印度出现了加强版Delta Plus变种,携带之前最牛逼的南非变种特征,牛翻天了。 https://www.ft.com/content/af162963-078c-4c63-9731-e4c8d5e5de2a India sounds alert on ‘Delta Plus’ strain Amy Kazmin in New Delhi The Indian government has warned that a potentially more dangerous version of the Delta coronavirus variant is circulating in at least three states and called for strengthened local restrictions to prevent it from gaining a stronger foothold. India’s health ministry has designated the “Delta Plus” strain as a “variant of concern”, saying it spreads more easily, binds to lung cell receptors more effectively and may reduce the antibody response. Scientists say the variant contains a mutation — known as K417N — that was found in the Beta variant first identified in South Africa and is considered to be particularly resistant to the antibody response generated by vaccines. Scientists said it remains to be seen what effects the mutation would have on the Delta variant, however. India’s health ministry said Delta Plus has been detected in 22 cases in six rural districts of three states – Maharahstra, Kerala and Madhya Pradesh – and urged local officials to introduce enhanced measures. Local news agency ANI, citing government sources, said 40 cases have been identified. New Delhi’s decision to highlight the Delta Plus cases follows criticism that it was slow to detect and sound the alarm on the emergence of the Delta variant. That strain fuelled the country’s devastating recent wave of infections and is spreading rapidly in Europe and the US. The latest strain has been found in several other European countries. The variant was identified by the Indian Sars-CoV-2 genomics consortium, which was set up at the end of last year to improve the country’s virus surveillance and provide an early warning about the latest variants.
印度出现了加强版Delta Plus变种,携带之前最牛逼的南非变种特征,牛翻天了。 https://www.ft.com/content/af162963-078c-4c63-9731-e4c8d5e5de2a India sounds alert on ‘Delta Plus’ strain Amy Kazmin in New Delhi The Indian government has warned that a potentially more dangerous version of the Delta coronavirus variant is circulating in at least three states and called for strengthened local restrictions to prevent it from gaining a stronger foothold. India’s health ministry has designated the “Delta Plus” strain as a “variant of concern”, saying it spreads more easily, binds to lung cell receptors more effectively and may reduce the antibody response. Scientists say the variant contains a mutation — known as K417N — that was found in the Beta variant first identified in South Africa and is considered to be particularly resistant to the antibody response generated by vaccines. Scientists said it remains to be seen what effects the mutation would have on the Delta variant, however. India’s health ministry said Delta Plus has been detected in 22 cases in six rural districts of three states – Maharahstra, Kerala and Madhya Pradesh – and urged local officials to introduce enhanced measures. Local news agency ANI, citing government sources, said 40 cases have been identified. New Delhi’s decision to highlight the Delta Plus cases follows criticism that it was slow to detect and sound the alarm on the emergence of the Delta variant. That strain fuelled the country’s devastating recent wave of infections and is spreading rapidly in Europe and the US. The latest strain has been found in several other European countries. The variant was identified by the Indian Sars-CoV-2 genomics consortium, which was set up at the end of last year to improve the country’s virus surveillance and provide an early warning about the latest variants. bigjohn123456 发表于 2021-06-23 11:24
