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NYT: 37 fully vaccinated doctors at a single hospital in India were infected with COVID

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Nothing to worry about yet, as breakthrough infections do happen. But 37 in the same building seems … noteworthy, given how rare infections among vaccinated people are. It raises an obvious possibility: Is India’s “double mutant” variant more capable of evading vaccine protection than other variants known to science?

And does that explain why India is having the most savage outbreak of any country since the pandemic began 14 months ago?

Some Indian experts are convinced that there’s something qualitatively different about the wave they’re experiencing, not just quantitatively different. “It’s affecting young adults. It’s affecting families. It’s a new thing altogether. Two-month-old babies are getting infected,” said one doctor to the Times.

At Sir Ganga Ram Hospital, a huge facility in the middle of India’s capital, 37 fully vaccinated doctors came down with Covid-19 earlier this month.

The infections left most with mild symptoms, but it added to their growing fears that the virus behind India’s catastrophic second wave is different. They wonder if a more contagious variant that dodges the immune system could be fueling the epidemic inside the world’s hardest-hit nation…

Preliminary evidence suggests that the variant is still responsive to vaccines, although slightly less so. India relies heavily on the Oxford-AstraZeneca vaccine, which clinical trials show is less powerful than the vaccines made by Pfizer-BioNTech and Moderna and could perhaps be more easily thwarted by mutations…

At Sir Ganga Ram hospital, the 37 doctors who became infected after immunization had received their first dose of the AstraZeneca vaccine between late January to early February and then their second dose four to six weeks after that. The hospital employs about 500 doctors.

Thirty-seven infections out of 500 doctors (all of whom were fully vaccinated, presumably) would be a rate of 7.4 percent. The CDC found just 5,800 breakthrough infections among 66 million fully vaccinated Americans, a rate of .008 percent. Vaccinated doctors at Sir Ganga Ram hospital were around a thousand times more likely to be infected, in other words, than vaccinated Americans are.

Hmmmm.

Before we conclude that the “double mutant” is the super-variant we’ve been dreading, though, note per the Times that data from the Indian Council of Medical Research through last week suggests an ultra-low “breakthrough infection” rate in that country of something like .02 to .04 percent among vaccinated people. How do we square those numbers with the bizarre outbreak among doctors at the hospital in Delhi? One possibility is that, because they’re front-line medical workers and Indian hospitals are overwhelmed with COVID patients, there’s a freakishly large amount of the virus circulating in the air around them. There’s probably no more dangerous place on Earth from an epidemiological standpoint right now than an Indian ER yet more than 90 percent of doctors at Sir Ganga Ram remained protected and the 37 who did get infected mostly had mild symptoms. And as noted in the excerpt, the AstraZeneca vaccine they received is somewhat less effective than the mRNA vaccines than most Americans have had.

So there’s no reason to conclude that the Indian variant is a threat to us, let alone a serious threat to most Indians who’ve already had their shots. On top of that, experts note that it’s the British variant that’s most common in some parts of India, not the “double mutant” homegrown strain, so clearly the latter isn’t wholly responsible for the country’s uncontrolled outbreak. Most Indians have no immunity to common COVID either, as only two percent have been fully vaccinated and the country’s mild case count until recently left relatively few with natural immunity. That’s a lot of “dry tinder” for even the standard virus or a more familiar variant, like the British one, to burn through without requiring any explanations about widespread breakthrough infections. And the virus had lots of opportunity to spread over the past month or so, since many Indians stopped taking precautions in the belief that they had defeated COVID and wouldn’t experience any frightening new surges.

“It must be a weird variant” has become the go-to explanation for countries beset by surges in cases since it’s easier to grasp than some multi-factor theory in which behavior and vaccination rates and lockdown measures and weak vaccines, etc, all combine to produce a spike. It’s the go-to explanation in South America too, the WSJ reports, as various countries there are seeing infections climb and have concluded that it must be the Brazilian variant, P.1, that’s made its way across the border and is now spreading.

In Peru, one of the world’s hardest-hit countries, a second surge made April the most deadly month since the pandemic began, often with more than 400 fatalities a day. Health officials said the country of around 30 million is awash in variants, including P.1, which medical authorities said caused 40% of infections in Lima. Authorities are also studying a new strain called C.37, which appears to have originated in Peru and is also raising concerns in Argentina, Chile and Ecuador…

Many of the countries in South America that are experiencing a sharp rise in cases and deaths have for the most part not done extensive genomic sequencing to determine how many have been infected by P.1. A hypothesis is that the variant from Brazil, for weeks one of the world’s hardest-hit countries, is driving the pandemic…

P.1 is up to 2.2 times more contagious and as much as 61% more capable of reinfecting people than previous versions of the coronavirus, according to recent studies in Brazil. Researchers are still investigating whether the strain is more lethal. They are also trying to determine with certainty how well vaccines work against P.1, though preliminary testing is promising.

Cases look dodgy lately not just in Brazil but in Chile, Colombia, Venezuela, Uruguay, and Peru, with countries either experiencing spikes or stubbornly slow declines from their recent peaks. Is that because P.1 has overrun them or is it maybe a seasonal thing, as they’re in the middle of fall and heading into winter? Even if it is P.1, the outbreak in South America isn’t evidence that the vaccines don’t work: China’s relatively weak vaccine was effective at fending off that variant in real-world tests. All they may need in order to get things under control is to ramp up vaccinations with the supply they already have.

I’ll leave you on an upbeat note. New data from Wisconsin finds that, out of 1.8 million vaccinated people, just 605 got infected. That’s a breakthrough infection rate of just .03 percent, right in line with India’s numbers.