Published in Vaccine, the research estimates vaccines averted 4,000 to 12,000 deaths and 34,000 to 56,000 hospitalisations within 18 months from January 2022.

However, among the highlighted outcomes were the disparities in health outcomes for Maori.

The study pointed out that if Maori vaccination rates had matched those of Pakeha, up to 75 of the 292 Maori deaths could have been prevented.

Professor Michael Plank, a co-author and Covid-19 researcher, emphasised the importance of ensuring equal vaccination rates among Maori and non-Maori to save lives and lessen the pandemic's toll on Maori communities.

The authors say the Covid-19 elimination strategy meant most people were able to be vaccinated before being exposed to the virus.

New Zealand's early elimination strategy allowed widespread vaccination before widespread virus exposure, contributing to one of the lowest pandemic mortality rates globally.

This research reinforces the crucial role of vaccines in protecting health while also calling attention to the need for equitable health strategies in Aotearoa.

Source

• 1News

It's the first sustained uptick since the "winter wave" of Omicron subvariant BA.5, University of Melbourne public health researcher Nancy Baxter told RN Breakfast on Friday.

"You have things like wastewater testing, sewage testing, and numbers are going up there [now]."

New Zealand is also experiencing an increase in Covid-19 cases after experiencing two months of declining cases in August and September, following a Covid peak in July.

In Australia, fewer people are getting tested, but of those that do, a larger proportion are testing positive.

In some states, hospitalisations are increasing too.

"Those are all signs that actually the decline is over, and we're starting to see the start of the new wave," Professor Baxter said.

This wave is driven not by one new variant but a bunch of Omicron offshoots, signalling a "turning point" in the pandemic, according to Norelle Sherry, medical microbiologist and infectious diseases physician at the Doherty Institute.

"It's no longer one big wave of a single variant being replaced by another single variant.

"We're actually in more of a Covid soup - not my original phrase, but I think it's definitely apt."

What are the new subvariants in Australia?

The Omicron variant of the SARS-CoV-2 virus has been the sole "variant of concern" since Delta was downgraded to "previous variant of concern" in June this year.

And in the year or so since Omicron was first detected, it's spun off into more than 300 subvariants (that we know of).

The big one - BA.5 - might be on the decline, yet still makes up most cases reported in Australia at the moment.

New Zealand's Ministry of Health figures indicate that BA.5 is also the dominant variant in Aotearoa currently accounting for 78 percent of cases.

BA.2.75 - which was first detected in India in May and was nicknamed Centaurus - is still kicking around too.

In New Zealand, the Health Ministry says BA.2.75 and XBB variants were over-represented in terms of people getting reinfected with the virus.

Variant XBB is one of the new names popping up in the Australian context, along with BQ.1.

So far these new variants have mostly spread in different parts of the world: BQ.1 and its close relative BQ.1.1 feature heavily in Europe and the US, whereas XBB took hold in Asia, notably causing a wave in Singapore that peaked in mid-October.

They differ in how they came to be, too. BQ.1 descended from BA.5, so can be considered a sublineage of a sublineage.

XBB, on the other hand, is what's known as a "recombinant", the result of two different Omicron subvariants swapping parts of their genetic material - in this case, Centaurus and BA.2.10.1.

Other Covid recombinants have appeared over the past couple of years, Dr Sherry said, but XBB is the first to spread widely.

What BQ.1 and XBB do have in common is a whole bunch of mutations in their spike protein.

This means that even if you've had another subvariant of Covid or been fully vaccinated, the new Omicron viruses might be able to sneak past your immune defences.

It also means some treatments might be less effective. One study, which has not yet been peer-reviewed, found monoclonal antibody drugs, which work like antibodies made by your own immune system to fight a Covid infection, aren't as effective against BQ.1 and XBB.

How do XBB and BQ.1 compare to BA.5?

Overseas data suggest XBB and BQ1 transmit faster than the currently reigning BA.5, but there is some good news.

"We don't know for sure yet, but the signs are that their disease severity is similar to the other Omicrons," Dr Sherry said.

During Singapore's XBB wave, for instance, while case numbers rose, hospitalisations didn't follow suit.

