There is increasing acknowledgement of the intrinsic connection between climate change and health. Now editors of more than 200 medical journals have issued a warning that climate change could cause “catastrophic harm” to human health. Published in BMJ (UK) and other journals the editors “call on the United Nations, political leaders, and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe. This overall environmental crisis is now so severe as to be a global health emergency. The world is currently responding to the climate crisis and the nature crisis as if they were separate challenges. This is a dangerous mistake…. Health professionals must be powerful advocates for both restoring biodiversity and tackling climate change for the good of health. Political leaders must recognise both the severe threats to health from the planetary crisis and the benefits that can flow to health from tackling the crisis. But, first, we must recognise this crisis for what it is: a global health emergency.”
If You Are in a Hurry
- Read Health Policy Watch on a new report on the fragile state of pandemic preparedness.
- Read the Coalition of Advocates for Global Health and Pandemic Preparedness new analysis and recommendations for the WHO pandemic accord.
- Read The Atlantic on paramyxoviruses and why we should be watching them for a new pandemic.
- Read Science on the first chikungunya vaccine.
- Read Devi Discourse on a new, simple TB test for children.
- Read Reuters on new US CDC recommendations for routine mpox vaccination.
- Read Medical Express on a call to rename antimicrobial resistance to help ensure people take it more seriously.
Pandemic Preparedness is “Perilously Fragile”
Health Policy Watch (Switzerland) reports, “The world’s preparedness for the next pandemic is “perilously fragile”, with gaps that “leave us dangerously exposed to a future threat”, according to the Global Preparedness Monitoring Board (GPMB) in its 2023 annual report released on Monday….Areas of decline from “already low levels of preparedness” include the global coordination of research and development (R&D); efforts to address misinformation; the participation of low and middle-income countries (LMIC) in the governance of pandemic preparedness; the lack of financing, and lack of independent monitoring.” Read the GPMB report here.
The Telegraph (UK) reports the report, “warned that deteriorating international relations and increasing polarisation has created a “fragmented and broken world”. ‘Trust between countries is at a low point, not only due to geopolitical rivalries but also as a result of the unequitable response to the COVID-19 pandemic,’ the report warned. Not only will this make it significantly more difficult to respond should a new disease threat emerge, but it is making it much more challenging to develop the systems needed to respond ahead of time.”
Washington Examiner (US) reports, “The report indicates that developing a ‘global mechanism to effectively address health-related misinformation and disinformation’ is a key goal for advancing health equity during emergency responses and addressing the "global trust deficit." To advance these goals, WHO has established initiatives to manage the so-called ‘infodemic,’ which the organization defines as a plethora of information from which it is difficult to distill the truth… ‘With growing digitization — an expansion of social media and internet use — information can spread more rapidly. This can help to more quickly fill information voids but can also amplify harmful messages,’ the WHO said.”
The Coalition of Advocates for Global Health and Pandemic Preparedness has released a new analysis that is “a compilation of recommendations from civil society and community organisations on the DRAFT Negotiating Text of the WHO convention, agreement or other international instrument on pandemic prevention, preparedness, and response (WHO Pandemic Agreement).” Among the recommendations are: “Expand strengthening of [science, public health and pandemic] literacy to include community engagement beyond community consultation; rather learn from civil society organizations in developing communications while strengthening their capacities along the process. In addition to including gender responsive and rights-based communications on pandemics.”
In a commentary in Health Affairs (US) on the failures of the UN’s Political Declaration On Pandemics, Lawrence O. Gostin and colleagues argue, “The ongoing Geneva negotiations are scheduled to culminate in both the IHR and Pandemic Accord being adopted at the May 2024 World Health Assembly. After all the loss of life, wealth, educational opportunity, and much more during the COVID-19 pandemic, failures of global cooperation and action would be unforgivable. Global leaders will not have another chance to achieve transformational reforms in our lifetimes. We owe it to ourselves and our children to make the world more secure and equitable. The next global public health emergency could be far worse than COVID-19. The only way to prevent or mitigate a new destructive pandemic is to act now to make the world more prepared and resilient before it hits.”
