The worldwide effort to roll out COVID vaccines suffered a blow this week when 11 European international locations paused using the Oxford-AstraZeneca jab, after plenty of folks developed blood clots quickly after receiving a dose. Outdoors of Europe, Indonesia additionally introduced it will delay administering the vaccine whereas it awaits a assessment. The well being authorities in these international locations said that the halting of the vaccine was merely a precautionary measure.

4 folks developed blood clots a number of days after having the Oxford-AstraZeneca vaccine in Norway in early March. Then, one other particular person in Austria was admitted to hospital with a blood clot on the lung and died, 10 days after being vaccinated. One other loss of life involving a blood clot has additionally been reported in Denmark.

On Thursday, after a number of days of investigation, nonetheless, the European Medicines Company said that it was happy the vaccine is “secure and efficient” and never, in any case, linked to the next threat of creating blood clots. It should proceed to conduct analysis. These international locations which halted using the vaccine can now resume.

This could put the difficulty to relaxation, however the scare has brought on comprehensible anxiousness for individuals who have already had their Oxford-AstraZeneca vaccine, or who could also be ready for his or her second dose. So, what are blood clots and what causes them?

Blood ought to usually circulation easily by way of blood vessels uninterrupted. Its fundamental job is to hold diet and oxygen to our organs. To take care of this easy circulation of blood, it wants to maneuver repeatedly and never stand nonetheless (which is why lengthy durations of immobility can improve your threat). It additionally wants the chemical compounds or “elements” that management blood clotting inside us to remain in steadiness and for the within of our blood vessels to remain easy so the blood doesn’t catch on something because it flows by, which is why irritation within blood vessels attributable to sicknesses together with COVID-19 can improve the chance of clots.

When any of this stuff upset the circulation of blood it may well clot, forming a clump of blood that has modified from a liquid to a gel-like or semi-solid state. This clot can then journey and block a blood vessel elsewhere, corresponding to within the lungs, inflicting this space to be shortly starved of meals and oxygen.

Blood clots occur in round one in 1,000 people every year. These are typically people who find themselves older, have sure cancers, are pregnant or spend lengthy durations not shifting about.

That is the variety of clots that may happen within the common inhabitants who haven’t had any of the COVID vaccines. Based on the European Medicines Company, as of March 10, 37 instances of thromboembolic occasions (blood clots) had been reported amongst shut to 5 million folks vaccinated with the Oxford-AstraZeneca COVID-19 vaccine within the European Financial Space. That’s considerably fewer than what must be anticipated from any common inhabitants, even with out being vaccinated. This quantity can be larger if the Oxford vaccine promoted clot formation. It’s really considerably decrease.

AstraZeneca mentioned in a statement: “A cautious assessment of all accessible security knowledge of greater than 17 million folks vaccinated within the European Union (EU) and UK with COVID-19 Vaccine AstraZeneca has proven no proof of an elevated threat of pulmonary embolism, deep vein thrombosis (DVT) or thrombocytopenia, in any outlined age group, gender, batch or in any specific nation.”

On Friday, nonetheless, medical researchers in Germany mentioned that they had found a hyperlink between the AstraZeneca vaccine and one notably uncommon sort of blood clot believed to have occurred in a “very small quantity” of people that have obtained the vaccine. A cerebral venous sinus thrombosis (CVST) is a clot in a part of the vessels that enable blood to empty from the mind. The signs of one of these blood clot embrace headache, blurred imaginative and prescient and weak point of a part of the face or limbs.

The incidence of one of these blood clot is three to 4 folks per million within the common unvaccinated inhabitants and, even with the “very small quantity” of individuals in whom this has occurred after having the vaccine, there isn’t any associated improve in instances within the vaccinated teams.

We do know that catching COVID itself can improve your threat of creating blood clots due to the irritation it causes within the physique, particularly contained in the blood vessels by way of which blood flows.

Many sufferers who’re handled for coronavirus in hospital are routinely placed on blood-thinning remedy to scale back their threat of creating clots. As a health care provider, I’d say it’s safer to get the Oxford vaccine than to get COVID. Mama Khan (my mum) has had her first dose of the Oxford vaccine and will probably be due her second one quickly. I will probably be more than pleased to take her to her appointment.

[Muaz Kory/Al Jazeera]

Progress Report: We should change our relationship with the pure world

SARS-CoV-2, the virus which causes COVID-19 in people, is regarded as a zoonotic virus (one handed from animals to people) which got here from a bat.

Zoonoses comprise a big share of all newly recognized infectious illnesses in addition to many current ones. Some illnesses, corresponding to HIV, started as a zoonosis however later mutated into human-only strains. Different zoonoses could cause recurring illness outbreaks, such because the Ebola virus and salmonella. Throughout the previous decade, hen flu was a notable zoonotic illness, with farmyard birds both culled or ordered to be saved indoors in lots of Western international locations. Others, such because the novel coronavirus that causes COVID-19, have the potential to trigger world pandemics.