In October, the Singaporean Ministry of Health reported that people infected with XBB had a 30 percent lower risk of hospitalisation compared to those with BA.5. Continue reading

However, there are plenty of other viruses circulating and people should keep up health measures such as wearing masks and staying home when sick, they say.

A panel of health experts answered readers' questions on all things Covid-19 - including what we should expect in the next six months - in a live discussion on Stuff. Read more

The two most concerning aspects of long COVID are its high prevalence (up to 30% of those infected) and a link between reinfection and a higher risk of harmful outcomes.

American science writer Ed Yong, commenting on government responses to the pandemic, described them as a case of debrouillez-vous, which approximates to "you work it out - you're on your own".

In the face of official attitudes that are increasingly laissez-faire towards the continuing pandemic, many people no longer take even those precautions over which we have individual control: mask wearing, physical distancing and choosing carefully whether to attend crowded events. The consequences are an increase in both daily case numbers and the lurking burden of long COVID.

Omicron's first variant, BA.1, emerged in late 2021, substantially different - clinically and genetically - from earlier variants. It displaced the Delta variant and, in early 2022, was itself replaced by BA.2.

The degree to which BA.2 had evolved away from BA.1 is far greater than the genetic distance between the original version of SARS-CoV-2 and the Delta variant. BA.5, a sub-variant of BA.2, is now quickly overtaking other variants.

Recent data from the US Centers for Disease Control and Prevention show the rapid rise of the BA.5 variant and its replacement of other Omicron variants.

Omicron variants, and BA.5 specifically, show several worrying features. They can evade immunity acquired through earlier infections and breakthrough infections in vaccinated people. BA.5 is better able to infect cells, acting more like Delta than the previous Omicron variants.

What we know about long COVID

SARS-CoV-2 is not unique in its ability to cause post-acute symptoms and organ damage. Unexplained chronic disability occurred in a minority of patients after Ebola, dengue, polio, the original SARS and West Nile virus infections.

Collection date (month/day format), for week ending.
Recent data from the US Centers for Disease Control and Prevention show the rapid rise of the BA.5 variant and its replacement of other Omicron variants. US CDC, Author provided

What is different is the sheer size of this pandemic and the number of people affected by long COVID. One of the absolutely critical issues about long COVID is that we should not underestimate it. It is now clear from multiple large studies that:

• It is a set of syndromes
• it affects multiple organs and systems
• it resolves in some but remains persistent in others
• it can be markedly debilitating
• its risk is reduced by vaccination
• its pathology is poorly understood
• we are just beginning to find ways to predict risk and monitor its course, and
• management is, at best, ad hoc.

Perhaps most crucially, reinfection may now become a feature of the pandemic for at least the next 12 to 36 months, raising the risk of long COVID with each repeat infection.

Some large studies in Denmark, England, and the US show 20-30% of people who tested positive for COVID-19 experienced at least one post-acute symptom, up to 12 months after infection. Symptoms included loss of smell and taste, fatigue, shortness of breath, reduced limb strength, concentration difficulties, memory disturbance, sleep disturbance and mental or physical exhaustion.

In England, the prevalence of persistent symptoms was higher in women and older people. Obesity, smoking or vaping, hospitalisation and deprivation were also associated with a higher probability of persistent symptoms. Those who were hospitalised with COVID in the UK showed even more severe outcomes.

Long COVID affects all age groups, but younger people have a higher risk for heart-rhythm disturbances.
In the US, younger survivors were at higher risk than people over 65 for heart-rhythm disturbances and musculo-skeletal pain. This is consistent with other observations that long COVID is not a disorder only of older age.

However, older survivors had a statistically significantly higher risk of developing certain conditions, including kidney failure, clotting disorders, cerebrovascular disease (stroke), type 2 diabetes, muscle disorders and a variety of neurologic and psychiatric conditions.

A US study involving more than five million people shows the risk of long COVID increases with the number of reinfections. But vaccination consistently reduces the risk of long COVID as well as severe disease, hospitalisation, ICU and death.

The century-old lesson we're yet to apply

There are lessons from the 1918-19 influenza pandemic that we need to bring back into our repertoire, not for a month or two but for the long term.

