Covid Deflation-Sri Lanka, MIS-C Inflation-Taiwan
I am breaking this off from my longer Sri Lanka Post because it was buried at the end and is somewhat interesting
Despite moderate vaccine uptake the debt crisis, inflation and protests seems to have wiped out COVID on the island
Could it be related to Ivermectin?
9-5-21
National Medicines Regulatory Authority (NMRA) had given a waiver of registration to import Ivermectin to prevent thriving black market sales
NMRA’s Chief Executive Officer Dr. Kamal Jayasinghe said that several local agents including George Steuart Health (Pvt) Ltd., ABC Pharma and Emerchemie have been granted this ‘approval of waiver’ to bring in Ivermectin.
When asked for what purpose Ivermectin would be prescribed, NMRA Chairperson Dr. Rasitha Wijewantha told the Sunday Times that it would have to be decided by clinicians after studying scientific evidence.
He said that a waiver of registration (WOR) was granted because there are many drugs including Ivermectin which fall under the category for which no agent usually seeks registration. This is because they are not popular drugs and have a small market share.
“We are in the process of taking a policy decision to encourage registration and import of such drugs by giving small incentives such as reducing the registration fee,” he said.
Deaths started falling shortly thereafter
And no Omicron wave came in 2022
https://www.sundaytimes.lk/210905/news/ivermectin-divides-doctors-while-nmra-gives-waiver-to-import-drug-to-stop-black-market-sales-454583.html
Basically Sri Lanka is letting their Doctors practice medicine. Maybe US and other countries should do the same. Off label use of approved medicines has always been allowed and even encouraged by the FDA
On the subject of COVID, since Taiwan began vaccination of 5-11 yo on May 2 it has reported 34 cases of MIS-C as of July 11 (none before vaccination began)
The CECC commented last month that MIS-C is more common in children between the ages of six and 12 but children as young as two to four years old, or as old as 19 can get it. The risk of contracting the disease can be reduced by up to 90% by receiving a dose of COVID vaccine, the CECC added
[Over 70% of 5-11 have now received 1 shot]
With Taiwan having had 520,000 COVID-19 cases among adolescents and children since January, there may be as many as 167 MIS-C cases in the next month, Lu said.
[he is saying 1/3000 COVID cases from those 520,000 cases will result in MIS-C. Currently its already at 1/15,000 as a lower limit-assuming all 34 cases as of July 11 came from one the 520,000 cases that were reported as of June 11]
https://focustaiwan.tw/society/202206110009
I decided to look into this some more
As of Aug 31, 2021, 21 335 331 individuals aged 12-20 years had received one or more doses of a COVID-19 vaccine, making the overall reporting rate for MIS-C after vaccination 1·0 case per million individuals receiving one or more doses in this age group. The reporting rate in only those without evidence of SARS-CoV-2 infection was 0·3 cases per million vaccinated individuals.
Funding: US Centers for Disease Control and Prevention.
https://pubmed.ncbi.nlm.nih.gov/35216660/
Well, I think we know to take CDC funded studies with a grain of salt, but thats all we seem to have. VAERs under reports and I cant seem to find the data from Duck Duck Go or Open VAERS
This caught my eye as a mechanism of MIS-C since if its the superantigen (part of the spike) then vaccines should trigger this in susceptible people
Potential triggers could be superantigens binding to T-cell receptors (αβTCRs) in combination with a genetic predisposition, such as specific HLA types.
https://www.frontiersin.org/articles/10.3389/fped.2021.656768/full
This from the Lancet indeed finds a relatively high frequency of MIS-C but this was mostly pre-Omicron
Among 2 117 443 children included in the study, 253 children developed MIS-C, corresponding to an incidence rate of 6·8 (95% CI: 6·0-7·6) per 100 000 person-years.
[Basically an incidence of 1/8000]
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00137-5/fulltext
This data from Washington State seems to show MIS-C dropping like a stone after a high in February when Omicron was prevalent. Keep in mind 5-11 yo began vaccinating in October and I suspect few have been getting the jab in the more recent months. So
And this study
Cumulative incidence of MIS-C per 100,000 persons aged younger than 21 years was 2.1 and varied by state from 0.2 to 6.3.
The investigators concluded that the temporal link between MIS-C and the COVID-19 pandemic implied that MIS-C resulted from a delayed immunologic response to severe acute respiratory syndrome coronavirus 2 infection. Clinical manifestations of MIS-C were varied and differed by age as well as the presence or absence of a preceding COVID-19 infection.
[thats quite the range, basically 1/500k to 1/16K]
https://www.contemporarypediatrics.com/view/examining-the-time-and-place-of-mis-c-cases
Now this study out of Israel is very interesting
Nationwide, in persons younger than 18 years, there were 188 800 SARS-CoV-2 infections and 103 patients with MIS-C during Alpha, 233 585 SARS-CoV-2 infections and 115 patients with MIS-C during Delta, and 946 779 SARS-CoV-2 infections and 36 patients with MIS-C during Omicron. MIS-C incidences per 100 000 persons younger than 18 years were 54.5 during Alpha, 49.2 during Delta, and 3.8 during Omicron.There was a higher incidence of MIS-C among patients during the Alpha wave (IRR, 14.34 [95% CI, 9.81-20.96]) and Delta wave (IRR, 12.94 [95% CI, 8.90-18.81]) compared with the Omicron wave (Table 2).
[3.8 per 100K is ~1/25,000, so Taiwan is already at a higher incidence and may reach 1/3000]
Possible explanations include the Omicron variant itself, previous infection with SARS-CoV-2, vaccination against SARS-CoV-2, and improvement in treatment over time.
https://jamanetwork.com/journals/jama/fullarticle/2792718
Notice they are leaving open the idea vaccinations may be a reason for lower MIS-C. Small problem. Israels vax rate for children is very low
As of June 2022-Only a small percentage of children aged 5 to 11 will actually be eligible to receive the additional dose, as 76 percent of children this age have not been vaccinated at all. In addition, among those who were vaccinated, many have received the second dose in the last three months.
[24% vax rate]
Children from 5 to 11 have the lowest vaccination rate among the Israeli population, much more so than children age 12 to 15 – of which 42 percent have yet to be vaccinated.
[58% vax rate]
Among teenagers aged 16 to 19, 22 percent are unvaccinated.
[78% vax rate]
https://www.haaretz.com/israel-news/2022-06-14/ty-article/israel-offers-third-covid-vaccine-for-children-5-to-11/00000181-621b-dd6c-a3a5-7f3f962c0000
A 2022 study from South Africa on the Omicron wave reported no cases of MIS-C, a finding that corroborates these results.
https://www.cidrap.umn.edu/news-perspective/2022/05/kids-covid-syndrome-mis-c-less-severe-omicron
As of May Currently, just 44% of adults have had one COVID-19 vaccine. Its lower in kids but I couldn’t find the figure
In any event, for some reason Taiwan is not getting or expecting the Omicron benefit when it comes to MIS-C. Hopefully they are wrong and no more kids get this miserable condition
Maybe they could try IVM, at least in a trial. Thats one of the benefits of a centralized health system, they should have been able to have got that up and running quickly rather than just trusting the US FDA.