Waiting for new Covid vaccines? There’s no point, says doctor
TUESDAY, DECEMBER 20, 2022
A respiratory specialist has advised people to protect themselves against Covid-19 with currently available vaccines rather than waiting for next-generation vaccines.
Dr Manoon Leechawengwongs of Vichaiyut Hospital explained on Tuesday that the Covid virus is mutating too quickly for next-gen vaccines to keep up.
The next-gen vaccines will target the current dominant strain in Thailand, but this will soon be replaced by new Omicron subvariants, such as BQ.1 and XBB, said Manoon on Facebook. The new-gen vaccines will not be as effective against these new subvariants, he added.
“People are still at risk of Covid-19 infection as new vaccines will not keep up with virus mutations,” he said.
However, both old and new vaccines reduce the risk of severe symptoms and death from Covid-19, he confirmed.
He also expects a vaccine that offers protection against up to four Covid strains to be rolled out in future.
Leading virologist Dr Yong Poovorawan has explained that the BA.1 Omicron subvariant that was dominant at the start of the year had since mutated to BA.2, BA.4, BA.5 and BA.2.75 subvariants.
BA.2.75 has become dominant over the past two months, overtaking BA.5 which accounted for most cases in June, he added.
However, Yong expects BA.2.75 to be replaced as Thailand’s dominant strain by Omicron BQ.1 and BQ.1.1 subvariants spreading from the West.
“The mutation is happening over time,” he said, confirming that genetic changes in the virus are occurring too quickly for vaccines to keep up.
Yong also said that the protection offered by new-gen vaccines targeted at Omicron strains was no higher than first-gen vaccines.
Thailand recorded 3,419 new Covid-19 cases and 113 deaths last week (December 11-17), according to the Covid-19 information centre‘s Facebook page.
Chula Medicine Determines “Cytokines” as Indicator of “Degenerative Joints”
MONDAY, DECEMBER 19, 2022
Chula Medicine announced the discovery of “cytokines” in the body’s immune system that can determine the severity of osteoarthritis in elderly adults, hoping to facilitate the planning of follow-up and treatment of the disease, and reduction of its severity.
Older adults and osteoarthritis seem to be two peas in a pod. As they age, many older adults begin to walk more slowly, and have a more difficult time going up and getting down the stairs with joint popping and crackling, or sometimes joint pain, be it the knees, the hips, or finger joints. The disease, although not life-threatening, undermines their happiness and quality of life.
“Osteoarthritis is a major public health problem in Thailand and around the world, affecting the quality of life of older people. The longer Thai people live today, the more they will have this disease. It is incurable, but if we can predict its severity, we will be able to find a way to lessen its impact,” Professor Sittisak Honsawek, M.D., Department of Biochemistry, Faculty of Medicine, Chulalongkorn University elaborated on the inception of the research project “Cytokines and Biochemistry Substances as Indicator and Target of Osteoarthritis Treatment” which received an Excellent Research Award by Chula personnel in health science 2021.
For more than 10 years in research, Sittisak and his team have been arduously working on this study to understand the causes of osteoarthritis, its mechanisms, and its severity indicators to determine ways of monitoring, preventing, and mitigating the disease, which will improve the patient’s quality of life.
Cytokines and osteoarthritis According to Sittisak, the study of osteoarthritis mechanisms show that some cytokines contribute to bringing about the disease and contribute to its progression.
“Cytokines are a group of proteins secreted by inflamed cells within the joints. Cytokines and some biochemicals encourage cartilage cells to secrete substances that aid cartilage formation and breakdown. The presence of unbalanced cytokines induces faster degeneration of cartilage, causing more degeneration of the joints.”
This discovered knowledge can be used to develop a monitoring process of patients to predict if their case of osteoarthritis would become acute in the future, as well as find ways to reduce or inhibit the cytokines responsible for osteoarthritis.
Currently, cytokine levels are only measured after the patients have undergone arthroplasty.
“After surgery, we will measure cytokine levels that help indicate whether there may be complications from inflammation. If the levels are very high, it indicates that there may be a postoperative infection. Therefore, antibiotics are needed until cytokine levels drop to normal,” He said.
