SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesMDMA – most commonly known as a party drug – could be more effective than therapy alone at treating post-traumatic stress disorder (PTSD). The results of a keenly-awaited trial suggest two-thirds of people no longer qualified for a PTSD diagnosis after treatment.The study represents a significant step towards approval of the drug in the US. But UK experts warn against overhyping MDMA’s potential, saying more research is needed to understand its effects. PTSD can be the result of a very distressing or frightening event, or longer-term series of experiences. That might include accidents, abuse, rape, combat or illness. And it can be very difficult to treat.This trial, run by US charity the Multidisciplinary Association for Psychedelic Studies (Maps), found 88% of people had a “meaningful reduction in symptoms” and 67% no longer qualified for a PTSD diagnosis at all after 18 weeks and three sessions of MDMA-assisted therapy. Talking therapy alone led to a significant improvement in 60%, and remission in 32% of people. The participants in the study, which was published in the journal Nature, had suffered from PTSD for an average of 14 years. While scientists acknowledge these findings provide important evidence in MDMA’s favour, they are based on just 91 people. And since they were self-selecting (they volunteered for the study), they may not be representative of all trauma survivors. The trial also compared MDMA with a type of therapy not recommended by the NHS for trauma, making the comparison less useful, according to some UK psychiatrists. How could MDMA treat mental health?MDMA appears to work in part by calming the amygdala – the part of the brain which acts as a smoke alarm, telling the body to prepare for danger.In people with PTSD and anxiety disorders, this part of the brain can overreact, sounding the alarm over seemingly small events (slight noises, changes of tone or facial expression, for example). The Maps researchers suggest flooding the brain with feel-good hormones like serotonin at the same time as dampening its response to fear, might allow people to face and deal with painful memories without becoming overwhelmed.”At its core, PTSD is a disorder of memory”, said Dr Michael Bloomfield, a consultant psychiatrist at University College London (UCL).Forming new connectionsWhen we are babies, and again during adolescence, we experience periods where our brains are very pliable – they grow and change much more than they’re generally capable of in adulthood, and we can form lots of new connections. The scientists involved in the study speculate that psychedelics and similar-acting drugs like MDMA might allow a “reopening” of this critical window of brain development, during which therapy can help healthier connections form. Magic mushroom compound ‘promising’ for depressionPsychedelic therapy could ‘reset’ depressed brainGaps in the researchThe Maps researchers said commonly prescribed antidepressants were ineffective for 40-60% of sufferers. But in the UK, talking therapy rather than medication is generally recommended as the first way of treating PTSD.Dr Bloomfield at UCL said the treatment most recommended for trauma involves a therapist actively working with an individual to relive and process traumatic memories. But the therapy used in the study was closer to counselling, involving empathetic but mostly passive listening. This makes it difficult to say whether MDMA-assisted therapy works better than trauma-focused therapy on its own, he explained. Positive expectations might also be driving some of the effects, Dr Bloomfield said, since the patients who volunteered to take part in the study were likely to have an existing interest in the drug. Although the study used a placebo group to help correct the effect of positive expectations, it’s difficult to “blind” someone to the fact they’ve been given a drug like MDMA, which causes a strong and fairly immediate reaction. Nevertheless, while more research is needed, Dr Bloomfield described the study as “very exciting”, providing further evidence MDMA-assisted psychotherapy may be helpful for people with PTSD. Guy Goodwin, a professor of psychiatry at the University of Oxford, also flagged the study’s relatively small sample size and self-selecting patients as limiting what the findings