First Chikungunya Vaccine Nears Approval
Science (US) reports, “The first vaccine against the mosquito-borne viral disease chikungunya will likely come to market next month…. [T]he debilitating disease [is] now afflicting more than half the countries in the world and threatening to spread further…” Approval is expected soon by the US FDA and the first access to the vaccine will likely be to US travelers to regions where the disease is common. “But many expect an FDA approval will also grease the wheels for the vaccine to become available in the most affected countries…. Valneva’s expected approval comes after years of frustratingly slow progress. More than 5 decades ago, the US Army made a chikungunya vaccine that protected monkeys and even entered a small human trial, but the military saw little need for it and didn’t advance the research. Other efforts similarly languished, in part because at the time, the disease surfaced only sporadically in a few African and Asian countries.”
Some Good News on Disease Elimination
UN News reports WHO “hailed the elimination of several life-threatening diseases in developing nations as a major breakthrough for public health…. Bangladesh has become the first country to be validated for the elimination of visceral leishmaniasis (also known as kala azar), which is a life-threatening neglected tropical disease that is common in the region…. Maldives is the first country to verify an interruption of the transmission of leprosy, having achieved the milestone of no child case detection for more than five consecutive years…. Based on evidence provided by the National Verification Committee of DPRK, the WHO’s Southeast Asia Regional Verification Commission for Measles and Rubella Elimination concluded that the endemic rubella virus has been eliminated from the country.”
COVID Vaccines Saved Millions of Lives; Could Have Saved More
CIDRAP (US) reports, “The COVID-19 vaccination campaign in 141 countries averted 2.4 million excess deaths by August 2021 and would have saved another 670,000 more lives had vaccines been distributed equitably, estimates a working paper from University of Southern California (USC) and Brown University researchers. The National Bureau of Economic Research circulated the non–peer-reviewed working paper for discussion and comment this week. The researchers estimated the real-world effectiveness of the global COVID-19 vaccine rollout on all-cause death rates, including both the direct and indirect effects of the pandemic.” Read the paper here.
New COVID Drug in Japan
The Atlantic (US) reports on a new COVID drug developed in Japan and approved there, but not in the US. The drug, ensitrelvir, appears to have some potential advantages over paxlovid. “Existing data (not all of which have been peer-reviewed) show that people with COVID who promptly take ensitrelvir, marketed as Xocova in Japan, test negative about 36 hours faster than people who take a placebo. Fever, congestion, sore throat, cough, and fatigue disappear about a day earlier too. Even smell and taste loss appear to resolve more quickly. The company also has some tentative evidence suggesting that the drug can help protect patients from developing long COVID.” More data from clinical trials is needed before the drug can be considered by the US FDA.”
Chance of Long COVID Highest with Original Strain
CTV News (Canada) reports, “the incidence rates of long COVID have also fallen with each new variant…. The study… looked at more than 270,000 adults across the UK and found that those who were infected with the original strain of SARS-CoV-2 were much more likely to experience both more serious and more long-lasting cases of long COVID compared to those infected with newer variants.” Read the study.
COVID Lockdowns: A Giant Experiment
Joe Nocera and Bethany McLean write in New York Magazine (US) in an expert from their book about the COVID pandemic in the US: “One of the great mysteries of the pandemic is why so many countries followed China’s example. In the US and the UK especially, lockdowns went from being regarded as something that only an authoritarian government would attempt to an example of “following the science.” But there was never any science behind lockdowns — not a single study had ever been undertaken to measure their efficacy in stopping a pandemic. When you got right down to it, lockdowns were little more than a giant experiment…. While it is reasonable to think of that policy (in all its many forms, across different sectors of society and the 50 states) as an on-the-fly experiment, doing so demands that we come to a conclusion about the results. For all kinds of reasons, including the country’s deep political divisions, the complexity of the problem, and COVID’s dire human toll, that has been slow to happen. But it’s time to be clear about the fact that lockdowns for any purpose other than keeping hospitals from being overrun in the short-term were a mistake that should not be repeated.”