Getting to Know osteoarthritis and its risk factors The major cause of osteoarthritis is the degeneration of articular cartilage with age, which can occur in people aged 40 and over, and is evident in people aged 60 and over — the greater the age, the more likelihood of osteoarthritis. According to recent statistics, more than 50 % of people aged 70 and over have osteoarthritis.
“All the joints in the body are made up of two bones: the hard bone and the cartilage. As people age, cartilage production deteriorates, resulting in the loss of cartilage function. The body then stimulates cartilage cells to produce cytokines, causing inflammation of the tissues around the joints, ligaments, and muscles,” He explained the mechanism of osteoarthritis in older adults, which occurs in various joints in the body, but the most common is the knee joints, followed by the hip joints and the knuckles.
Apart from the age factor, women are 2 – 3 times more likely to suffer from osteoarthritis than men because of the reduction in hormone production during menopause, thus affecting the quality of cartilage. Moreover, another risk factor is excessive body weight which contributes to more severe osteoarthritis.
Symptoms and severity levels of osteoarthritis The degree of severity of osteoarthritis varies depending on the duration of the disease. At first, joint pain occurs when walking, standing, or going up and down the stairs. Then, the joints begin to make noise. You need to take a rest after walking for a while. The symptoms will improve when you stop putting pressure on the joints.
If osteoarthritis becomes more acute, the patients will experience pain, swelling in the joints, inflammation, or inability to bend or fully extend the joints. In severe cases, the joints will become bent and disfigured, causing knee flexion, and finger flexion. X-rays will show bone spurs piercing the tissue in the knee joints, causing inflammation and pain.
“This disease is not fatal, but it makes it impossible to live a normal life. Quality of life has been deteriorating in patients who have had this disease for a long time. Muscle weakness may be caused by inactivity, and 50 % of osteoarthritis patients have a chance of having bilateral osteoarthritis.”
Healable though not curable Although osteoarthritis is incurable, there are ways to improve the quality of life and reduce pain. According to Sittisak, after the patient has been diagnosed through an X-ray for the abnormalities in the joints, they will undergo one of the 3 types of treatment currently available, depending on the severity of the disease, starting with no medication, medication, and surgery as a last resort.
Nonmedicinal treatment Sittisak says that 80 % of people with osteoarthritis are overweight, so proper weight management will reduce the shock exerted on the joints and alleviate joint pain.
“To calculate excessive weight, Body Mass Index (BMI) can be used as an indicator by dividing body weight in kg by height in meters raised to the power of 2. The figure between 18-23 is a normal range. Another simple calculation is by subtracting your height in cm. with 100. If your weight exceeds the result, you are overweight.”
He advised the patients to regularly exercise the muscles around the joint to strengthen them, especially knee joints, by stretching their legs for 10 seconds and lowering them. Repeat for 20 sets of 20. Joint support braces or a cane will help patients improve their gait.
Treatment with medication for example, with a pain reliever, muscle relaxants, or anti-inflammatory drugs. Moreover, injections are also available to help patients with an early stage of osteoarthritis, i.e., hyaluronic acid, or platelet-rich plasma to alleviate joint inflammation.
“Cold compress must be administered in the first 24 hours to allay joint pain from inflammation. Once the symptoms improved, but later exhibit persistent flare-ups, a warm compress can be used. This will help improve blood circulation in the area and relax the muscles,” advised Sittisak on pain management, while recommending acupuncture and ultrasound treatment as alternatives for joint pain treatment as well.
Surgery This method is used in acute cases in which joint deformities or excessive pain are found to interfere with patients’ work and daily life. There are many types of surgeries: arthroscopy to detect bone spurs, or splints inside the joints and clean the joints up, bone deformities correction surgery,
“The last type is arthroplasty (joint replacement surgery) which will help improve the patient’s quality of life, by giving them a chance to lead a normal life. How long the artificial joints will last depend on care and maintenance.”
Vitamin D & E for bone enhancement He added that this research project also studies the efficiency of Vitamin D2 supplements in 200 osteoarthritis patients who received treatment at the Department of Orthopaedics, King Chulalongkorn Memorial Hospital. Patients aged 60 and older who were found to have Vitamin D lower than 30 nanograms per millilitre were given 2 Vitamin D2 pills (Ergocalciferol 20,000 unit/pill) per week for 6 months.