印度出现了加强版Delta Plus变种,携带之前最牛逼的南非变种特征,牛翻天了。 https://www.ft.com/content/af162963-078c-4c63-9731-e4c8d5e5de2a India sounds alert on ‘Delta Plus’ strain Amy Kazmin in New Delhi The Indian government has warned that a potentially more dangerous version of the Delta coronavirus variant is circulating in at least three states and called for strengthened local restrictions to prevent it from gaining a stronger foothold. India’s health ministry has designated the “Delta Plus” strain as a “variant of concern”, saying it spreads more easily, binds to lung cell receptors more effectively and may reduce the antibody response. Scientists say the variant contains a mutation — known as K417N — that was found in the Beta variant first identified in South Africa and is considered to be particularly resistant to the antibody response generated by vaccines. Scientists said it remains to be seen what effects the mutation would have on the Delta variant, however. India’s health ministry said Delta Plus has been detected in 22 cases in six rural districts of three states – Maharahstra, Kerala and Madhya Pradesh – and urged local officials to introduce enhanced measures. Local news agency ANI, citing government sources, said 40 cases have been identified. New Delhi’s decision to highlight the Delta Plus cases follows criticism that it was slow to detect and sound the alarm on the emergence of the Delta variant. That strain fuelled the country’s devastating recent wave of infections and is spreading rapidly in Europe and the US. The latest strain has been found in several other European countries. The variant was identified by the Indian Sars-CoV-2 genomics consortium, which was set up at the end of last year to improve the country’s virus surveillance and provide an early warning about the latest variants. bigjohn123456 发表于 2021-06-23 11:24
其实楼主没错。 efficacy 是attack rate 在vaccinated 和unvaccinated的比率关系。假设attack rate of the unvaccinated不变,为a, 那么之前的attack rate of the vaccinated 是0.05a, 现在对于delta variant是0.2a, 所以attack rate的确是原来的4倍。
5月WHO宣布印度出现的这个更强病毒变种是全球的concern时,美媒体上也都在播放印度一些地方疫情严重的惨况、美 迟迟不控制往来飞行乘客检疫、隔离,CDC等卫生官员一直都说美国不必担心印度出现的这个更强病毒变种,直到最近才有些改口风…… 提早加强预防不好吗?重复犯同样错误。 https://www.bbc.com/news/world-asia-india-57067190 5/11/2021 WHO says India Covid variant of 'global concern'
首先是delta变种变态的传播能力。现在的共识是delta变种比英国的alpha变种的传播能力至少增加了60%,而英国alpha变种的传播能力又比之前的D614G毒株强了50%以上,而D614G突变是一个出现在意大利并且快速变成主流毒株的突变,传染力又比武汉早期的wild type要强。一般认为武汉毒株的basic reproduction rate在3-4之间,而现在的delta毒株的basic reproduction rate已经高达8-10,也就是说在完全没有预存免疫和管制措施的社会,平均一个人能够传染8-10个人,传染力翻倍都不止。
可以看看具体的实例:
澳洲发现两例”fleeting encounter“传播,不需要什么密切接触,打个照面几秒钟就传上了。
https://www.abc.net.au/news/2021-06-22/covid19-cctv-footage-worrying-nsw-health-authorities/100231832
一架飞机上32个确诊,连打完疫苗并且全副武装的海关工作人员都被传上了。越南的航班上病毒顶着客机上强大的换气过滤系统,隔着6个座位和两条过道都能传染,