Zoonotic illnesses can go to people by way of home, farmed or wild animals. This may occur in a number of methods together with consuming wild animal meat, by way of bugs which transmit illnesses by biting people, wild animal assaults (bites and scratches), and thru coming into contact with animal faeces and urine.

“Moist markets” which commerce in dwell or lifeless wild animals are notably excessive threat as there are prone to be many micro-organisms residing inside wild animals that we merely usually are not conscious of. The 2 largest moist markets on the planet are in China and the USA.

As extra wild areas are commandeered for farmland, additionally it is more likely that cattle will come into contact with wild animals which have been compelled into smaller and smaller residing areas. This will increase the chance of micro-organisms that trigger infections discovering a route from wild animals to human consumption.

Following a month-long fact-finding mission in China, a World Well being Group (WHO) staff investigating the origins of the COVID-19 pandemic concluded that the virus in all probability originated in bats and handed to folks by way of an intermediate animal, both by one animal consuming one other, or by mixing bodily fluids by way of scratching or biting. Subsequently, it’s unlikely {that a} human being ate the bat which transmitted this virus.

Bats are an necessary ecological mammalian species that may be discovered on all continents besides Antarctica. They’re a known reservoir of quite a lot of coronaviruses which typically don’t make them sick, however which can turn into harmful to agricultural animals or people.

The COVID-19 virus isn’t the primary virus thought to have originated in bats. Center Jap respiratory syndrome (MERS), first recognized in Saudi Arabia, has been traced again to bats, as has extreme acute respiratory syndrome (SARS), which was first present in China. Each of those viruses are from the coronavirus household.

Analysis has proven {that a} coronavirus at the moment being studied in bats, often known as RaTG13, can’t bind with cell receptors in people. This implies it must have jumped first to a different animal and mutated to a degree at which it may then bind to receptors on human cells. Analysis is constant as to how this will likely have occurred.

This the place the plot thickens; an unassuming mammal referred to as the pangolin, probably the most trafficked wild animal on the planet, has been implicated as this intermediate animal. The pangolin is a small animal which resembles an anteater or aardvark.

In addition to a protracted snout, it has giant paws that enable it to dig away at soil so it may well get to the bugs it likes to eat. It’s lined in giant plate-like scales, save for its smooth pink underbelly. Every time it feels threatened, it curls itself right into a ball and the scales act like protecting armour. That is the right safety in opposition to a predator that wishes to eat it, however sadly makes it simple choosing for people who wish to poach it. They merely scoop it up and take it to what’s most certainly its loss of life.

The pangolin’s scales, that are comprised of the identical stuff as human nails and hair, are a lot wanted within the Far East for conventional medicinal functions. Pangolin scales have additionally been used within the manufacture of luxurious leather-based objects in Western international locations.

Research have proven that coronaviruses just like the one which brought on the worldwide pandemic have been present in pangolins, and extra not too long ago a research paper confirmed the spike protein present in a particular pangolin, the Guangdong pangolin, may bind to receptors on human cells.

Nevertheless, that is when it begins to turn into a bit murky. There’s at the moment no proof that the RaTG13 coronavirus in bats can bind on to the cells of a pangolin, so it could be this was not the route of transmission for both pangolins or people, opening up the potential for one other intermediate animal.

Moreover, now we have but to search out conclusive proof {that a} pangolin handed the virus to people; all we do know is that there’s the potential for it to have carried out so. The authors of the examine hypothesise that the RaTG13 coronavirus in bats could have merged with one other coronavirus which was then in a position to infect a yet-unidentified animal after which people, or probably that there’s an unknown coronavirus in bats that was in a position to infect pangolins and subsequently people.

Extra analysis is required however one factor stays clear, it’s our interference within the pure world that triggered this pandemic.

By tearing down wild areas for agriculture, trade and human habitation, we’re forcing wildlife into smaller and smaller areas which then ends in wild and domesticated species coming into contact with one another when they need to not. If we proceed to illegally site visitors animals throughout the globe in inhumane situations, placing them in cages alongside different species, we’re solely going to encourage cross-species an infection additional.

This pandemic ought to function a warning; we should present kindness and compassion to the residing world. The hazards of not doing so will probably be far-reaching and can have an effect on generations to return. Growing the quantity of house given to the pure world and bettering biodiversity is prone to profit not solely the creatures we share the planet with, but additionally ourselves.

Within the Physician’s Surgical procedure: Caring for sufferers with ‘lengthy COVID’

Miss W* is a 29-year-old lady who has come to see me at my surgical procedure. She has excessive fatigue, reminiscence loss and unrelenting ache in most of her physique. Lower than eight months in the past, she had been a match, able-bodied one that went for lengthy runs and loved spending time along with her younger kids. She was good at her job as a supervisor of a neighborhood store.

