest terms, vaccines are a way to give your immune system a sneak peek at a pathogen. There are different ways to do this. One way is to inject inactivated versions of a virus, as has been done with polio. Another is to use noninfectious viral components such as the proteins used for flu vaccines. And most recently, scientists have found ways to deliver mRNA “instructions” that tell your body how to make those noninfectious viral components, as has been done with the Moderna and Pfizer vaccines against COVID-19. These vaccines all train your immune system to identify and respond against critical components of a potential invader. An important part of that response is to get your body to produce antibodies that will hopefully prevent future infections, breaking the cycle of person-to-person transmission.
However, it takes time for your immune system to generate those protective responses. Your immune system is immensely powerful – capable of destroying dangerous pathogens as well as your own tissue. The risk of accidentally producing antibodies that attack your own body is both very real, and potentially catastrophic.
To prevent this, your immune system rigorously tests immune cells that produce antibodies – called B cells – to make sure that they are responding with high specificity to the pathogen and not your own tissue. This process can take weeks. Rushing it carries risks, and may be an important component of the manifestations of severe COVID-19.
Vaccination gives your body the time to safely carry out that process – generating antibodies against the pathogen that pose no risk to your own cells. The antibodies you produce in that time will last months, and your immune system also remembers how to make them. The establishment of immune memory is a critical component of vaccines. The ability to remember what your immune system has responded against in the past gives it a significant edge when it encounters the same pathogen in the future.
But what happens when the virus evolves, and that memory becomes “obsolete”?
During a response to a pathogen, such as a virus, your immune system produces large amounts of a limited set of antibodies. Think of a virus as a car trying to run you over. You might produce one kind of antibody against the hood, one against the bumper, and one against the hubcaps that prevents the wheels from turning. You have produced three kinds of antibodies that are specific to the car, but only the hubcap antibodies will slow the car down. Your immune system will remember how to produce all three, and doesn’t distinguish between them.
Now the virus-car mutates. It changes the changes the shape of the hubcaps, changes the material, or removes them altogether. Your immune system will remember the car – but not the hubcaps. The system doesn’t know that targeting the hubcap was the only important part, so it will ramp up its attack on the hood and bumper – minimizing the importance of all other responses. It may “tweak” its hubcap response, or perhaps even develop a new one from scratch, but that process will be slow and certainly of lower priority.
In ignoring the new hubcap response, the immune system’s memory of the original car is not only obsolete, but actively interfering with the response necessary to target the new car’s wheels. This is what immunologists call ‘original antigenic sin’ – ineffective immune memory that hampers desired responses to new pathogen strains. This phenomenon is well documented in influenza where seasonal variants and repeat vaccinations dominate the landscape. However, this sort of interference is extraordinarily difficult to quantify making it hard to routinely study.
Scientists and public health officials cannot ignore this threat in COVID-19, and must get out front of the virus. Fortunately, there is a path forward.
[Get the best of The Conversation, every weekend. Sign up for our weekly newsletter.]
Multiple-strain vaccinations offer hope
To combat this problem, significant efforts are being made to prioritize the pursuit of a single-shot flu vaccine, or a universal vaccine. The goal is to make a vaccine capable of neutralizing many different viral strains at once.
To this end, researchers have begun making headway in the development and use of complex multi-strain vaccines, capitalizing on emerging research showing that if your immune system is presented with multiple versions of the same pathogen, it will tend to choose targets that are shared between them.
Presented with a Model-T, Ford F150, and electric Mustang all at once, your immune system will often choose to ignore differences between the targets. Instead of focusing on the hood, or even the easily modified hubcaps, your immune system might recognize the shape and rubber on the tires. This altered response would not only interfere with the function of all three vehicles, but it would be targeting a region of the vehicle that is generalized. You have not created a vaccine against Mustangs, you have created a vaccine against road-based vehicles that use tires.
The recent knowledge gains in influenza vaccination must be immediately applied to SARS-CoV-2. I am hopeful that the current class of mRNA vaccines will continue to provide protection against emerging strains, but this pandemic has taught us that hoping is not enough.
Over the last year, governments around the world have stepped up to provide resources into the basic investigation of immune responses to COVID-19, and ongoing vaccination efforts. They had the foresight and courage to fund a new mRNA-based vaccination technology that has ushered in a new era in vaccination. Let’s build on that momentum and prioritize research into truly innovative approaches to vaccination that stand to benefit billions of people across the globe.
I put on weight has year because of lockdown.
The govt and the virus is to blame. It is not my fault
The govt and the virus is to blame. It is not my fault
the soylent green community can produce more tasty snacks with just half of you.
i lost weight due to diy projects on homes and yards. less fat, more muscles, body is denser and harder.