can tell us. But he agreed the study “adds to the growing conviction that drugs producing psychedelic effects have real potential in the treatment of severe mood and anxiety disorders”.Final hurdleMany psychedelic studies are exploratory – early-stage research investigating the potential of various drugs but remaining a long way from actually being available to prescribe. But the Maps research is what is known as a phase three trial – the final hurdle before investigators can apply for the drug to be approved and therefore becomes available to patients.The study was designed and conducted with the approval of the US regulatory authority, the Food and Drug Administration.Maps’ chief scientific officer Dr Berra Yazar-Klosinski said MDMA could be legalised and available for prescription by 2023 in the US, and this summer she plans to travel to Europe to begin the process of seeking regulatory approval from the EU and the UK. The team later plans to explore its potential for other conditions, including depression. Follow Rachel on Twitter

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesThe most common side effects of the Covid-19 vaccines are pain or tenderness at the injection site – in other words, a sore arm – a UK study has suggested. Roughly one in four people had wider effects like fever, headache, nausea and fatigue.But these only lasted on average for one day.Researchers involved in the ZOE Covid Symptom Study app saw fewer reactions than were seen in clinical trials. Confidence in the vaccines has continued to grow since the end of last year, with more than 80% saying they believe the vaccines are safe and effective, compared with about 70% who said the same towards the end of 2020, according to a survey of 5,000 people.The survey, run in association with the National Institute for Health Research, found twice as many people say they want to have the vaccine as soon as possible – although the number of people saying they would actively prefer the Oxford-AstraZeneca vaccine has fallen.The ZOE study researchers looked at self-reported symptoms in 627,383 people using their app in the eight days after being vaccinated. My vaccine side effects and what they meanAbout 70% of people having the Pfizer jab had some reaction around where the needle went in, including pain, tenderness, redness or swelling, compared with just under 60% for the AstraZeneca jab. The trend was reversed for those reactions that affect the whole body rather than just the site of the injection.For the AstraZeneca jab, 34% had some “systemic” (whole body) reaction like headache, tiredness or chills. For the Pfizer vaccine this was only 14% after the first dose and 22% after the second. The most common of these side effects was a headache. ‘Mild and short-lived’The study’s lead scientist, Prof Tim Spector of King’s College London, said these findings should reassure people the after effects of the vaccine are “usually mild and short-lived”.But he pointed out there was a wide range of responses to the vaccine, just as there was to the virus, depending on age and sex among other things. The study did not look at what happened after a second dose of the Oxford-AstraZeneca jab since hardly anyone had received it at the time of the study, which went up to 10 March. Among all vaccinated users of the ZOE symptom app, one in four (25%) had one of these whole body reactions and two-thirds (66%) had a local reaction.Women, people under 55 and those who had a Covid infection in the past were all more likely to experience side effects.In the final stage of the Pfizer vaccine’s clinical trials, roughly 77% of people had pain at the injection site compared with just under 30% in this study, while the proportion of people experiencing fatigue and headache was three to five times smaller. For AstraZeneca, roughly half as many people had a whole body reaction like fever or fatigue as was recorded in clinical trials.This may be because people in the clinical trials were younger and healthier, or because people enrolled in the trial of an experimental vaccine might be more nervous and so more likely to identify symptoms, Prof Spector suggested. Dr Cristina Menni from King’s College London, lead author of the paper, said the results supported the safety of both vaccines and should “help allay safety concerns of people willing to get vaccinated”.

