COVID-19 NSW State Of Play 2023: Counting Dead People - Part 4

IMAGE: www1.racgp.org.au

According to the World Health Organisation (WHO) Omicron variants of SARS-CoV-2 remain the currently circulating variants of concern.

By the end of February 2023 the SARS-CoV-2 sequences by variant pool found in Australia were estimated at 24.46% Omicron (BA 2.75), 1.09% Omicron (BA.5),13.59% Omicron (BQ.1), 3.26% Omicron (XBB), 26.63% Omicron (XBB1.5) and 30.98% recombinant variants. NOTE: Only a fraction of all cases are sequenced and Recently-discovered or actively-monitored variants may be overrepresented, as suspected cases of these variants are likely to be sequenced preferentially or faster than other cases [Our World Of Data, 5 March 2023].

In the 7 days up to 25 February 2023 in NSW South Wales a total of 48 people were recorded as having died from COVID-19.

Of these 26 were adult men and 22 were adult women.

Two of the dead were in the 40-49 year age group and the other 46 deceased individuals were aged between 70 years of age & 90+ years.

Three of the dead were from the Northern Rivers region, which in that 7 day period had seen 223 local residents recorded as newly infected with COVID-19.

In the 7 days up to 2 March 2023 an est. 213 Northern Rivers residents were recorded as newly infected with COVID-19. 

NOTE: NSW COVID-19 data is held at multiple points on the NSW Government’s online public access health data site/s. For reasons best known to itself these sites rarely use identical time periods for their published summaries. This means there is a 2 day overlap in the two 7 day periods for the Northern Rivers which renders the infection number for 2 March an estimate. As yet no deaths have been published for local health district for these particular 7 days.

Over the 12 days from 19 February to 2 March 2023 multiple confirmed cases of COVID-19 were reported in the following Northern Rivers local government areas:

• Tweed Shire – postcodes 2484, 2485, 2486, 2487, 2488, 2489;

• Kyogle Shire – postcodes 2474;

• Ballina Shire – postcodes 2477, 2478;

• Byron Shire – postcodes 2479, 2480, 2481, 2482, 2483;

• Lismore City – postcodes 2472, 2480;

• Richmond Valley – postcodes 2469, 2470, 2471, 2473, ; and

• Clarence Valley – postcodes 2460, 2462, 2463, 2464, 2465, 2466.

State-wide in NSW in the 7 days up to 2 March 2023 a total of 7,163 new cases of COVID-19 infection were recorded With 800 infected people hospitalised and a total of 29 deaths recorded.

At that point in time (2 March 2023) the total number of COVID-19 cases recorded in NSW since the pandemic began in January-February 2020 had reached est. 3,907,940 people infected, of which 6,493 have been recorded as dying as a result of contracting the viral infection.

By 3 March 2023 the cumulative total of COVID-19 deaths Australia-wide had reached est. 19,459 men, women and children.

The recorded cumulative number of people infected with the virus, as well as those dying as a result of infection, continues to rise in what is now the fourth year of uncontrolled viral infection spread in the general populace.

Sources:

NSW Health

Data NSW

covidlive.com.au

Our World In Data

WHO

So what is currently in the SARS-Cov-2 viral soup swirling around us as we go about our daily lives?

 

 

The NSW Perrottet Government decided in late 2021 that it would ignore the SARS-CoV-2 pandemic. It no longer publicly report instances of COVID-19 infection in a meaningful way. As well as removing in stages all mandatory health measures, including an obligation to get tested or to isolate if unwell. 

Therefore the general public knows little about the viral soup that now swirls arounds Australia's public spaces, transit systems, workplaces and even our homes.

So as a new cluster of Omicron subvariants make themselves felt this month in New South Wales: the population is generally under-vaccinated; the viral transmission rate is rising; the number of people testing positive is growing by approx. six to eight thousand confirmed cases every 7 days; hospital admissions due to COVD-19 are climbing; and somewhere between 22 to 39 deaths are occurring over 7 day periods.

With all statistics belatedly supplied by NSW Health indicating an increase in the already massive under reporting, once all pretence of a public health approach to this pandemic was abandoned.

So how many SARS-CoV-2 subvariants are there now?

Well since the original subvariants Apha, Beta, Gamma and Delta gave way to Omicron, there have been so many more subvariants of concern spawned in Australia and around the world.

Here is an outline of what is currently in the viral soup......

Doherty Institute, News, 3 November 2022:

From Centaurus to XBB: your handy guide to the latest COVID subvariants (and why some are more worrying than others)

The Omicron variant of concern has splintered into multiple subvariants. So we’ve had to get our heads around these mutated forms of SARS-CoV-2, the virus that causes COVID-19, including BA.1 and the more recent BA.5.

We’ve also seen recombinant forms of the virus, such as XE, arising by genetic material swapping between subvariants.