New Simple TB Test for Children Developed
Devi Discourse (India) reports, “A simple, rapid blood test can help diagnose tuberculosis accurately in children, according to the findings of a study conducted in five countries, including India. About 2,40,000 children worldwide die of tuberculosis every year. The disease is among the top 10 causes of death in children under the age of 5, the researchers said. One of the main reasons for this mortality is that tuberculosis is often misdiagnosed or not diagnosed in time, particularly in regions with limited resources, they said. The new diagnostic tool, described in The Lancet Infectious Diseases journal, and tested as part of a large-scale study in five countries, offers significant progress in this area.” Read the study here.
Growing Mpox Outbreak in Indonesia
BNN (India) reports on a growing mpox outbreak in Jakarta, Indonesia, where on October 31, there were 22 confirmed cases. “In Jakarta, the number of monkeypox cases had increased by five from October 27, 2023. One patient had recovered, but the remaining 21 were in isolation. In addition, the Indonesian Ministry of Health reported five positive cases in Banten and West Java. “As the storm of monkeypox continues to surge in Jakarta and air pollution clouds the city’s skyline, the importance of early detection, isolation, and vaccination, as well as stricter regulations on animal trade and pollution, are clear. Public awareness and education are also crucial in addressing these challenges effectively.”
US CDC Calls for Routine Mpox Vaccination for Some
Reuters (UK) reports, “Danish pharmaceutical company Bavarian Nordic said on Wednesday a US Centers for Disease Control and Prevention panel has voted in favor of recommending the routine use of Jynneos vaccine for adults at risk of mpox. The CDC's Advisory Committee on Immunization Practices (ACIP) voted to recommend that individuals 18 years and older with certain risk factors should receive two doses of Jynneos. The panel had previously recommended the vaccine for individuals at risk of mpox only during an outbreak, Bavarian said. The CDC estimates that 2 million US individuals are eligible for vaccination against mpox under these recommendations, according to Bavarian. About 23% of this group has received the recommended two doses of Jynneos during the 2022/2023 mpox outbreak to date, Bavarian said.”
Clean Water Shortages Fuel Outbreaks in Malawi and Zimbabwe
BBC (UK) reports, “For months now, Zimbabwe has been battling to stem the spread of deadly cholera in its cities and villages because the country simply lacks clean water…. This outbreak first struck back in February and as October ended official figures from the Health and Childcare Department are listing nearly 6,000 cases and some 123 suspected deaths…. In the capital, Harare, residents can go for weeks, or even months, without a regular supply of water from the Harare City Council. In Harare's satellite township of Chitungwiza, more than 50 deaths were reported as October ended - all from cholera.”
The Guardian (UK) reports, “Malawi has seen a resurgence of the infectious skin disease scabies in an outbreak that is being linked to the climate crisis. Just months after a cholera outbreak killed more than 1,800 people and affected a total of 58,982 people in August, the country has seen the return of the disease in the northern city of Mzuzu and the southern Nsanje district, with 4,152 cases registered in the past week…. Health campaigners believe the outbreak could be directly linked to the climate crisis, as the current heatwave, high humidity and water shortages across Malawi make people more vulnerable to disease outbreaks. Public health expert Maziko Matemba said Malawi needs to do more to address the impact of the climate crisis on health. ‘Looking at scabies, which has affected Mzuzu city and Nsanje districts, I believe that could be as a result of climate change.’”