Japan adopted mask-wearing as a key public-health element on a short list of available measures. As science writer Laura Spinney notes in her excellent 2017 coverage of the flu pandemic's history, it "probably marked the beginning of the practice of mask-wearing to protect others from one's own germs".

In Japan, mask use was compulsory for some, such as the police. In some towns, people were not permitted on public transport or allowed to enter a theatre without a mask. Japan had the lowest death rate of all Asian countries in the flu pandemic and is looking to be close to the lowest cumulative mortality in the OECD for the COVID-19 pandemic.

Mask-wearing has protected people in Japan during the flu pandemic a century ago and again now as new Omicron variants continue to surge.

During the 1918-19 pandemic, the US, unlike Europe, put considerable effort into public-health interventions, which reduced total mortality. San Francisco, St Louis, Milwaukee and Kansas City had the most effective interventions, reducing transmission rates by 30-50%.

In historian Geoffrey Rice's Black November and Black Flu (together the most comprehensive coverage of the 1918-19 pandemic in Aotearoa), there are some photographs of people wearing masks and a reference to "gauze masks" for shopkeepers. However, there is little evidence to suggest mask wearing was widespread or encouraged in New Zealand.

The influential Italian newspaper Corriere della Sera reported daily death tolls during the 1918-19 flu pandemic until civil authorities asserted it was stirring up anxiety and forced it to stop. As Spinney notes, people could see the exodus of dead bodies from their neighbourhoods and the silence was provoking even more anxiety.

The pandemic and the silence conspired to confuse people about the efficacy of public-health measures and compliance dropped off even further. People drifted back to church and race meetings - and left masks at home. Public-health infrastructure collapsed.

Vaccines (not available a century ago) are almost all that stands between us and a similar collapse. We would remain stronger and healthier - and reduce the burden of long COVID - if we increased vaccination coverage and universally adopted Japanese-style regular mask use and physical distancing.

• John Donne Potter. Professor Research Centre for Hauora and Health, Massey University
• First published in The Conversation. Republished with permission

Auckland's Carmel College says on its website that the school will be using online learning from Tuesday 5 - Friday 8 July.

Schools in New Zealand are on holiday from 9 July.

Amid battling Covid, influenza, RSV, tummy bugs and staff having to care for ill family members, the NZ Herald reported, Sunday, schools are 'just hanging on' till the end of term.

University of Otago epidemiologist Professor Michael Baker is again urging New Zealanders to brace for the second Omicron wave as the community case average increased by almost 50 per cent in nine days.

Baker described the 49 per cent increase of the seven-day rolling average of cases on June 25 (4737) to Monday 4 July (7046) as an "abrupt rise."

Baker is warning that New Zealand could be at the beginning of another Omicron infection wave.

"It's a dynamic; a battle between us and the virus and there are factors mainly favouring the virus at the moment," Baker said.

On Monday, health officials reported 6498 community cases, and 487 hospitalisations. The weekly rolling average of hospitalisations has increased from 335 this time last week to 420 today.

While some schools have gone back to compulsory wearing of masks, last week, the Government only encouraged mask wearing for year 4 students and above.

A mandate for wearing masks in schools was removed in mid-April, just before the end of the first school term.

On June 30, the Government made changes to reinfection advice, saying anyone who experienced symptions 29 days or longer after a previous infection must test and isolate if they return a positive result.

"Moving back to red is unnecessary at the moment. We can continue to manage the virus at orange, but are putting in place a range of additional measures to help manage a recent rise in cases," Covid Response Minister Dr Ayesa Verrall said.

Sources

• Carmel College
• NZ Herald
• NZ Herald
• Stuff

That is despite slightly more women having been infected overall, according to Ministry of Health data.

Women also made up about 56 percent of those who have been hospitalised with the virus, according to the data.

The ministry said 190 of the people who have died with Covid-19 this year have been men, compared with 114 women.

Epidemiologist Michael Baker said that followed the same pattern that had been seen across the globe.

"Of course, there's been huge speculation about why it is such a big difference. At the moment, there isn't one theory that's dominating," Prof. Baker said. Read more

This troubling rise may signal that another wave of Covid-19 is rising in countries just coming out of their own omicron shadows.

Hong Kong now reports the world's highest death rate from the disease.

