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Roadmap to normal, will normal ever be a thing?

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South Australians were eagerly awaiting the news of what would be a ‘roadmap to normal’. After the majority of people did what they were asked and got vaccinated, they were excited to reap the rewards and see what the future was to bring after such a long couple of years.

Restriction and mask fatigue are ramping up in South Australia and businesses along with the entertainment industry are buckling under patron caps and the inability for people to stand up for a drink and dance. After all, why would you head to a club if you cannot dance the night away on that very missed dance floor?

Changes needed to be made. Luckily for the mental health of many South Aussies and their businesses, Stephen Marshall announced a South Australia Covid-Ready Plan. From the 23rd of November borders to fully vaccinated Australian states and territories open. Although many public activities will not be lifted until the State reaches 90% of South Australians fully vaccinated, which the Premier and SA health claim could happen by the end of the year.

The eagerly awaited high-risk activities like a full capacity nightclub will be available to those fully vaccinated people and if you can prove your vaccination status, then you can finally stand up for a drink. This is fantastic news for the fully vaccinated, however what no one is talking about is how this ‘Covid-Ready Plan’ will affect the mental health of those who are unvaccinated or those ‘high risk’ business owners who will choose not to discriminate on vaccination status.

During press conferences, Stephen Marshall and Nicola Spurrier have often avoided speaking of mandating any industry to only allow vaccinated patrons, and that may be because there is very little scientific evidence to suggest this even works.

Pouwels et al. (2021), Brown et al. (August 2021), Riemersma et al. (preprint July 2021) and Chau et al. (preprint August 2021) all indicate the double vaccinated are being infected and have similar peak high viral loads of the delta SAR-CoV-2 variant as the unvaccinated. This places a big question over the ability of vaccination to prevent any onward transmission.

Put in another way, Delta variant viral loads and therefore transmission ability is now being accepted as being equivalent in both vaccinated and unvaccinated people, therefore there is no therapeutic or clinical benefit in minor changes in rates of transmission of vaccinated compared to unvaccinated.

To further highlight the nonsense of discriminating against vaccinated vs unvaccinated people and forced mandating of vaccinating people we also have:

  • Public Health England (PHE) Technical Briefing 22 (3 September 2021) also shows double vaccinated (1091) now represent 67% of Delta variant deaths against unvaccinated deaths (536). That is a 9,100% increase in double vaccinated deaths from June 7th when reporting began during a time when the percentage of people double vaccinated only increased by 20%.
  • Egan et al. (2021) reports increasing UK hospitalization of fully vaccinated SARS-CoV-2 PCR positive patients, suggesting vaccine failure.
  • Brown et al. (August 2021) finding of 469 cases in Barnstable County, Massachusetts, USA, 74% of all cases were among fully vaccinated persons (i.e. those having completed a 2-dose course of mRNA (Pfizer or Moderna) or single dose of Johnson & Johnson/ AstraZeneca and were >/= 14 days post vaccination before exposure. Of these vaccinated patients, 79% with breakthrough infections were symptomatic 80% of hospitalised patients were fully vaccinated, no one died.

Eyre et al. (preprint Sept 2021) suggests that vaccination may still reduce transmission of Delta SAR-CoV-2 but it certainly has less of an effect than it had on the Alpha variant, with the impact of vaccination decreasing over time.

Whether the vaccinated could become ‘super-spreaders’ needs to be considered because of the potential for high viral loads but fewer symptoms causing less self-isolation of infected individuals.

This is clear in a Sydney Gym, which has only been visited from vaccinated guests with an outbreak of over 15 vaccinated patrons so far.

Singanayagam et al. (2021) & Chia et al. (2021) also suggest the duration of viral shedding may be reduced, which may lessen viral transmission but whether this is of significance needs to be determined.

Chemaitelly et al. (2021), Keehner et al. (Sept 2021) both reports waning immunity for the mRNA gene therapies from Pfizer and Moderna companies. Somewhere around the 4th month, you can see waning immunity dropping in these studies to around 65 to 66%. This may be the tip of the iceberg because of the studies being of mixed Pfizer and Moderna vaccinations and also over variable starting points, i.e. both newer and older vaccine immunity would be represented in the studies.

This data does make some wonder, what is the difference between an infected traveller or night club patron who is unvaccinated and one who might have had their covid shot, say 8 months ago?