Vitamin D2 helps stimulate bone construction, and the formation of minerals, calcium, magnesium, and phosphate in the bones. Vitamin D also works with parathyroid hormone in intestinal calcium absorption, as well as promoting the kidneys’ reabsorption of calcium thereby increasing the level of blood calcium which helps strengthen the bone further. Moreover, Vitamin D also increases the muscles’ stamina, strength, and functioning.
He further stated that the research team also studied the use of Vitamin E supplements in osteoarthritis patients by having them take the vitamin E for 2 months.
Vitamin E helps decrease antioxidants in the body. It was found that vitamin E helps relieve joint pain and promote joint functioning.
The recommended dose of Vitamin D is 400-600 IU/day and 40-200 IU/day for Vitamin E. The recommended dose varies according to the age and physical conditions of each individual. Therefore, taking D and E vitamin supplements should be under the supervision of physicians or pharmacists.
Who should take Vitamin D supplements? 1. People who risk Vitamin D deficiency like the elderly and pregnant women; 2. Patients with osteoporosis and low bone mass; 3. Chronic-kidney disease patients; 4. Patients with certain intestinal diseases that cause defective intestinal Vitamin D absorption; 5. People with defective lipid digestion and absorption (because Vitamin D is fat-soluble) decrease vitamin D absorption as well.
Change your behaviour to slow down joint degeneration He further advised the elderly who suffer from osteoarthritis to avoid behaviours that would exacerbate their conditions such as kneeling, sitting crossed-legged, squatting, or walking up and down the stairs often. They should also exercise to strengthen joint muscles and do other types of exercises like swimming, walking, and light biking.
“More importantly, they should control their weight to minimize shock on the knee joints, and slow down osteoarthritis,” Sittisak concluded.
People with osteoarthritis conditions can contact the Department of Orthopaedics, King Chulalongkorn Memorial Hospital, 5th Floor, Phor Por Ror Building, tel. +66-2256-5351 for doctor’s appointments during and outside of office hours (Orthopaedics Clinic).
EctoLife : the world’s first artificial womb facility?
FRIDAY, DECEMBER 16, 2022
It looks like a scene from The Matrix. Rows upon rows of babies are developing in the ‘world’s first artificial womb facility,’ which can supposedly incubate up to 30,000 lab-grown children per year.
EctoLife, the ‘world’s first artificial womb facility’ is just a concept for now, which offers a way for parents to produce customised babies. The concept is the brainchild of Berlin-based Hashem Al-Ghaili, a producer, filmmaker and science communicator and molecular biologist by trade”, as per his website.
It offers parents to ‘produce’ customised babies with the help of artificial wombs. An ‘Elite Package’ would allow people to choose their baby’s level of intelligence, height, hair, eye colour, physical strength and even skin tone.
The concept of EctoLife is based on over fifty years of groundbreaking scientific research” by researchers globally, says Al-Ghaili
The facility – which would run on renewable energy -plans to house 75 labs, each equipped with up to 400 growth pods or artificial wombs. These pods are designed to provide the same environment that is present inside a mother’s womb.
Parents can keep a track of their baby’s growth and development through a screen on the pods that showcase real-time data. This data can also be monitored via an app on the phone.
On his website (https://hashem-alghaili.com) Al-Ghaili says he uses his “background in science and technology to develop brand-new concepts”. He speaks of “imagining the future,” though some online have clearly mistaken his latest film as a real-life advert.
In the video, for a fictional facility called EctoLife, we hear that artificial wombs could provide a solution for cancer patients who’ve had their uteruses removed, that they could reduce pregnancy complications, and that the pods will help countries experiencing population decline, such as Japan, Bulgaria, South Korea.
Hashem says he believes this technology is ready and that we could see such facilities in as little as 10 years.
Experts believe the technology is not that far-fetched and could become a reality in the future. Al-Ghaili believes that artificial womb facilities could become a reality in 10 years or so if ethical restrictions are removed. “Every single feature mentioned in the concept is 100 per cent science-based and has already been achieved by scientists and engineers”, he said.