https://www.zhihu.com/question/465324619 https://zhuanlan.zhihu.com/p/381631964
其次是致病能力,根据最新的数据,alpha变种和wild type比起来,Hospital admission增加42%,ICU admission增加215%,Death增加65%:https://twitter.com/EricTopol/status/1407471348180414467
而和alpha变种比起来,delta变种的住院风险又增加了80%,死亡率还没有统计,因为数据还不太够:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/994839/Variants_of_Concern_VOC_Technical_Briefing_16.pdf
所以delta变种导致重症的概率和早期毒株比起来至少是翻倍的。新冠轻症出现各种后遗症的概率还不是特别高,但是重症/ICU非常危险,由于免疫系统被过渡激活,会出现大量后遗症。看新冠的危险不能只看死亡率,只要发展到肺炎住院就是很危险的疾病了,后患无穷。
最后是对疫苗的影响,这种疫苗的real world efficacy不能简单地数病例,要针对查出来的已接种和未接种病例一对一match,然后看感染的风险到底下降了多少。目前mRNA疫苗的实战保护率已经有数据的是英格兰88%,苏格兰79%,新加坡79%。可以认为mRNA疫苗避免有症状感染的能力已经下降到了80%左右,和本来95%的有效率比起来,相当于增加了4倍的breakthrough风险。这个影响一方面是因为血清中和能力下降了,目前的体外实验证明接种mRNA疫苗的血清对delta变种的中和能力下降了3-6倍,没有南非变种那么厉害,但也是很明显的。另外一方面病毒载量更高、和受体结合能力更强,也会导致有症状感染的风险上升。疫苗预防有症状感染基本上全靠粘膜里面的一点IgG,这道防线一突破就会出现一些上呼吸道的症状。
但是疫苗保护下呼吸道防止重症的效果仍然很明显,根据英国的数据,疫苗对重症的保护和wild type或者alpha变种比起来好像并没有看到有什么变化。这是因为病毒感染扩散到下呼吸道是需要时间的,只要免疫系统能够在这段时间内动员起来,引起肺炎的概率就会大幅下降。免疫系统动员起来靠的不是血清里面已经有的抗体,而是T细胞、记忆T细胞和记忆B细胞。T细胞对抗原的识别能力更强,病毒想要短时间内逃掉T细胞的识别基本上不可能。这也是为什么体液免疫能力差很多的阿斯利康疫苗对重症仍然有很好的保护作用。
Delta变种还有一个非常厉害的地方在于,已经感染过gamma(巴西)或者beta(南非)变种的血清对delta变种的交叉中和能力非常差,特别是gamma变种,和delta变种之间的交叉中和已经差到了基本上可以忽略的程度,看下面的图。这样就使得药厂很难专门为了delta变种开发一个新的booster,因为打了以后对其他变种的保护能力并不会有提高,这样会引起同样很危险的gamma变种大流行。而delta变种还在继续突变,总有一天会突变到疫苗失效需要打加强针的程度。可能的解决方案是使用alpha变种这样和其他变种交叉中和能力都比较好的毒株,或者像moderna那样直接搞多价疫苗。
最后,很多人不愿意打疫苗,对疫苗有concern,我不支持但是理解这种担心。不过如果不打疫苗的话千万千万做好防护,不要去尝试自然免疫,普通的布口罩很难抵挡这种通过气溶胶传播的病毒,室内要戴上N95并且注意不要漏气。打过疫苗的人如果本地感染率高的话,室内也是需要戴口罩的,打过疫苗之后粘膜里面会有很多抗体,只要减弱一点病毒量很可能就不会突破上呼吸道粘膜的防线。CDC的guideline是为了刺激大家打疫苗,毕竟口罩可以重新戴回去,疫苗打了那就是打了不能抽回去。口罩的作用有限不能代替疫苗那是真的,但是这两个并不互相排斥,作为个人还是要加强防护。
最后是美国目前delta变种的形势和预测,目前这个变种在美国占到了20-30%,而且每两周会翻倍,这个速度没有英国那么快,但也是很明显的。贴两张图,一个是delta变种在一些州的新增数量,可以看到不光是比例,绝对数量也在增加,在接种率和既往自然感染率都非常高的地方比如麻省上升的还不是那么快,但是在疫苗接种率低的州这个上升的势头很明显。事实上由于delta变种的影响,现在疫苗接种率低的几个州比如AR, UT, MO,疫情已经有很明显的反弹了,这些州未接种疫苗的高危人群很快就会面临巨大的风险。第二张图是目前delta变种的Rt值,也就是目前平均一个人会传染多少人,可以看到大部分州都在1.2-1.5的样子,说明delta变种还在快速扩散。
美国现在各种限制措施已经基本取消,而高传染性的alpha变种的比例和绝对数量都仍然在快速下降,说明现在至少80%的人已经通过自然感染或者疫苗获得了免疫能力。而要想抑制delta变种,这个数量要上升到接近90%。再考虑到疫苗本身的breakthrough和二次感染,可以认为目前美国还有3000万左右的缺口,这个缺口一部分要靠疫苗,另一部分肯定要用自然感染来填补。我估计今年夏天这一波疫情至少会带来500-1000万的新增确诊(因为很多无症状和症状很轻的人不会去检测),整个走势可能和英国的情况乘以5(人口比例)差不多。英国现在每天新增10000多,已经摆脱了指数增长,但是还在快速上升,有一些早期爆发delta变种的地区刚刚出现下降。但是另一方面由于高危人群疫苗接种率已经很高了,住院和死亡的数据不会太难看。
🔥 最新回帖
非常常见 所以很难理性的探讨问题
按照你这个逻辑。Delta变种在广东爆了,说明广东失职没管理好,Delta变种在广东没爆,说明变种不厉害。这个好像是版上常见的神逻辑。
其实这个80%有个误解。因为最开始的对照组,对病毒是基本没有抗体的;而现在的对照组,由于大流行的原因,可能已经有10%的人有自然抗体了,要把这部分加回。 简单加10%的话,那就有90%;如果只加5%,那也有85%。疫苗有效率没有下降那么多。
我们学校管的很严,只要有任何流鼻涕咳凑不舒服的症状,就让回家,做完test negative,也要在家呆到症状完全消失,现在还是室内必须戴口罩
🛋️ 沙发板凳
https://www.ft.com/content/af162963-078c-4c63-9731-e4c8d5e5de2a
India sounds alert on ‘Delta Plus’ strain Amy Kazmin in New Delhi
The Indian government has warned that a potentially more dangerous version of the Delta coronavirus variant is circulating in at least three states and called for strengthened local restrictions to prevent it from gaining a stronger foothold. India’s health ministry has designated the “Delta Plus” strain as a “variant of concern”, saying it spreads more easily, binds to lung cell receptors more effectively and may reduce the antibody response.