Hospitals are overwhelmed and the surge is fuelling a mental health crisis and leading to suicides, particularly among elderly residents.

Mainland China is also seeing major outbreaks in metropolises like Shenzhen and Shanghai, putting millions of people under lockdown and halting production in major international manufacturing centres.

These outbreaks are testing China's stomach for its zero-Covid approach to the pandemic, a costly but effective approach where entire cities grind to a halt to control outbreaks.

In South Korea, once hailed as a pandemic success story, case counts have broken a new record with daily reported infections topping 600,000.

Australia and New Zealand, which had previously held cases to enviably low levels, have also seen new spikes in recent weeks. The list goes on: Singapore, Thailand, Vietnam.

Setting its own agenda

There are some common factors among these outbreaks.

The biggest one is that the virus itself has changed.

The mutations in the omicron variant of the virus that causes Covid-19, first detected in November 2021, make it the most contagious version of the virus known to date and allowed it to evade immunity — both from vaccines and from previous infections — better than other variants.

Many of the earlier omicron waves were caused by a sub-variant known as BA.1.

Another omicron sub-variant known as BA.2 is even more transmissible and is now driving a distinct spike in new cases.

However, there are also variables that make each of these outbreaks unique, namely how leaders in these regions deployed their public health strategies — testing, contact tracing, travel restrictions, vaccination — and when they relaxed them.

The good news is that most Covid-19 vaccines are just as protective against severe disease caused by BA.2 as they are against BA.1. And omicron causes a lower rate of hospitalisations and deaths among vaccinated people compared to other variants.

As the world enters the third year of the pandemic, these surges are a tough lesson about the perils of complacency.

But for countries watching from afar that may be on the cusp of another round of infections, the latest series of outbreaks abroad also offer policy lessons on the best ways to dampen Covid-19's worst effects.

How Hong Kong ended up with the world's highest death rate from Covid-19

Hong Kong, a dense city of 7.4 million people, saw daily new Covid-19 cases climb above 66,000 this month.

The per-capita death rate reached 37 per million residents and one fatality per 20 infections, very high compared to rates among developed countries.

It's a stark shift from how well Hong Kong weathered much of the pandemic, building on its experience with other coronaviruses like the 2003 SARS outbreak.

Hong Kong has also maintained strict border controls.

Visitors face a 14-day quarantine requirement with location-tracking wristbands when they are allowed to enter the city at all. City health officials also maintained a robust contact tracing system.

That cases are surging now is partly a function of the recent emergence of BA.2, but also because governments are starting to relax.

As a result, Hong Kong went long stretches during the pandemic without any cases at all and with life largely continuing as normal.

"We had a period of about six months without a community outbreak of Covid in Hong Kong in the second half of 2021, but I think it was inevitable that an outbreak would occur sooner or later," said Benjamin Cowling, chair of epidemiology at the University of Hong Kong's public health school, in an email.

What's changed now is that the BA.2 sub-variant, which is driving the current wave of infections, is very, very easy to contract.

Viruses like SARS-CoV-2, which causes Covid-19, are prone to mutation.

The more people they infect, the more likely it is that they will change, and some of those changes can make the virus more transmissible, cause more severe illness, or better evade the immune system. (A variant is a category of a virus with a distinct grouping of mutations. But if two strains of a virus have only a handful of differences between them, they may be classified as sub-variants like BA.1 and BA.2.)

BA.2's reproductive number — how many other people each infected person goes on to infect on average — is around 10.

With stringent public health measures like social distancing, frequent testing, and quarantining, the reproductive number dropped to 2 or 3, "which is a very substantial reduction, but not enough to prevent an outbreak from occurring," Cowling said.

As long as the virus's reproductive number says above 1, it will continue to spread. But BA.2's raging transmission also means that it quickly runs out of people to infect, leading to a sharp rise and rapid decline in cases. Continue reading

They have written an open letter to the New Zealand Catholic Bishops Conference.

The Wellington EJP letter is a response to an anonymous "open letter" from a group of Catholic men asking the bishops to ask the government to review and remove vaccine mandates and other restrictions.

CathNews published a story on Monday 28 February about the anonymous open letter to the bishops.

The letter itself appears to remain unpublished.