Could it be possible that an unvaccinated patron who has had Covid-19 in the past and recovered is less of a risk than a vaccinated patron who received their last dose over 4 months ago? It is completely feasible.

The federal government is claiming that once you have had your two doses, they deem you fully vaccinated for all purposes and that the booster is just extra protection. In time, it will be interesting to see if the Premiers who have run their own show this entire pandemic take that advice. Considering most of the population has chosen the gene therapy vaccination, which seems to have a rapid falling immunity.

Premiers could very well ignore the advice of the Federal Government and declare anyone who has not had a third dose unvaccinated. There could be even new vaccination targets for booster shots.

In the meantime, unvaccinated people all over the country, especially those in Victoria, have little idea about their future or if they will ever be able to travel around their own country like a free Australian with the rights they were born with.

There needs to be more research into the detrimental mental health effects of being unvaccinated ‘in the new normal’ and with little scientific backing to claim segregation works, there needs to be a roadmap to a true normal.

Where anyone, no matter what their health status, will be free. Until this happens, there is no normal, and many will not just give up on seeing their rights restored. We MUST get back to normal one day for the future and wellbeing of all Australians.

References

Brown et al. (August 2021). Outbreak of SARS-CoV-2 Infections, Including COVID-19 Vaccine Breakthrough Infections, Associated with Large Public Gatherings – Barnstable County, Massachusetts, July 2021. MMWR. Morbidity and mortality weekly report70(31), 1059–1062. https://doi.org/10.15585/mmwr.mm7031e2

Chia et al. (2021) Virological and serological kinetics of SARS-CoV-2  Delta variant vaccine-breakthrough infections: a multi-center cohort study. Medrxiv 2021; :2021.07.28.21261295

Chau et al (preprint August 2021). Transmission of SARS-CoV-2 Delta Variant Among Vaccinated Healthcare Workers, Vietnam. EClinicalMedicine, Volume 41, November 2021, 11043 https://doi.org/10.1016/j.eclinm.2021.101143https://www.sciencedirect.com/science/article/pii/S2589537021004235, Available at SSRN: https://ssrn.com/abstract=3897733 or http://dx.doi.org/10.2139/ssrn.3897733

Chemaitelly et al (2021) Waning of BNT162b2 Vaccine Protection against SARS-CoV-2 Infection in Qatar. N Engl J Med DOI: 10.1056/NEJMoa2114114.

Egan et al (April 2021) Hospitalised vaccinated patients during the second wave, update April ‘21 Semple ISARIC4C / CO-CIN https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/973183/S1143_Hospitalised_vaccinated_patients_during_the_second_wave__2_.pdf

Eyre et al (preprint Sept 2021) The impact of SARS-CoV-2 vaccination on Alpha & Delta variant transmission medRxiv 2021.09.28.21264260; doi: https://doi.org/10.1101/2021.09.28.21264260

Farinholt et al (preprint August 2021)  Transmission event of SARS-CoV-2 Delta variant reveals multiple vaccine breakthrough infections medRxiv 2021.06.28.21258780; doi: https://doi.org/10.1101/2021.06.28.21258780 

Keehner et al (Sept 2021) Resurgence of SARS-CoV-2 Infection in a Highly Vaccinated Health System Workforce. N Engl J Med 2021; 385:1330-1332; DOI: 10.1056/NEJMc2112981https://www.nejm.org/doi/full/10.1056/NEJMc2112981

Pouwels, K.B., Pritchard, E., Matthews, P.C. et al. Effect of Delta variant on viral burden and vaccine effectiveness against new SARS-CoV-2 infections in the UK. Nat Med (2021). https://doi.org/10.1038/s41591-021-01548-7

Riemersma et al (preprint July 2021) Vaccinated and unvaccinated individuals have similar viral loads in communities with a high prevalence of the SARS-CoV-2 delta variant medRxiv 2021.07.31.21261387; doi: https://doi.org/10.1101/2021.07.31.21261387 

Singanayagam et al. (2021) Community Transmission and Viral Load Kinetics of SARS-CoV-2 Delta (B.1.617.2) Variant in Vaccinated and Unvaccinated Individuals. Ssrn Electron J 2021. DOI:10.2139/ssrn.3918287.

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