Now, she is weak and worn out on a regular basis. “The ache is simply there day by day,” she advised me. “Simply choosing up my two-year-old daughter leaves me feeling exhausted.” She was making an attempt exhausting to not cry.

When different outlets and companies have been closed due to the lockdown final March, Miss W saved going to work, managing her staff, and making certain that individuals may proceed to purchase meals and important items.

She had contracted COVID-19 on the peak of the pandemic, struggling solely comparatively delicate signs, and had stayed at dwelling all through, not needing medical intervention.

After the preliminary two weeks, she felt she was making restoration: her cough improved and he or she started to really feel much less drained. However three months later, simply as she felt she was turning a nook, issues immediately went downhill. She discovered she may now not focus on what was on the tv, she was exhausted on a regular basis and a boring ache set into her whole physique. Initially she put it all the way down to the restoration course of, however then she started forgetting issues and he or she may now not stroll along with her kids to the park with out ache and exhaustion.

After analyzing her, I advised her I assumed she had “lengthy COVID”, a situation that has but to be formally outlined however which entails not returning to a pre-COVID stage of well being and performance even months after the preliminary an infection. Widespread signs of lengthy COVID embrace breathlessness, complications, cough, fatigue, pins and needles, joint ache, despair and anxiousness, earaches, feeling sick, diarrhoea, abdomen aches, lack of urge for food and cognitive impairment or “mind fog”. Folks affected by continual fatigue syndrome or myalgic encephalomyelitis (ME), each situations regarded as triggered by viral illness, have signs that overlap with lengthy COVID.

Having a proper analysis usually helps us decide a remedy plan to deliver a affected person out of the distress of their sickness. Not so with lengthy COVID. It’s poorly understood, and we don’t know why some folks, and never others, appear to endure from it. It might be that there’s an ongoing low stage of irritation within the physique even after the virus has been cleared and a few have speculated that it’s a sort of autoimmune response, the place the immune system carries on reacting even after the virus has been cleared and begins to assault wholesome human cells.

Regardless of the purpose, Miss W was seeking to me to assist her along with her signs and to get her again to her outdated actions.

When there isn’t any particular remedy for an sickness, it may be a problem to elucidate that to sufferers. They really feel like they’ve been left to handle their situation on their very own or, worse, failed by the medical career altogether.

“It is a new situation,” I defined. “We have no idea rather a lot about it, nor do we all know one of the best ways to deal with it.”

Miss W appeared as if any hope she could have had was now being cruelly snatched away.

“There are lengthy COVID clinics being arrange on the hospital and I feel it will be greatest if I referred you there,” I advised her. Certainly, our native hospital has arrange a clinic to assist these sufferers and is headed by the respiratory staff who deal primarily with lung illness as a result of many sufferers current with shortness of breath and a cough. Different specialists corresponding to physiotherapists and occupational therapists are additionally concerned in remedy.

She thanked me as she left, however I felt as if I had carried out little or no for her. I knew regardless of the hospital may provide her, there can be no fast repair and the main target can be on getting again to an appropriate high quality of life quite than the life she was robbed of by COVID-19.

Many would say she is without doubt one of the fortunate ones – she has had COVID-19 and survived. However at what price? This virus has affected so many individuals in numerous methods and, as we really feel our manner out of this pandemic, we’re prone to see the influence of those results for years to return.

And Now, Some Good Information: Vaccinations arrive in Palestine

On Wednesday, the COVAX programme, which has been arrange to make sure equitable distribution of COVID vaccines to the world’s poorest international locations, delivered a cargo of 60,000 vaccines to Palestine, one-third of which can go to the Gaza Strip.

Over the following 12 months, COVAX goals to ship sufficient vaccines to inoculate a million folks residing within the Palestinian Territories. Because the begin of the pandemic, the West Financial institution, the place 3.1 million Palestinians dwell, has reported 146,359 instances of COVID, with 1,667 deaths. The Gaza Strip, the place two million folks dwell, has reported a minimum of 57,891 instances and 572 deaths.

[Muaz Kory/Al Jazeera]

Reader’s Query: How can I inform if I’ve hay fever or COVID-19?

The primary signs of coronavirus are a excessive temperature, a brand new, steady cough and the lack of your sense of scent and style. Definitely, with hay fever you might get extra mucus manufacturing within the sinus space which may have an effect on your scent and style in addition to extra tear fluid manufacturing within the eyes, however the overwhelming majority of individuals with hay fever don’t get a excessive temperature. In case you are unsure, it’s at all times safer to take a COVID-19 take a look at and discover out for certain.

*Particulars have been modified to guard anonymity