The EJP letter recognises the Covid-19 pandemic continues to pose a threat to the lives and wellbeing of vulnerable people, which requires a prudential and ethical response from all of us.

The letter recognises there will be a time for removing mandates and other restrictions, but not now when daily case numbers are over 10,000 and hundreds are hospitalised.

"We support reviewing and removing mandates when they are no longer required. But that time is not now," the group says.

The anonymous open letter claims that removal of mandates would increase the morale of New Zealand Catholics, but the EJP members do not agree.

"We are Catholics who would be dismayed if the Bishops were seen to abandon the precepts of solidarity, protection for the poor and vulnerable, and concern for the common good which are foundational to Catholic Social Teaching."

They say it is in the light of these principles that many New Zealanders have accepted the restrictions of the past two years.

The EJP letter reminds the Bishops of Pope Francis' theme for his 2022 Lenten message, taken from St Paul's letter to the Galatians: Let us not tire of doing good.

"We hope, pray and believe that our current restrictions will not be necessary for much longer. But we ask you, following the example of St Paul, to continue to exhort our whole community not to give up, but to continue with practices that protect the most vulnerable, for the good of all."

The EJP letter's aim is to strengthen the resolve of New Zealand Catholic Bishops Conference in continuing with the position taken in their November 2021 pastoral letter until the current Omicron outbreak has passed.

• We recognise that the Covid-19 pandemic is a threat to the life and wellbeing of vulnerable people, that requires a prudential and ethical response from all of us.
• We support the position of the New Zealand Catholic Bishops Conference in your pastoral statement of November 2021 that vaccine mandates are an appropriate solution in the present circumstances, but must be monitored and reviewed.
• We believe the present state of the Covid-19 pandemic requires the continued practices outlined in your November 2021 pastoral letter, by church, government and by all of us and each of us.

Source

• Supplied

As daily Omicron cases soar throughout the country, avoiding high risk places means steering clear of bars, restaurants, cafés, gyms, churches and protests.

Retail shops, offices, lifts, stairwells, malls, community pools, public transport and other commonly shared public spaces that offer slightly more space between people are at the next tier of risk.

Passing aerosols (breath) around the room in small, indoor areas is the perfect recipe for virus transmission. Singing, yelling, talking and laughing in enclosed spaces are particularly risky, Wilson explains.

He also says it's important to note that having your vaccine pass checked at high risk places - like churches and bars - won't stop you getting Covid.

In his view it's "irresponsible" to claim people are safe just because their vaccine passes have been checked, Wilson says.

Nonetheless, it is possible to live a relatively normal life provided you take sensible precautions along the way.

Wilson and Baker recommend keeping the "3 Cs" rule in mind before going out - crowded, confined, close contact settings are the highest risk places.

Particularly high risk meeting places meet all three criteria. Churches fall into this category.

One way we can help ourselves when we're out and about is to think how well a space is ventilated and how well people are spaced apart before entering, Baker suggests.

He and Wilson also suggest wearing a high quality N95 mask and ensuring you are vaccinated and boosted.

"Avoid unmasked situations with lots of people Baker said. "I would certainly prefer not to have it [Covid]".

Sunday Mass needs to be safe

Cardinal John Dew says it's important for people to feel safe coming to Mass by clearly having precautions in place for their safety.

He says this may involve going beyond the government's guidelines in some areas, such as by not singing, and requiring the priest and other ministers to be masked.

Priests and lay pastoral leaders in the Archdiocese of Wellington have been advised they may have to cancel Mass if local Omicron numbers rise to a point they consider unsafe, or if they themselves have to self-isolate.

Keeping safe by not going to Mass at present is an option, as Dew says there is a dispensation from the Sunday obligation during the pandemic.

He also has a request: that while numbers in churches are limited to 100 people or fewer, people avoid trying to book in to attend Mass in other parishes. Those parishes will be trying to accommodate their parishioners within their 100-person limits too.

Source

• Stuff
• Supplied - Archbishop of Wellington
• Image: NZ Herald

A defining feature of Mangere in South Auckland is the number of large churches.

The suburb is also full of sleep-outs, converted garages and portable cabins. These are clear indications of a community struggling with an under-supply of affordable housing.

Then there are the over 3,700 active Covid cases in South Auckland.