Scientists say the variant contains a mutation — known as K417N — that was found in the Beta variant first identified in South Africa and is considered to be particularly resistant to the antibody response generated by vaccines. Scientists said it remains to be seen what effects the mutation would have on the Delta variant, however.
India’s health ministry said Delta Plus has been detected in 22 cases in six rural districts of three states – Maharahstra, Kerala and Madhya Pradesh – and urged local officials to introduce enhanced measures. Local news agency ANI, citing government sources, said 40 cases have been identified.
New Delhi’s decision to highlight the Delta Plus cases follows criticism that it was slow to detect and sound the alarm on the emergence of the Delta variant. That strain fuelled the country’s devastating recent wave of infections and is spreading rapidly in Europe and the US.
The latest strain has been found in several other European countries.
The variant was identified by the Indian Sars-CoV-2 genomics consortium, which was set up at the end of last year to improve the country’s virus surveillance and provide an early warning about the latest variants.
另外补充一点,接种过灭活疫苗之后赴美的老人我觉得可以认真考虑加强一针mRNA疫苗了,对老人来说,混合接种的收益已经明显大于风险。从一些anecdotal data来看,面对delta变种,灭活疫苗不仅对感染的保护作用不好,连对重症/死亡的保护能力也很成问题。印尼最近一段时间由于delta变种造成的350个科兴疫苗breakthrough case里面就有几十个重症住院。这些breakthrough case都是医护人员,这个年龄的重症率本来不应该这么高的。作为对比,新加坡最近发现的120多个breakthrough case里面只有一人需要短暂的吸氧,绝大多数是无症状和轻症。
另一个新闻是最近4个月印尼死于新冠的61名医护人员里面有10人已经完成疫苗接种,也说明类似的问题。(印尼的疫苗接种率很低,fully vaccinated只有4.6%)
https://www.reuters.com/world/asia-pacific/hundreds-indonesian-doctors-contract-covid-19-despite-vaccination-dozens-2021-06-17/ https://www.nytimes.com/2021/06/22/business/economy/china-vaccines-covid-outbreak.html
楼主,那今天夏天开学的小朋友们该怎么保护呢?
K417N其实不是最厉害的突变位点,这个delta plus到底多危险还是要看传播能力
这个delta变种有点绝望。
我也很愁,室内戴好口罩,大人积极打疫苗,也只能这样了。还好小孩的症状普遍比较轻。
小浣熊,妳对於7岁以下小朋友的防护有什麽建议? 我有一娃上小一,一个在daycare
我都关注了,特别是子陵在听歌,每天都会更新新冠研究方向的paper。还有个”最后一次吃糖“也是专门搞这个的。知乎上还有个喷总,moderna员工,懂得也很多,不过基本上一张嘴就被封。。。
找中国人比较多(比较在乎新冠),防护措施比较好的幼儿园,比如戴口罩早上检查体温。私立学校其实比公立安全我觉得,因为可以更customized 知道好几家一直没中断送幼儿园的,没被传染
啊哈哈哈哈 我漏说了 对 还有最后一次听歌 他之前就是接种灭活,返美后来了一针摩德纳。之前朋友问我接种灭活后能不能打mrna,我就用这个例子跟朋友说
这种就指望同学家里大人都打过疫苗了,如果你自己属于高危人群,也考虑打吧。
我前几天去做健康检查,护士是说打完疫苗的不太可能再把新冠传给免疫力正常的人。不过她自己怀着孕,我猜也许接种了,但明显比其他护士谨慎很多,不止口罩,还戴了plastic face shield, 进来exam room 以后什么都不摸,我们聊完天她立马闪
我在加州南湾,上周末买菜在室内没看到不戴口罩的,大部分人都是戴好了才下车,有个别拿在手上进店前才戴的。但是现在大形势在放松,不晓得普遍戴口罩能坚持多久--我自己会坚持室内戴,室外比如hiking,口罩备着,近距离有人戴。我们县说12岁以上80%接种一针,70%完成接种,政府不断放宽,一般百姓心态肯定也是会越来越放松的。
well…
何以解忧,唯有躺平。 Delta目前看不算六边形战士,Delta和Beta(South Africa) variant还有组合的空间……
去看看。谢谢推荐
你现在问候印度同事, 人家说, 疫情在印度已经过去了, 没人还当回事了。
这么多病毒,HIV、乙肝、甲流、狂犬病、手足口,从来没有听说过哪个病毒越来越弱了,病毒的自然选择性变异方向是传染性越来越强。
他现在很少发言了,也是怕被删
不会,该得的还是要得,不该得的一定没事。拼基因吧
我问的就是毒性是在自然变异中是会越来越强吗? 大家都知道变异后传染性会越来越强. 传染性和致命性是相对的吧,致死率太大会导致宿主死得太快来不及传播.