Yes they can but soylent dog is a much better option n its wat our ancestors eat. Soylen Green. Its For people
you can ask tiong why they release virus
Europe clears Johnson & Johnson's single-shot COVID-19 vaccine
FILE PHOTO: A vial of the Johnson & Johnson's COVID-19 vaccine is seen at Northwell Health's South Shore University Hospital in Bay Shore, New York, US on Mar 3, 2021. (Photo: Reuters/Shannon Stapleton)
11 Mar 2021 09:54PM
(Updated: 12 Mar 2021 03:18AM)
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BRUSSELS: Europe approved Johnson & Johnson's single dose COVID-19 vaccine on Thursday (Mar 11), paving the way for the first shots to be delivered in a month as the bloc seeks to speed up a stuttering inoculation campaign and boost its supplies.
The COVID-19 shot is the fourth to be endorsed for use in the European Union after vaccines from Pfizer-BioNTech , AstraZeneca-Oxford University and Moderna , and is recommended for those over 18 years of age, the European Medicines agency (EMA) said. It's the first single-dose COVID-19 vaccine.
The United States, Canada and Bahrain have also approved the shot. South Africa is carrying out an expedited review.
"With this latest positive opinion, authorities across the European Union will have another option to combat the pandemic and protect the lives and health of their citizens," EMA's Executive Director Emer Cooke said after the agency gave its conditional approval.
The official nod came from the European Commission shortly after, the final step to allowing its use across the bloc.
The region is having difficulty taming a spike in cases driven by a more contagious variant of the coronavirus, with countries including Italy and France imposing fresh lockdowns.
J&J Chief Scientific Officer Paul Stoffels described it as a "landmark moment" for the US drugmaker and the world as governments struggle to control the pandemic which has crushed economies and killed more than 2.7 million.
The shot, called COVID Vaccine Janssen after the J&J unit that developed it, will help bulk up EU vaccine supplies after a faltering rollout due to delivery delays from Pfizer and AstraZeneca.
The first shipments will start in the second half of April, the company said, adding it is committed to delivering at least 200 million doses to the EU this year.
Exact volumes are not clear though and the US drugmaker has told the European Union it is facing supply issues that may complicate plans to deliver the 55 million doses due in the second quarter in full.
J&J's factory in Leiden in the Netherlands and a plant in Baltimore in the United States run by Emergent BioSolutions have both been authorised by the drugs' regulator as a manufacturer of ingredients for the vaccines.
READ: US authorises Johnson & Johnson's single-shot COVID-19 vaccine
Earlier this year, some EU countries raised questions about J&J's production network and contract with the EU, which would require it to send vaccines made at the Dutch factory to the United States for bottling before being shipped back to the EU.
News that the EU had approved Johnson & Johnson's vaccine came as Norway and Denmark temporarily suspended the use of AstraZeneca's vaccine after reports of the formation of blood clots in some who have been vaccinated.
TRIAL DATA
In J&J's 44,000-person global trial, the vaccine was found to be 66 per cent effective at preventing moderate-to-severe COVID-19 four weeks after inoculation. It was 100 per cent effective in preventing hospitalisation and death due to the virus. In its statement on Thursday, the EMA said the vaccine was found to be 67 per cent effective two weeks after inoculation.
The side effects were usually mild or moderate and cleared within a couple of days after vaccination, it said. The most common ones were pain at the injection site, headache, tiredness, muscle pain and nausea.
Though many rival shots have reported a higher protection rate, J&J's vaccine could help boost thin EU supplies and simplify inoculation campaigns because it does not require a second dose or need to be shipped frozen.
Direct comparison between headline numbers reported by different drugmakers is difficult because their trials had different goals, and J&J's study was conducted while new, more contagious variants of the virus were circulating.
Its vaccine delivers instructions for human cells to manufacture immunity-building proteins, using a weakened version of a common-cold virus to carry them in, similar to AstraZeneca's shot, which uses a chimpanzee cold virus. J&J has also used the technology in its EU-approved Ebola vaccine.
EU conditional marketing authorisation allows a treatment to be sold for a year without full data on its efficacy and side-effects being available.
FILE PHOTO: A vial of the Johnson & Johnson's COVID-19 vaccine is seen at Northwell Health's South Shore University Hospital in Bay Shore, New York, US on Mar 3, 2021. (Photo: Reuters/Shannon Stapleton)
11 Mar 2021 09:54PM
(Updated: 12 Mar 2021 03:18AM)
Bookmark
BRUSSELS: Europe approved Johnson & Johnson's single dose COVID-19 vaccine on Thursday (Mar 11), paving the way for the first shots to be delivered in a month as the bloc seeks to speed up a stuttering inoculation campaign and boost its supplies.
