February 28, 2024

AVAC's weekly Pandemic Watch provides a curated perspective on what COVID news is worth your time.


Although today’s scientific community has embraced the ideals of open data sharing, the world is no closer to a fair system for sharing vaccines and therapeutics. Intellectual property, not benefit-sharing, is the antithesis of open science. We dream of a world in which such barriers are dismantled for lifesaving medicines. Until that day, the Pandemic Agreement offers the last best chance to avoid repeating the mistakes made during the COVID-19 pandemic.”
—Colin Carlson and colleagues in Nature

Table of Contents
• If You Are in a Hurry
• Call for Vaccine Equity in the Pandemic Treaty
• Global Cholera Vaccine Stockpile Empty
• New Avian Flu Infections in Humans
• Long COVID Updates
• Documenting Stakeholder Participation in National Pandemic Preparedness Plans
• Lassa Fever is Surging in West Africa
• Drought and the Risk of Zoonotic Disease in Zambia
• Polio Vaccination Campaign in Zimbabwe
• Polio Vaccinator Killed in Pakistan
• Peru Declares Emergency Ahead of Dengue Outbreak
• Making Money on Disinformation

The politicization of public health is not new, but one of the lingering effects of the COVID pandemic is an increase in political interference in public, often through mis- and dis-information. As a measles outbreak grows in the US state of Florida, Axios ([link removed]) (US) reports, “Florida Surgeon General Joseph Ladapo contradicted federal health guidelines on measles this week by not urging parents to vaccinate their children against one of the world's most contagious viruses…. Ladapo's apathy toward measles vaccinations comes as a Florida elementary school is attempting to contain an outbreak and as measles cases have remerged across the U.S. It's also an extension of effort by Ladapo and other conservative officials to undermine federal public health norms and Centers for Disease Control and Prevention recommendations — particularly those about vaccinations.” NBC News
([link removed]) (US) reports, “Measles is so contagious and has such a long incubation period that the decision of the state’s Surgeon General Dr. Joseph Ladapo to let parents decide whether to quarantine their children or let them keep going to school could allow cases to spread, experts warn. ‘Measles is the most infectious pathogen in humans that we know of,’ said [pediatric infectious disease expert David] Kimberlin. ‘It’s like a heat-seeking missile. It will find the people who are not immune, and they’re going to get sick.’”

LA Times ([link removed]) (US) columnist Michael Hiltzik writes, “Cases of measles, which should have been eradicated in the U.S. years ago, are appearing again because of disinformation about the vaccines. Six cases have occurred in a single school in Florida, a state whose Republican governor, Ron DeSantis, has placed anti-vaccine propaganda at the center of his public health policies. The school's measles vaccination rate is about 89%, well below the 95% level thought to provide communal immunity protecting even the unvaccinated.

Hiltzik calls disinformation “a public health crisis.” He writes, “Prominent politicians, up to and including the former president, have promoted useless drugs as supposed cures for COVID-19. Partisan attacks on the safety and efficacy of COVID vaccines have expanded into attacks on all vaccines…. The sheer volume of lies and misrepresentations injected into the political mainstream has some scientists despairing of ever regaining the public’s attention.” Hiltzik quotes experts who advise, “recognizing disinformation techniques and how they implant sticky but erroneous concepts in the minds of laypersons… [and showing people] how to recognize disinformation tactics, such as an appeal to emotion or personal stories of adverse side effects that are claimed to be representative of patients as a whole rather than rare occurrences.”

If You Are in a Hurry
* Read a comment in Nature ([link removed]) calling for vaccine equity provisions in the WHO pandemic treaty.
* Read Science ([link removed]) on the severe shortage of cholera vaccines and hope for new manufacturing plans in the future.
* Read CIDRAP ([link removed]) on a new study that shows COCVID vaccination can protect against long COVID.
* But also read Clear Health Costs Blog ([link removed]) and USA Today ([link removed]) on who is most affected by long COVID and disappointment about research priorities.
* Read the Health Times ([link removed]) on a new polio vaccination campaign In Zimbabwe to combat vaccine derived polio.
* Read the Washington Post ([link removed]) on the lucrative business of vaccine disinformation.

Call for Vaccine Equity in the Pandemic Treaty
Colin Carlson and colleagues write in a comment in Nature ([link removed]) (UK), “Opinions differ on what [pandemic treaty] negotiators should prioritize. But no issue has captivated public attention as much as vaccine equity — or done more to bring countries to the negotiating table…. Across all fields, scientists from the global north have frequently extracted data and samples from the global south without the permission of the people there, without collaborating meaningfully — if at all — with local scientists, and without providing any benefit to the countries where they conduct their work…. As a collective of 290 scientists from 36 countries, we argue that a pandemic treaty cannot succeed unless it ensures that everyone will benefit from pandemic science….Although today’s scientific community has embraced the ideals of open data sharing, the world is no closer to a fair system for sharing vaccines and therapeutics. Intellectual property, not
benefit-sharing, is the antithesis of open science. We dream of a world in which such barriers are dismantled for lifesaving medicines. Until that day, the Pandemic Agreement offers the last best chance to avoid repeating the mistakes made during the COVID-19 pandemic.