He says once ethical constraints are relaxed, people can be willing to adopt the technology in the near future.
“In terms of timeframe, it really depends on the ethical guidelines. Right now, research on human embryos is not allowed beyond 14 days. After 14 days, embryos must be destroyed due to ethical concerns”, the producer said.
“If these ethical restrictions are relaxed, I give it 10 to 15 years before EctoLife becomes widely used everywhere”.
“Add to that five years of public awareness and education to help people become more receptive to the technology”, Al-Ghaili added.
Thailand urged to roll out antibody treatment as Covid hospitalisation surges
WEDNESDAY, DECEMBER 14, 2022
A top virologist has urged the Public Health Ministry to roll out long-acting antibody (LAAB) treatment to protect people vulnerable to Covid-19 as infection levels surge.
The Department of Disease Control reports that hospital beds occupied by Covid patients have jumped from 5% last month to 8.5% this month.
Writing on Facebook, Dr Yong Poovorawan said LAAB treatments such as AstraZeneca’s Evushield should be administered to at-risk groups to protect against the Omicron BA.2.75 driving Thailand’s latest Covid-19 wave.
He added that LAAB could be used prevent serious infection and death among people who cannot be fully vaccinated due to health conditions including cancer and kidney disease.
Dr Yong, who heads Chulalongkorn University’s Centre of Excellence in Clinical Virology, said the Public Health Ministry has sufficient stocks of LAAB to treat patients.
“People vulnerable to Covid-19 infection should receive antibodies to reduce their risk of developing severe symptoms and death,” he said.
He added that these stocks should be used immediately to reduce health impacts of Covid-19 as their efficiency would drop as the virus mutates further.
Thai experts working on breathalyser to screen Covid-19 patients
TUESDAY, DECEMBER 13, 2022
The National Research Council of Thailand (NRCT) is pushing for a breathalyser innovation to screen Covid-19 patients with the goal of detecting cycle threshold (CT) values similar to RT-PCR tests.
Pisit Mitkuakun, the president of the Radio Control Airplane Modeller Sport Association (RCSA), on Monday said that the research team was a collaboration with RCSA, Rajavithi Hospital, Mahidol University, and the private sector with a supporting budget from the NRCT.
The tool will be an innovation for screening Covid-19 as it will use only one’s breath without nasal swabs, blood tests, or saliva samples.
Pisit said that the test has high sensitivity and specificity as it took only five minutes to get a result so patients will be screened quickly to get immediate treatment and reduce the chance of spreading in a wide area.
He added that the research team is improving the tool to be able to get the CT value similar to RT-PCR tests.
Dr Sathit Niramitmahapanya of Rajavithi Hospital said that the team is studying continuously and collecting information from 3,000 samples before sending them to the research team to develop the tool.
Sathit said, “It is an important progress of the research team and will be beneficial for the medical field, especially for treating emergency patients who require urgent surgery or treatment, but it is necessary for them to get the amount of virus or CT value to assess the risk of Covid-19 spreading before entering the treatment process.”
Only RT-PCR tests currently can provide the CT value, which will take several hours. He added that Thailand might be the only country to use CT value in categorising patients in each level to control the disease.
Tiersidh Nasomphan, a researcher from Mahidol University’s Faculty of Pharmacy, said that the tool could detect those who are infected with Covid-19 and those who are not infected with the help of machine learning and AI system.
Apart from detecting CT value, he aimed to develop it for convenience. It will be able to scan the ID card and passport and print out the slip after getting the result.
The machine will be released as a portable bag version and the stationary kiosk version and will be developed to detect other respiratory diseases, including tuberculosis and lung cancer while also detecting drugs.
The Shanghai Symphony Orchestra and the Shanghai Mental Health Center, also known as the Mental Health Center affiliated with Shanghai Jiao Tong University School of Medicine, recently released a series of products that include 10 packs of blended coffee, with each claiming to be able to address a mental status or problem such as anxiety, depression and insomnia.
Each pack also comes paired with a short piece of symphonic music and a three-minute audio clip of a mental health professional’s interpretation of symptoms.