The COVID-19 shot is the fourth to be endorsed for use in the European Union after vaccines from Pfizer-BioNTech , AstraZeneca-Oxford University and Moderna , and is recommended for those over 18 years of age, the European Medicines agency (EMA) said. It's the first single-dose COVID-19 vaccine.
The United States, Canada and Bahrain have also approved the shot. South Africa is carrying out an expedited review.
"With this latest positive opinion, authorities across the European Union will have another option to combat the pandemic and protect the lives and health of their citizens," EMA's Executive Director Emer Cooke said after the agency gave its conditional approval.
The official nod came from the European Commission shortly after, the final step to allowing its use across the bloc.
The region is having difficulty taming a spike in cases driven by a more contagious variant of the coronavirus, with countries including Italy and France imposing fresh lockdowns.
J&J Chief Scientific Officer Paul Stoffels described it as a "landmark moment" for the US drugmaker and the world as governments struggle to control the pandemic which has crushed economies and killed more than 2.7 million.
The shot, called COVID Vaccine Janssen after the J&J unit that developed it, will help bulk up EU vaccine supplies after a faltering rollout due to delivery delays from Pfizer and AstraZeneca.
The first shipments will start in the second half of April, the company said, adding it is committed to delivering at least 200 million doses to the EU this year.
Exact volumes are not clear though and the US drugmaker has told the European Union it is facing supply issues that may complicate plans to deliver the 55 million doses due in the second quarter in full.
J&J's factory in Leiden in the Netherlands and a plant in Baltimore in the United States run by Emergent BioSolutions have both been authorised by the drugs' regulator as a manufacturer of ingredients for the vaccines.
READ: US authorises Johnson & Johnson's single-shot COVID-19 vaccine
Earlier this year, some EU countries raised questions about J&J's production network and contract with the EU, which would require it to send vaccines made at the Dutch factory to the United States for bottling before being shipped back to the EU.
News that the EU had approved Johnson & Johnson's vaccine came as Norway and Denmark temporarily suspended the use of AstraZeneca's vaccine after reports of the formation of blood clots in some who have been vaccinated.
TRIAL DATA
In J&J's 44,000-person global trial, the vaccine was found to be 66 per cent effective at preventing moderate-to-severe COVID-19 four weeks after inoculation. It was 100 per cent effective in preventing hospitalisation and death due to the virus. In its statement on Thursday, the EMA said the vaccine was found to be 67 per cent effective two weeks after inoculation.
The side effects were usually mild or moderate and cleared within a couple of days after vaccination, it said. The most common ones were pain at the injection site, headache, tiredness, muscle pain and nausea.
Though many rival shots have reported a higher protection rate, J&J's vaccine could help boost thin EU supplies and simplify inoculation campaigns because it does not require a second dose or need to be shipped frozen.
Direct comparison between headline numbers reported by different drugmakers is difficult because their trials had different goals, and J&J's study was conducted while new, more contagious variants of the virus were circulating.
Its vaccine delivers instructions for human cells to manufacture immunity-building proteins, using a weakened version of a common-cold virus to carry them in, similar to AstraZeneca's shot, which uses a chimpanzee cold virus. J&J has also used the technology in its EU-approved Ebola vaccine.
EU conditional marketing authorisation allows a treatment to be sold for a year without full data on its efficacy and side-effects being available.
Pfizer-BioNTech say data suggests COVID-19 vaccine 94% effective in preventing asymptomatic infection
An Israeli man receives his second Pfizer-BioNTech COVID-19 vaccine from a medical professional at a vaccination center set up on a mall parking lot in Givataim, Israel, during a nationwide lockdown to curb the spread of the virus on Jan 20, 2021. (Photo: AP/Oded Balilty)
12 Mar 2021 03:34AM
(Updated: 12 Mar 2021 07:58AM)
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NEW YORK/JERUSALEM: Pfizer and BioNTech said on Thursday (Mar 11) that real-world data from Israel suggests their COVID-19 vaccine is 94 per cent effective in preventing asymptomatic infections, suggesting it could significantly reduce virus transmission.
The companies also said the latest analysis of the Israeli data shows the vaccine was 97 per cent effective in preventing symptomatic disease, severe disease and death. That is in line with the 95 per cent efficacy reported in the vaccine's late-stage clinical trial in December.