What A COVID Mask Analysis Got Wrong
Scientific America (US) looks at the Cochrane Library’s highly publicized mask analysis and what it got wrong. “One group of scientists has seriously muddied the waters with a report that gave the false impression that masking didn't help. The group's report was published by Cochrane, an organization that collects databases and periodically issues ‘systematic’ reviews of scientific evidence relevant to health care. This year it published a paper addressing the efficacy of physical interventions to slow the spread of respiratory illness such as COVID. The authors determined that wearing surgical masks ‘probably makes little or no difference’ and that the value of N95 masks is ‘very uncertain.’…. Cochrane Reviews base their findings on randomized controlled trials (RCTs), often called the ‘gold standard’ of scientific evidence. But many questions can't be answered well with RCTs, and some can't be answered at all…. In fact, there is strong evidence that masks do work to prevent the spread of respiratory illness. It just doesn't come from RCTs. It comes from Kansas. In July 2020 the governor of Kansas issued an executive order requiring masks in public places. Just a few weeks earlier, however, the legislature had passed a bill authorizing counties to opt out of any statewide provision. In the months that followed, COVID rates decreased in all 24 counties with mask mandates and continued to increase in 81 other counties that opted out of them.”
Call to Rename Antimicrobial Resistance
Medical Express (US) reports, “The public is failing to take antimicrobial resistance seriously and it could all be down to the scientific terminology used. A study by Dr. Eva Krockow from the University of Leicester, which looked at public health communication shows that the term commonly used to describe bacteria resistant to current medicines or antibiotics (Antimicrobial resistance or AMR) is not taken seriously enough and therefore fails to stick in people's memories…. Dr. Krockow said, ‘It's imperative that if we're to protect modern medicine and conserve existing medication for future generations, we reduce antibiotic use internationally. To do so we need effective public health campaigns that encourage behavior change. Our study highlights the need to rename AMR to a memorable term that's fit for the wider public and not just those from the medical or scientific communities.’" Read the study here.
Study Looks at Efficacy of Antibiotics for Common Childhood Infections
CIDRAP (US) reports, “A review and analysis of data from previously published studies found high levels of resistance to the antibiotics commonly used for empiric treatment of sepsis and meningitis in babies and children in the Asia-Pacific region, researchers reported today in The Lancet Regional Health–Southeast Asia…. The findings suggest new regimens are needed to treat children with sepsis and meningitis, which are the leading cause of neonatal and childhood mortality globally. An estimated 3 million children under the age of 5, mostly newborns in low- and middle-income countries (LMICs) in sub-Saharan Africa and Asia, died from sepsis in 2017.” Read the study here.
What Is a Paramyxovirus and Could One Start the Next Pandemic?
Katherine Wu writes in The Atlantic (US): Paramyxoviruses, meanwhile, have mostly been “simmering in the background,” says Raina Plowright, a disease ecologist at Cornell. Unlike flu viruses and coronaviruses, which have already clearly ‘proven themselves’ as tier-one outbreak risks, paramyxoviruses haven’t yet been caught causing a bona fide pandemic. But they seem poised to do so, and they likely have managed the feat in the past. Like flu viruses and coronaviruses, paramyxoviruses can spread through the air, sometimes very rapidly. That’s certainly been the case with measles, a paramyxovirus that is ‘literally the most transmissible human virus on the planet,’ says Paul Duprex, a virologist at the University of Pittsburgh. And, like flu viruses and coronaviruses, paramyxoviruses are found in a wide range of animals; more are being discovered wherever researchers look…. Researchers are keyed into these looming threats. The World Health Organization highlights Nipah virus and its close cousins as some of its top-priority pathogens; in the US, paramyxoviruses recently made a National Institute of Allergy and Infectious Diseases list of pathogens essential to study for pandemic preparedness. Last year, the Bill & Melinda Gates Foundation announced a hefty initiative to fund paramyxovirus antiviral drugs. Several new paramyxovirus vaccines—many of them targeting Nipah viruses and their close relatives—may soon be ready to debut.”
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