More recently, XBB and BQ.1 have been in the news.

No wonder it’s hard to keep up.

The World Health Organization (WHO) has had to rethink how it describes all these subvariants, now labelling ones we need to be monitoring more closely.

What’s the big deal with all these subvariants?

Omicron and its subvariants are still causing the vast majority of COVID cases globally, including in Australia.

Omicron subvariants have their own specific mutations that might make them more transmissible, cause more severe disease, or evade our immune response.

Omicron and its subvariants have pushed aside previous variants of concern, the ones that led to waves of Alpha and Delta earlier in the pandemic.

Now, in Australia, the main Omicron subvariants circulating are BA.2.75, and certain versions of BA.5. More on these later.

 

Viral genomes from Australia: once we had Alpha and Delta waves. Now we have waves of Omicron subvariants. Author provided

We still don’t fully understand the driving forces behind the emergence and spread of certain SARS-CoV-2 subvariants.

We can, however, assume the virus will keep evolving, and new variants (and subvariants) will continue to emerge and spread in this wave-like pattern.

How do we keep track of this all?

To monitor these subvariants, the WHO has defined a new category, known as “Omicron subvariants under monitoring”.

These are ones that have specific combinations of mutations known to confer some type of advantage, such as being more transmissible than others currently circulating.

Researchers and health authorities keep track of circulating subvariants by sequencing the genetic material from viral samples (for instance, from PCR testing or from wastewater sampling). They then upload the results to global databases (such as GISAID) or national ones (such as AusTrakka).

These are the Omicron subvariants authorities are keeping a closer eye on for any increased risk to public health.

Newer versions of BA.5

The BA.5 subvariant that arose in early February 2022 is still accumulating more mutations.

The WHO is monitoring BA.5 versions that carry at least one of five additional mutations (known as S:R346X, S:K444X, S:V445X, S:N450D and S:N460X) in the spike gene.

The spike gene codes for the part of the virus that recognises and fuses with human cells. We are particularly concerned about mutations in this gene as they might increase the virus’ ability to bind with human cells.

Throughout recent months, BA.5 has been the dominant subvariant in Australia. However, BA.2.75 has now established a foothold.

BA.2.75 or Centaurus

The BA.2.75 subvariant, sometimes called Centaurus, was first documented in December 2021. It possibly emerged in India, but has been detected around the globe.

This includes in Australia, where more than 400 sequences have been uploaded to the GISAID database since June 2022.

This subvariant has up to 12 mutations in its spike gene. It seems to spread more effectively than BA.5. This is probably due to being better able to infect our cells, and avoiding the immune response driven by previous infection with other variants.

 

BJ.1

This was first detected in early September 2022 and has a set of 14 spike gene mutations.

It has mostly been detected in India or in infections coming from this area.

We know very little about the impact of its mutations and at the time of writing, there was only one Australian sequence reported.

BA.4.6 or Aeterna

BA.4.6, sometimes called Aeterna, was detected in January 2022 and has been spreading rapidly in the United States and the United Kingdom.

There have been more than 800 sequences uploaded to the GISAID database in Australia since May 2022.

It may be more easily transmitted from one person to the next due to its spike gene mutations.

Early data suggests it is better able to resist cocktails of therapeutic antibodies compared with BA.5. This makes antibody therapies, such as Evusheld, less effective against it.

BA.2.3.20

This was first detected in the US in August 2022. It has a set of nine mutations in the spike gene, including a rare double mutation (A484R).

Like BA.2.75, this subvariant is probably better able to infect our cells and avoid the immune response driven by previous infection.

There are more than 100 Australian genomic sequences reported in the GISAID database, all from August 2022.

XBB

This recombinant version of the virus was detected in August 2022. It is a result of the swapping of genetic material between BA.2.10.1 and BA.2.75. It has 14 extra mutations in its spike gene compared with BA.2.

Although there have only been 50 Australian genomic sequences reported in GISAID since September, we anticipate cases will rise. Lab studies indicate therapeutic antibodies don’t work so well against it, with XBB showing strong resistance.

Although XBB appears to be able to spread faster than BA.5, there’s no evidence so far it causes more severe disease.

 

How about BQ.1?

Although it is not on the WHO list of subvariants under monitoring, cases of the BQ.1 subvariant are rising in Australia. BQ.1 contains mutations that help the virus evade existing immunity. This means infection with other subvariants, including BA.5, may not protect you against BQ.1.

In the meantime, your best protection against severe COVID, whichever subvariant is circulating, is to make sure your booster shots are up-to-date. Other ways to prevent SARS-CoV-2 infection include wearing a fitted mask, avoiding crowded spaces with poor ventilation, and washing your hands regularly.

Written by

Dr Ash Porter, Research officer and Dr Sebastian Duchene, Australian Research Council Future Fellow.

This article is republished from The Conversation under a Creative Commons license. Read the original article.