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesA leading Israeli doctor believes the country may be close to reaching “herd immunity”.This happens when enough of a population has protection against an infection that it stops being able to spread – and even people who don’t themselves have immunity are indirectly protected.For Covid the estimated threshold for herd immunity is at least 65%-70%. But scientists in the UK are more cautious. Dr Sarah Pitt, a virologist at the University of Brighton, urged “extreme caution” in concluding that herd immunity had been reached – something she believes will be difficult even at high vaccination rates. She said it was still too early to tell: “We need to see whether the cases in Israel continue to fall and stay at low levels.” Reaching this level of population immunity is important to protect people who can’t be vaccinated or whose immune system is too weak to produce a good, protective response. In Israel, more than half (5.3 million) its residents have been vaccinated and an additional 830,000 people have tested positive for the virus in the past, which should give them some natural immunity. That works out as roughly 68% of the population who are likely to have antibodies in their blood which can fight off the virus. Prof Eyal Leshem, a director at Israel’s largest hospital, the Sheba Medical Center, said herd immunity was the “only explanation” for the fact that cases continued to fall even as more restrictions were lifted. “There is a continuous decline despite returning to near normalcy,” he said. “This tells us that even if a person is infected, most people they meet walking around won’t be infected by them.” And cases are falling in all age groups including children, even though under-16s are not generally being vaccinated. How does herd immunity work?Experts think that with no restrictions in place, someone infected with the original strain of the virus that causes Covid-19, will infect, on average three to four other people.If it’s three, then, in theory, once two-thirds of the population becomes immune to the virus, an infected person will, on average, only pass it to one other person. That’s enough for the virus to spread, but not enough for it to grow.You’ve eliminated two of those three people from the chain of transmission. It sounds simple on paper. In reality, though, it’s a little more complicated.The vaccines are not 100% effective, and even when they stop people from getting sick they don’t completely block infections in everyone. That means some vaccinated people might still be able to pass on the virus.Not everyone with a past Covid infection has strong or long-lasting natural immunity, and newer variants of the virus are more transmissible.This means we may have to inoculate many more people before we reach that magic threshold. But it’s not all bad news. “I would say that we should not be looking for ‘herd immunity’ alone as a sign that we can lift all public health measures and get back to ‘normal’,” Dr Pitt explained. “Rather we should be looking for consistently low levels of Covid-19 infection”. Is the UK close to herd immunity?The UK is a way off this milestone – if it is ever reached. Only about half the population has Covid antibodies, either from infection or vaccination. But the country is already starting to see the impact of vaccination on hospitalisations and deaths, with the biggest declines seen in the most vaccinated age groups.There have been big falls in infection and illness among younger people too which might suggest the vaccine is blocking some transmission – although lockdown will have had a major effect too. After herd immunity, what’s next?So far, new variants don’t seem to be resistant to the vaccine. But a future variant which does show resistance to the virus, Prof Leshem explained, could mean people have less protection and the country could dip below the herd immunity threshold. This isn’t insurmountable – it could be tackled with tweaks to the vaccine, as already happens with the annual flu jab. It serves as an important reminder, though – even if Israel has reached herd immunity, and if the UK follows, this is not necessarily a permanent state.We can look at what’s happened with measles in recent years. The virus was considered to have been eliminated in the UK, but the World Health Organization revoked this status in 2019 after a “marked increase” in measles cases driven by a fall in the proportion of vaccinated people. Measles is highly contagious – each infected person infects roughly 15 other people – so vaccination coverage needs to be over 90% to prevent outbreaks. Follow Rachel on Twitter

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesPeople diagnosed with Covid-19 in the previous six months were more likely to develop depression, dementia, psychosis and stroke, researchers have found.A third of those with a previous Covid infection went on to develop or have a relapse of a psychological or neurological condition. But those admitted to hospital or in intensive care had an even higher risk.This is likely to be down to both the effects of stress, and the virus having a direct impact on the brain.UK scientists looked at the electronic medical records of more than half a million patients in the US, and their chances of developing one of 14 common psychological or neurological conditions, including:brain haemorrhagestrokeParkinson’s Guillain-Barré syndrome dementiapsychosismood disordersanxiety disorders Anxiety and mood disorders were the most common diagnosis among those with Covid, and these were more likely to be down to the stress of the experience of being very ill or taken to hospital, the researchers explained.Conditions like stroke and dementia were more likely to be down to the biological impacts of the virus itself, or of the body’s reaction to infection in general. Covid-19 was