激动?我是怕怕。。。看你的图,我们州delta变种比例很高啊,可我们明明疫苗普及率很高呀,为什么会这样?
没错
不过这种天天宣扬到处打疫苗的情况继续下去 不要说delta
再🐂的变种的出现 也是分分钟的事
是啊 好问题
Delta变种比例高不说明问题吧。假设一个接种率很高的地方,一天就一个case 是Delta变种,那就是100%, 说明什么问题呢? 这个只是相对其他变种的比例。
印度真厉害,天朝巴西南非都望其项背
如果疫苗接种率更高,Delta变种因为更容易突破疫苗防护,在感染人群中比例高一些也没啥奇怪。 只要总感染人数少就行了,并且目前看到疫苗能让重症减少,暂时还是不用太担心的。
全球免疫专家病毒专家疫苗专家都说不好的事情,一个护士说的你就信了?
说明这已经是目前医学界主流认知了。。。
谨慎的人当然可以选择自己戴,我家每次出门都戴口罩,但是你不要对别人报太高希望。。。我觉得对别人期望越高,越焦灼,怨气越大
打了疫苗大概率是轻症,不打疫苗就不好说了
how so?现在不打疫苗的大部分都是在一般情况下不打也是轻症的
关键还是做好该有的防护 但是社区传播了 你该重症还是要重症的 除了躲起来 基本没办法
这说明狼要来了。。。我们州的R值从最低时的0.46一直在上升,现在已经到0.99了,我本来还觉得奇怪,怎么疫苗越打越多,R值反而在上升呢
不是说病毒会向传染性更强,致死率更低进化吗?Covid19却是进化成了耐高温全天候,高传染性高致死率的超级病毒。以后疫苗需要有针对multi-variants才行啊。
因为疫苗给病毒过筛了呀。其他变种被疫苗扛住了,只有delta变种又能传播又能逃逸,可不就占比高了么。要看疫苗的效果,你还得看感染总人数。
致死率更低那是基于宿主死得太多太快不利于病毒传播这一事实,要是致死率原来是10%,那的确应该会降。新冠的致死率本来也不高,所以才会有那么多人口口声声病毒不存在、无所顾忌地在外头浪,变得致死率强一些也不会让它减弱传播的。
大部分lz的信徒都不懂这个95%保护率究竟是个啥
你考虑两个对照实验,一个是95%有效的疫苗,一个是80%有效的疫苗,环境类似,实验结束的时候安慰剂组都有100个感染。那么是不是95%有效率的疫苗平均会出现5个感染,80%有效的疫苗平均会出现20个感染呢?
你这不过是把同样的数学事实换了个表达式而已。抬个什么杠呢?明明你们是一个意思
delta一来,打过疫苗的人群里,感染数比没有delta增长4倍,就是这样
人家管理的好
其实楼主没错。 efficacy 是attack rate 在vaccinated 和unvaccinated的比率关系。假设attack rate of the unvaccinated不变,为a, 那么之前的attack rate of the vaccinated 是0.05a, 现在对于delta variant是0.2a, 所以attack rate的确是原来的4倍。
纽约市将为任何想打疫苗的人提供上门接种服务。
1010 WINS NYC expands in-home vaccinations to 'anyone who wants one': de Blasio https://bit.ly/3gNOmqA
半夜排队全民检测好几次了
你应该想,就是因为delta变种厉害,广东才这么紧张
你还是谦虚点吧。
没想到华人里也有这种弱智
安全健康方面,不都应该先重视预防吗?等有病了、传染不能排除了,不就晚了吗?导致更多更强的变种。 印度出现的这个更强病毒变种,报道是演变自南非变种和美加州变种……
不敢出去玩了
https://www.bbc.com/news/world-asia-india-57067190 5/11/2021 WHO says India Covid variant of 'global concern'