For example, those who scan the QR code on the pack of coffee marked “anxiety” will hear Bach’s Sheep May Safely Graze, while scanning the pack titled “inferiority complex” will produce sounds of Ravel’s Morning Song of the Jester.
Developed by the two organizations, the products are aimed at addressing common mental health issues that have been exacerbated by the pandemic.
“We believe music has healing power and can provide emotional support for those in need,” explains Qiao Ying, a doctor at the mental health centre.
The new products have been an instant hit — the first 5,000 sets of coffee were sold out so quickly that even Xie Bin, the Party secretary of the mental health centre, has to wait until mid-December before he can sip the coffee, which he ordered on the WeChat platform of the orchestra.
This is not the first time the mental health centre has sold merchandise. The institution previously sold face masks together with Shanghai Museum that were just as popular.
According to Xie, the decision to sell official merchandise came about when the mental health centre realized that many online vendors were selling goods that bore the institution’s name and address as a joke.
This joke, however, has inadvertently played a role in raising awareness about mental health and eliminating the stigma associated with mental illness, he adds.
“People in China used to be evasive about their mental issues, and they would be afraid to let others know about their visits to mental health specialists,” Qiao says. “Today, I have seen children who proudly share their experiences of receiving counselling at our clinics, and other children have responded with feelings of envy and admiration.”
Regarding the decision to collaborate with the centre, Zhou Ping, director of the orchestra, says that music and other art forms play positive roles in helping people through difficult times.
“We have quite a number of avid symphony lovers who have claimed that a particular piece of music has helped them through their difficulties. This particular piece of music would eventually lead them to other musicians and composers until the music becomes an indispensable part of their daily life,” says Zhou.
“With the introduction of this coffee series, we would love to see increased awareness of mental health issues. We would also consider presenting concerts aimed at helping people heal mentally in the future.”
Thais urged to get booster shots as Covid-19 subvariant’s prevalence increases
SATURDAY, DECEMBER 10, 2022
As the number of Covid-19 cases and deaths rise during the cool season, the omicron subvariant BA.2.75 has become the main subvariant of the virus circulating in Thailand, officials say.
Omicron subvariant BA.2.75 has replaced subvariant BA.5 as the main cause of infection due, in part, to the swiftness with which it spreads, officials said.
They say confusion about the different variants is one reason people neglect to get booster shots, and urge members of the public to understand that booster shots are critical to prevent people from getting infected by new variants. Those who get infected after receiving a booster shot are less likely to experience severe illness, medical experts say.
Covid-19 variants have changed since the first arrived in Thailand. Below is a list of the variants that have arrived in Thailand since 2019.
Wuhan variant
Covid-19 is believed to have originated in China’s Wuhan city, most likely jumping from bats to people before human-to-human transmission occurred. The Wuhan variant (also known as the Serine variant) spread quickly around the globe, arriving in Thailand in January 2020. The first infection detected was in a Chinese tourist who was visiting from Wuhan.
The disease spread rapidly with large clusters around Rajadamnern Stadium and in Samut Sakhon.
Beta variant (B.1.351)
This variant was first detected in South Africa. It was found in Thailand in January 2021, likely arriving via a tourist from Tanzania.
This variant was found to spread 50% quicker than the original one. Moreover, it caused severe symptoms.
Alpha variant (B.1.1.7)
This variant was first detected in the United Kingdom and arrived in Thailand in April 2021. It was first detected here in a cluster of covid-19 infections traced to a venue in Bangkok’s Thong Lor district. This variant was considered less of a threat because it was found to be less powerful than its predecessors.
Delta variant (B.1.617.2)
This variant was first detected in India. It was found in Thailand in May 2021 after a cluster of Covid-19 cases was found at a construction site in Bangkok’s Lak Si district. It spread rapidly and caused alarm because it was more dangerous than the Alpha variant and caused severe illness even among people who had been fully vaccinated.
Omicron variant
Omicron was first detected in South Africa. It reached Thailand in December 2021. The World Health Organisation announced that it was a variant of concern because it could spread quicker than previous variants even among those who were fully vaccinated.
The variant caused the number of new cases to surge in a short time. Even some people who had previously recovered from Covid-19 became sick again after being infected with this variant.