not associated with an increased risk of Parkinson’s or Guillain-Barré syndrome (a risk from flu).Cause and effectThe study was observational, so the researchers couldn’t say whether Covid had caused any of the diagnoses – and some people would have had a stroke or depression in the next six months regardless. But by comparing a group of people who had had Covid-19 with two groups – with flu and with other respiratory infections respectively – the researchers at the University of Oxford concluded Covid was associated with more subsequent brain conditions than other respiratory illnesses.The participants were matched by age, sex, ethnicity and health conditions, to make them as comparable as possible.Sufferers were 16% more likely to develop a psychological or neurological disorder after Covid than after other respiratory infections, and 44% more likely than people recovering from flu. On top of this, the more severely ill with Covid the patient had been, the more likely they were to receive a subsequent mental health or brain disorder diagnosisMood, anxiety or psychotic disorders affected 24% of all patients but this rose to 25% in those admitted to hospital, 28% in people who were in intensive care and 36% in people who experienced delirium while ill. Strokes affected 2% of all Covid patients, rising to 7% of those admitted to ICU and 9% of those who had delirium. And dementia was diagnosed in 0.7% of all Covid patients, but 5% of those who’d experienced delirium as a symptom.Dr Sara Imarisio, head of research at Alzheimer’s Research UK, said: “Previous studies have highlighted that people with dementia are at higher risk of developing severe Covid-19. This new study investigates whether this relationship may also hold in the other direction.”The study doesn’t focus on the cause of this relationship and it is important that researchers get to the bottom of what underlies these findings.”What does Covid-19 do to the brain?How Covid-19 can damage the brainUK biobank scans aim to reveal health legacyThere is evidence the virus does enter the brain and cause direct damage, neurology professor Masud Husain at the University of Oxford, explained.It can have other indirect effects, for example by affecting blood clotting which can lead to strokes. And the general inflammation which happens in the body as it responds to infection can affect the brain.For just over a third of people developing one or more of these conditions, it was their first diagnosis.But even where it was a recurrence of a pre-existing problem, researchers said this did not rule out the possibility that Covid had caused the episode of illness.Prof Dame Til Wykes, at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said: “The study confirms our suspicions that a Covid-19 diagnosis is not just related to respiratory symptoms, it is also related to psychiatric and neurological problems.”Looking over six months after diagnosis has demonstrated that the “after-effects” can appear much later than expected – something that is no surprise to those suffering from Long Covid.”Although as expected, the outcomes are more serious in those admitted to hospital, the study does point out that serious effects are also evident in those who had not been admitted to hospital.”LOOK-UP TOOL: How many cases in your area?LOCKDOWN RULES: What are they and when will they end?YOUR QUESTIONS: We answer your queriesGLOBAL SPREAD: How many worldwide cases are there?

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesRoughly half of people in the UK now have antibodies against Covid, either through infection or vaccination, tests conducted by the Office for National Statistics (ONS) show. Most of this will be through vaccination – with 30 million people having received at least one dose.Antibodies are proteins in the blood which recognise specific infections and fight them off.Among the oldest who are most at risk, levels are even higher.But there has been a small decline in detectable antibodies in that group since the peak of infections in January.The ONS speculates this might be people who received the vaccine earliest having had their first dose but not their second – but they stress this is not evidence that these people have less immunity.Yes/no resultOnce someone has had an infection, antibodies help your body to be ready if it encounters it again. Vaccines provide a safe way to develop antibodies without risking getting ill. The tests used in the ONS study give a yes/no result based on whether the amount of antibodies in your blood cross a certain threshold.But people can be protected by lower levels of antibodies. And there are other element of your immune system like T-cells which are not being measured here. There is some evidence to suggest protective T-cells might be detectable for longer than antibodies.It’s possible some of the decline is from infections in the first wave, as we know antibodies from infection drop off over time. The study is conducted by taking blood from a representative sample of people around the UK to estimate what proportion of the whole population has antibodies. By 14 March, an estimated 55% of people in England had antibodies, 51% in Wales, 49% in Northern Ireland and 43% in Scotland. Vast majority retain Covid antibodies six months onCan you catch Covid twice?But among the over-65s, who are most likely to have been vaccinated, roughly 90% had antibodies. The figures mark a rapid rise in people in the population having protection against Covid – up from roughly a third of people testing positive when levels were measured at the start of March.Other data published today shows the number of deaths seen across the UK has remained below what is expected at this time of year, having dipped under average last week. There were 11,666 deaths registered in the week ending 19 March – 8% below the five-year average for this week.