Israel's Health Ministry, which is working with the healthcare providers administering the vaccine, said in an emailed statement that the data was developed from the ministry's tracking of morbidity.
Israel’s Health Ministry previously found that the Pfizer-BioNTech vaccine reduces infection, including in asymptomatic cases, by 89.4 per cent and in symptomatic cases by 93.7 per cent. That was from data collected from Jan 17 to Feb 6.
Pfizer Chief Executive Albert Bourla said the data was important for society because it means fewer people are passing on the virus to others without knowing it. The company plans to publish the data in a peer reviewed journal, he said.
The analysis also shows real-world evidence of the vaccine's effectiveness against a highly infectious variant of COVID-19 first discovered in Britain, known as B117. More than 80 per cent of the tested specimens were that variant.
There was no evaluation of its effectiveness against the virus variant first discovered in South African known as B1351 due to the limited number of infections with that variant in Israel.
As of Wednesday, around 55 per cent of Israel's 9 million population had been given at least one dose of the Pfizer-BioNTech COVID-19 vaccine, according to Health Ministry data, and 43 per cent have received both doses.
According to the analysis of data collected from Jan 17 to Mar 6, unvaccinated individuals were 44 times more likely to develop symptomatic COVID-19 and 29 times more likely to die from the illness.
In a previous unpublished study by the health ministry and Pfizer, Israeli researchers said further study was needed on asymptomatic transmission among fully vaccinated people because they are less likely in Israel to be tested for COVID-19.
Since the mid-January peak, Israel has seen 71 per cent fewer COVID-19 deaths, 55 per cent fewer cases, 45 per cent fewer new critically ill patients and 40 per cent fewer critically ill patients in hospitals, according to Eran Segal, a data scientist at the Weizmann Institute of Science.
On Wednesday, 2,802 Israelis tested positive, or 2.9 per cent, from nearly 99,000 tests.
An Israeli man receives his second Pfizer-BioNTech COVID-19 vaccine from a medical professional at a vaccination center set up on a mall parking lot in Givataim, Israel, during a nationwide lockdown to curb the spread of the virus on Jan 20, 2021. (Photo: AP/Oded Balilty)
12 Mar 2021 03:34AM
(Updated: 12 Mar 2021 07:58AM)
Bookmark
NEW YORK/JERUSALEM: Pfizer and BioNTech said on Thursday (Mar 11) that real-world data from Israel suggests their COVID-19 vaccine is 94 per cent effective in preventing asymptomatic infections, suggesting it could significantly reduce virus transmission.
The companies also said the latest analysis of the Israeli data shows the vaccine was 97 per cent effective in preventing symptomatic disease, severe disease and death. That is in line with the 95 per cent efficacy reported in the vaccine's late-stage clinical trial in December.
Israel's Health Ministry, which is working with the healthcare providers administering the vaccine, said in an emailed statement that the data was developed from the ministry's tracking of morbidity.
Israel’s Health Ministry previously found that the Pfizer-BioNTech vaccine reduces infection, including in asymptomatic cases, by 89.4 per cent and in symptomatic cases by 93.7 per cent. That was from data collected from Jan 17 to Feb 6.
Pfizer Chief Executive Albert Bourla said the data was important for society because it means fewer people are passing on the virus to others without knowing it. The company plans to publish the data in a peer reviewed journal, he said.
The analysis also shows real-world evidence of the vaccine's effectiveness against a highly infectious variant of COVID-19 first discovered in Britain, known as B117. More than 80 per cent of the tested specimens were that variant.
There was no evaluation of its effectiveness against the virus variant first discovered in South African known as B1351 due to the limited number of infections with that variant in Israel.
As of Wednesday, around 55 per cent of Israel's 9 million population had been given at least one dose of the Pfizer-BioNTech COVID-19 vaccine, according to Health Ministry data, and 43 per cent have received both doses.
According to the analysis of data collected from Jan 17 to Mar 6, unvaccinated individuals were 44 times more likely to develop symptomatic COVID-19 and 29 times more likely to die from the illness.
In a previous unpublished study by the health ministry and Pfizer, Israeli researchers said further study was needed on asymptomatic transmission among fully vaccinated people because they are less likely in Israel to be tested for COVID-19.
Since the mid-January peak, Israel has seen 71 per cent fewer COVID-19 deaths, 55 per cent fewer cases, 45 per cent fewer new critically ill patients and 40 per cent fewer critically ill patients in hospitals, according to Eran Segal, a data scientist at the Weizmann Institute of Science.
On Wednesday, 2,802 Israelis tested positive, or 2.9 per cent, from nearly 99,000 tests.
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