Mass vaccination against covid-19 means we're in a very different place to two years ago. Where once GPs received no positive covid tests (because you weren't allowed one unless you were admitted to hospital) but plenty of calls from frightened breathless patients unsure if they were allowed to go to hospital, we now have positive test results coming in by the hour, but thankfully few people becoming severely unwell. The largest national study quantifying the risk of hospital admission or death after infection with omicron variant compared with delta, has been published in the Lancet. A whopping 4 135 347 positive covid tests were recorded in England between 29 November 2021 and 9 January 2022. The headline results were that omicron cases had a 59% lower risk of hospital admission and a 69% lower risk of death than delta cases. Thanks to the large database of individual-level data, researchers were able to delve further: unvaccinated people with prior infection had similar levels of protection against hospital admission as seen with two doses of the Oxford/AstraZeneca vaccine or one dose of the Pfizer or Moderna vaccines; and the lower risks of hospital admission with omicron was not seen in children aged 0-9, with the authors suggesting that this may "reflect a lower clinical threshold for hospital admission for young children due to symptoms common to omicron infection, rather than more severe disease." Trastuzumab deruxtecan is an emerging treatment for the 20% of women with HER2-positive breast cancer: the drug binds to and blocks the human of cancer cells, then the trastuzumab antibody gets internalised carrying deruxtecan with it. Once inside the cell, deruxtecan can interfere with DNA replication and cell division. A new randomised control trial of trastuzumab deruxtecan reports positive findings for patients with continued to progress despite first line treatment with anti-HER2 antibodies and a taxane. Of the 524 patients randomised to either trastuzumab deruxtecan or the usual treatment of trastuzumab emtansine, 76% of