Global Cholera Vaccine Stockpile Empty
Science ([link removed]) (US) reports, “The world has run out of cholera vaccines—just when the deadly disease is on a rampage not seen in many years. Fifteen countries are currently reporting active outbreaks, with more than 40,900 cases and 775 deaths reported in January alone. But all available doses of oral cholera vaccines in the global stockpile have been allocated until mid-March, Philippe Barboza, cholera team lead at the World Health Organization (WHO), said on 23 February. He said there is now ‘no buffer for unforeseen outbreaks or preventive campaigns.’” The shortage is caused in part because only one company is manufacturing the cholera vaccine. Science reports, “EuBiologics is working to ramp up production of a simplified vaccine, and companies in South Africa and India are preparing to enter the market as well. The shortage ‘will lessen in 2024 and should be substantially addressed by 2025,’ says Julia
Lynch, director of the cholera program at the International Vaccine Institute (IVI), also in Seoul; by 2026 or 2027, it could even be a ‘crowded market,’ she predicts.”

New Avian Flu Infections in Humans
CIDRAP ([link removed]) (US) reports, “Cambodia's health ministry has reported another human infection from H5N1 avian influenza, part of an uptick in similar cases that began in 2023…. Cambodia has now reported 5 cases for 2024 and a total of 11 since February 2023, following nearly a decade with no human infections…. Elsewhere, Hong Kong's Centre for Health Protection (CHP) today reported an influenza A H9 case, which involves a 22-month-old girl who had recently visited the city of Zhongshan in mainland China's Guangdong province.”

Long COVID Updates
CIDRAP ([link removed]) (US) reports, “A new study of almost 1.2 million people in Hong Kong demonstrates the protective effect of COVID-19 vaccination against long COVID, and suggests that the more doses people have had the less likely they experience long-term symptoms related to the virus. The study was published yesterday in Nature, and it adds to a growing body of literature suggesting COVID vaccines play an important role in reducing the risk of long COVID…. ‘As the pandemic progresses, our findings provided real-world evidence supporting the effectiveness of the COVID-19 vaccines in the prevention of long-term health consequences following SARS-CoV-2 infection,’ the authors concluded.” Read the study ([link removed]) .

Clear Health Costs Blog ([link removed]) (US) reports on the disproportionate impact of long COVID on trans and bisexual patients in the US. “Less than 2% of U.S. adults are trans or nonbinary, yet nearly 24% of all transgender adults report that they have experienced Long Covid. Bisexual adults report Long Covid cases at the same percentage rate (24%). That makes trans adults and bisexual adults, along with disabled adults, the demographic groups that are experiencing Long Covid in the highest percentages in the country…. A hypothetical Long Covid response that focuses merely on physical symptoms could clearly ignore the myriad of factors that make trans and bisexual people particularly vulnerable. But a response fueled by an understanding of disability justice stands a chance — not just at treating symptoms, but ensuring that Long Covid does not render people invisible.”

USA Today ([link removed]) (US) reports, “Federal estimates suggest at least 16 million Americans have long COVID and maybe 4 million of them… are disabled by it…. The complexity of both the disease and the drug development system, not to mention the difficulty of getting doctors to believe them and insurance to pay for visits, has left long COVID patients feeling alone and adrift…. In a paper in the journal Science published last week, researchers argue long COVID provides an historic opportunity to rethink acute chronic diseases that result from many infections and to prepare for future pandemics…. Still, long COVID advocates see the federal effort as anemic, inflexible and slow.” Read the Science ([link removed]) paper.

Helio ([link removed]) (US) reports, “Long COVID, fibromyalgia and chronic fatigue syndrome demonstrate overlapping characteristics that warrant further investigation, according to a speaker at the Basic and Clinical Immunology for the Busy Clinician symposium.”

CIDRAP ([link removed]) (US) reports, “Disruptions in the blood-brain barrier along with a hyperactive immune system are the likely mechanisms behind "brain fog" in patients who are experiencing long COVID, an Irish research team reported today in Nature Neuroscience. Brain fog has been reported during acute COVID infection and has also been reported in nearly 50% of patients who experience long COVID, or symptoms well past the acute phase of COVID-19. Read the paper in Nature Neuroscience ([link removed]) .