Three sub-variants were subsequently detected in Thailand: BA.2, BA.4/BA.5, and BA.2.75. All spread widely.
In October 2022, Thai health officials downgraded the threat posed by Covid-19 from a “dangerous communicable disease” to a “communicable disease under surveillance”. Still, epidemiologists forecast that the disease would be more prevalent in some seasons than others.
Even though prevention measures have been eased, they are still important to protect health, doctors say, adding that the best protection is to continue getting booster shots to increase immunity against the virus. Booster shots also help decrease the severity of symptoms for those who still get infected.
Vaccines losing race against new Omicron mutants in Thailand: Dr Yong
THURSDAY, DECEMBER 08, 2022
The Covid-19 virus is mutating so quickly that new vaccines cannot keep up, leading virologist Dr Yong Poovorawan warned on Thursday.
Writing on Facebook, Yong explained that the Omicron variant that was dominant at the start of the year had since mutated from BA.1 to BA.2, BA.4, BA.5 and BA.2.75 subvariants, respectively.
BA.2.75 has become the dominant strain in Thailand over the past two months, overtaking BA.5 which accounted for most cases in June, he added.
BA.2.75 has sent daily Covid infections in Thailand soaring to over 700 per day in the past week.
However, Yong expects BA.2.75 to be replaced as Thailand’s dominant strain by Omicron BQ.1 and BQ.1.1 subvariants spreading from the West.
“The mutation is happening over time,” he said, adding that genetic changes are occurring too quickly for vaccines to keep up.
Yong also said that the protection offered by second-generation vaccines targeted at Omicron strains was no higher than first-gen vaccines.
But Covid-19’s severity would drop as awareness and immunity in Thailand rise, he added.
He also expects the Covid situation to improve once new antiviral drugs are rolled out.
Don’t wait for newer Covid-19 vaccines, get your jabs now, says top virologist
SATURDAY, DECEMBER 03, 2022
People should not wait for newer Covid-19 vaccines to arrive before they get their booster shots, a top Thai virologist has advised citing rising cases.
However, he said the numbers will start dropping from mid-February before picking up again during the rainy season from June to September.
Hence, he said, it is important for people to boost their immunity right away instead of waiting. He added that though the vaccines available in Thailand target older variants, they are still very effective.
Dr Yong said that though vaccines targeting specific variants may offer more immunity, this protection will reduce over time. But, he said, the more shots and boosters people get, the better chance they will have of preventing severe symptoms.
Hence, he said, everybody should get at least three shots and the fourth one within six months.
Those who received their fourth jab more than six months ago could also get a fifth one because their immunity will have started dropping.
Dr Yong went on to say that Omicron and its BA.1, BA.2, BA.2.75, BA.4 and BA.5 subvariants are still most prevalent in Thailand and had infected nearly 70% of the population. He was citing a study from blood samples in Chonburi.
As for news of Deltacron infections, he said it will not be a problem in Thailand because the main variant is still Omicron.
1. The quicker and wider spread means this Covid-19 wave will end quickly.
2. Covid-19 infections with clear symptoms may be more beneficial in creating stronger future immunity than infections with no symptoms.
3. A combination of immunity from infection and vaccination is better than immunity from vaccination alone. (Thiravat added that he does not encourage people to get infected.)
4. Severity of symptoms depends on patients’ health, frequency of exercise, and diet.
5. The current surge in Covid cases will make people more aware and cautious.
6. Symptoms are likely to be weaker as the number of infected and vaccinated people has increased.
7. New Covid-19 variants and symptoms may not be linked to Long Covid symptoms (according to King’s College London).
8. Long Covid can be treated by exercising, getting sunlight, and eating a diet heavy in fruit vegetables and fish while reducing flour and meat.
9. The mix of coronavirus and other cold-season viruses will boost natural immunity to Covid-19.
10. Covid-19 will eventually become a weaker endemic disease if Thais strengthen their health.
The number of new confirmed cases soared to 4,914 last week, or 702 per day on average.
Patients severely ill with Covid currently number 553. Of these, 319 are on ventilators. Last week also saw an average of 10 Covid-related deaths per day or 74 in total.
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