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesThe Covid-19 vaccine blocks pretty much all cases of serious illness – but the government has been much more cautious about saying whether it stops people carrying the virus and infecting others. Until evidence had built up from lots of people being vaccinated, scientists could not say for sure if the jab would stop transmission – and there was concern those vaccinated might stop taking precautions, potentially leading to a rise in infections. But with some now refusing the vaccine in the belief it will not stop them passing on the virus, is this caution becoming counterproductive?A number of people have contacted the BBC, saying they believe the jab could stop them becoming severely ill only. But the evidence is moving fast.Protection from the vaccine may not be perfect and people still need to be careful – but this does not mean it provides no protection to others. It is becoming increasingly clear the jab is a very big step towards protecting those around you – particularly people who are vulnerable, including the elderly and those with care needs such as learning disabilities or mental illness. And a growing body of real-world evidence suggests it stops a big chunk of people catching the virus at all – they do not fall ill and cannot infect people. When will over-40s get a jab?Covid vaccines: How fast is worldwide progress?The vaccines that work – and the others on the wayThink of a ladder with the worst Covid effects, intensive-care admission or death, at the top and the mildest, no or asymptomatic infection, at the bottom.Being vaccinated effectively moves people down the rungs of this ladder.Even the small number who do not receive complete protection might move from a very high risk of dying down to mild or moderate symptoms. And those who would have very mild or asymptomatic Covid without the jab are probably most likely to move down to no infection at all.What does the government say?”There has been some early evidence that suggests vaccines do have an impact on transmission,” an official said.”But the full impact on infection rates will not become clear until a large number of people have been vaccinated.”It is important to continue following the national restrictions, instructions from NHS Test and Trace, and to self-isolate if you are instructed to do so, even if you have had the vaccine.”What about the evidence?Regular testing of participants in the Oxford-AstraZeneca vaccine trials, with or without symptoms, found positive tests fell by more than half.And this suggested “the potential for a substantial reduction in transmission”, the team reviewing the trial results said.The Pfizer-BioNTech trial participants, meanwhile, were tested only if they had symptoms.But a later study of 40,000 health workers in England suggested one Pfizer-BioNTech dose cut the risk of infection – symptomatic or otherwise – by 70%, and two doses by 85%.Also, people living with vaccinated NHS staff in Scotland were considerably less likely to catch the virus than those living with unvaccinated health workers. And a separate analysis of the test results of hospital workers in Cambridge found a 75% decrease in asymptomatic infections after vaccination. In Israel, the Pfizer-BioNTech vaccine appeared to reduce all infections by as much as 90%, although the Ministry of Health could not be certain of the precise number as not everyone came forward for asymptomatic testing. And, a separate Israeli study found, the infections there had much lower “viral loads” – people shed less virus, meaning they would be less contagious as well as at lower risk of becoming ill.Similar conclusions have been drawn in studies of patients in the US and care-home residents in England.And, overall, the picture is clear – vaccines reduce transmission.Aren’t asymptomatic cases less contagious anyway?Asymptomatic Covid cases do seem to be less contagious – but those without symptoms may unknowingly infect more people. Studies estimate between a third and a half of new cases were caught this way.And those vaccinated are much less likely to pass on the virus.You only need to look at the disproportionately large number of outbreaks and deaths in care homes during the first wave of the pandemic to see the impact of relying on symptoms. And people are most infectious – at very high risk of passing on the virus – the day or two before symptoms develop.Follow Rachel on Twitter