​Documenting Stakeholder Participation in National Pandemic Preparedness Plans
A study in Health Policy ([link removed]) (Netherlands) looks at stakeholder participation in COVID pandemic preparedness and response plans across 70 countries. “We found that most plans were prepared by the Ministry of Health and acknowledged WHO guidance, however less than half mentioned that additional stakeholders were involved. Few plans described a strategy for stakeholder participation and/or accounted for public participation in the plan preparation. However, diverse stakeholders (including multiple governmental, non-governmental, and international organizations) were proposed to participate in the implementation of the plans. Overall, there was a lack of transparency about who participated in decision-making and limited evidence of meaningful participation of the community, including marginalized groups. The critical relevance of stakeholder participation in priority setting requires that governments develop
strategies for meaningful participation of diverse stakeholders during pandemics such as COVID-19, and in routine healthcare priority setting.”

Lassa Fever is Surging in West Africa
Science ([link removed]) (US) reports, “Lassa fever has long been concentrated in endemic areas in Nigeria, Guinea, Liberia, and Sierra Leone. But in recent years, cases of the deadly hemorrhagic disease have been popping up in other parts of West Africa. With climate change and population growth, the virus is expected to extend its reach…. Lassa fever kills far more people than Ebola does—10,000 or more a year, some researchers suspect, although no one knows for sure. But except for a small cadre of dedicated researchers, it has been largely ignored. Identified only half a century ago, the rodent-borne disease, which can more rarely be transmitted between people via body fluids, affects the rural poor, who live far from any health center. Most cases go undiagnosed and unreported, and many people die in their villages.”

Drought and the Risk of Zoonotic Disease in Zambia
Lusaka Times ([link removed]) (Zambia) reports, “Amidst growing concerns over the impact of drought on public health, the Zambia National Public Health Institute (ZNPHI) has embarked on a collaborative effort with government departments responsible for animal health to mitigate the risks of zoonotic diseases…. through the ZNPHI’s Pandemic Preparedness Programme, Chilengi revealed ongoing collaboration with various government institutions to prevent the spread of zoonotic diseases. This initiative aims to address the challenges posed by the drought and minimize the potential health implications for both humans and animals.”

Polio Vaccination Campaign in Zimbabwe
Health Times ([link removed]) (Zimbabwe) reports, “Over the past few days, the Ministry of Health and Child Care (MoHCC) launched an emergency polio vaccination blitz in response to the new strain. The vaccination campaign is targeting not less than 4.2 million children aged 10 years and younger following a Ministry of Health's risk analysis which identified children within that age range as high risk group for the circulating mutated virus. The vaccination campaign kicked off on February 20, ending March 1, 2024.”

AP ([link removed]) (US) reports the campaign comes “after health authorities detected three cases caused by the rare mutation of the weakened virus used in oral vaccines, including a 10-year-old girl who was paralyzed in January. The health ministry said laboratory tests from samples collected from sewage sites in several areas of the capital, Harare, late last year showed the presence of a mutated polio virus that originated in an oral vaccine used in the global eradication effort. In rare instances, the live polio virus in vaccines can mutate into a form capable of sparking new outbreaks, especially in places with poor sanitation and low vaccination levels.”

Polio Vaccinator Killed in Pakistan
Telegraph ([link removed]) (UK) reports on the killing of Dr Abdur Rehman a passionate advocate for polio vaccination in Pakistan. “Coordinating polio vaccination campaigns to stamp out the crippling childhood virus in the border areas of Pakistan might be admirable work, but it was also dangerous. Scores of Pakistan’s polio workers and their police guards have been shot dead by militants who are opposed to vaccination and also see the medics as soft targets in a wider war against the state. On January 19, the worst fears of Dr Rehman’s family were realised. The senior health official was ambushed by gunmen and shot dead as he returned from work in Bajaur district along the Afghan border. One of his police guards was injured in the attack. His death brought the number of polio staff and their police guards killed in the country to 108.”

Peru Declares Emergency Ahead of Dengue Outbreak
Reuters ([link removed]) (UK) reports, “Peru declared a health emergency across most of the country on Monday as a heat wave and heavy rains have led to a spike in dengue fever cases. The South American nation's death toll due to the virus has risen to 32 so far this year, Health Minister Cesar Vasquez said on Monday. Total cases also climbed to 31,300 in the first eight weeks of the year…”

Making Money on Disinformation
Washington Post ([link removed]) (US) reports, “Four major nonprofits that rose to prominence during the coronavirus pandemic by capitalizing on the spread of medical misinformation collectively gained more than $118 million between 2020 and 2022, enabling the organizations to deepen their influence in statehouses, courtrooms and communities across the country, a Washington Post analysis of tax records shows…. The four groups routinely buck scientific consensus. Children’s Health Defense and Informed Consent Action Network raise doubts about the safety of vaccines despite assurances from federal regulators.”

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