It's struggling to deal with them, given the extra pressure that self-isolation rules obviously place on overcrowded households.

But Reverend Victor Pouesi (pictured) says churches like his EFKS congregation in Mangere East are uniquely equipped to be able to help.

Pouesi has been supporting 14 boys recuperating from Omicron inside his church's large hall.

The boys, whose families all attend the church, had been away as a group together when their families became exposed to the virus.

They were initially invited to stay at the hall to avoid catching it themselves.

It turned out most of the group was infected anyway, so they have to stay where they are until they return negative tests.

He explains his church has relatively new facilities, including a kitchen and recreation space, which makes it ideal for isolating young men in their late teens and 20s.

Along with health and wellbeing checks undertaken by South Seas Healthcare staff (Otara's largest Pacific health provider), the minister keeps in touch with his young guests.

"Every night we hold our evening prayer service to encourage them and make sure they are doing OK mentally. And given they are all friends, they've been saying that even though they tested positive they have enjoyed being able to support each other".

Pouesi, who has just recovered from Covid, says almost his entire 90-family congregation is currently self-isolating.

"We haven't really been affected as we are all vaccinated and most have had the booster", he says.

This is the second outbreak at the church since the pandemic began. The first was in March 2020.

"In a way, we have learnt a very valuable lesson about the importance of complying with the Ministry of Health and working with the Pacific providers who have helped us a lot", Pouesi says.

"I actually think the Lord has prepared us for this as we installed all the technology needed to run home services back in 2017, so we've been able to stay connected right through this time".

He would like his church to continue to be used as a self-isolation facility for South Seas to use once the boys leave, if possible.

"There are so many churches in South Auckland, but they have been pretty much locked down - due to attendance restrictions for church services - so we might as well use them in this way" he says.

South Seas Healthcare agrees saying that as Omicron's spread accelerates the Ministry of Health needs to rely more on local organisations.

Source

• The Spinoff
• Image: Stuff

And the Ministry of Health is urging the Pacific communities in New Zealand to receive their booster vaccination to protect themselves against the Omicron variant.

Ministry of Health Pacific health director Gerardine Clifford-Lidstone said in the past few days there had been a big increase in the positive cases of Covid-19 in Pacific communities.

"What we're seeing over the last few days is quite a big increase in the cases for Pacific and we did anticipate that it's what we've seen internationally. At the moment, about 50 percent of the cases are Pacific people and mainly in the Auckland region." Read more

The newly-established Taupo Churches-Community Support Hub is offering services to anyone in the community who is self-isolating or facing challenges during the Covid-19 pandemic.

The Churches-Community Support Hub comprises the Catholic Church, Baptist Church, Taupo's Salvation Army, C3 Church, Advance Church and Church at 109.

The services are being offered in conjunction with any already offered by the Lakes DHB, local government and non-governmental organisations.

A doctor from St Patrick's Catholic parish and members of the Taupo Baptist Church met to "toss around some ideas for a support service" in November of last year, says Monsignor Trevor Murray from St Patrick's.

They sent an invitation to local churches and meetings were held to put the group together.

The inter-church group's aim was to provide non-denominational support to anyone facing difficulties with the disease in Taupo.

"We want to be clear that this service is for everybody - vaccinated, unvaccinated, it doesn't matter - it's about being prepared and offering support for all who may need it," Monsignor Murray stresses.

Seventh-Day Adventist Church Pastor Phil Laws and his wife Lynelle say the pandemic has turned the world as we know it upside down.

"It is this constant uncertainty that has unsettled so many - that has been the catalyst for the churches of Taupo to come together and form the group," Lynelle Laws says.

"If isolating, you may find you need support with activities for the children, food parcels or food pick-up and delivery, pharmaceutical deliveries or simply a listening ear.

"We didn't want to shut the gate after the horse had bolted but instead be prepared for when it happens, and we have tried not to duplicate other services being offered to the community," Phil Laws adds.

The services the group offers include help with food and other practical support needs, friendship, and a video about things to consider when required to isolate, provided by paediatrician Dr Belinda Coulter.

To contact the Support Hub, go to its website, www.taupochurches.com. The Hub is also on Facebook.

Source

• Waikato Times