Pandemic Watch News Brief: The News You Need To Know ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

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[link removed] April 25, 2024
AVAC's weekly Pandemic Watch is a curated news digest on the latest pandemic prevention, preparedness and response (PPPR) news and resources.


Vaccines are among the most powerful inventions in history, making once-feared diseases preventable. Immunisation was the single greatest contribution of any health intervention to ensuring babies not only see their first birthdays but continue leading healthy lives into adulthood." - WHO chief Tedros Adhanom Ghebreyesus in France 24 ([link removed])
Table of Contents
• If You Are in a Hurry (#If You Are in a Hurry)
• Concerns Rise Around Avian Flu (#Concerns Rise Around Avian Flu)
• Republic of Congo Declares Mpox Epidemic (#Republic of Congo Declares Mpox Epidemic)
• US Government Report Documents Failures in US Mpox Response (#US Government Report Documents Failures in US Mpox Response)
• Uganda Ebola Plan Could Be Blueprint for Future Responses (#Uganda Ebola Plan Could Be Blueprint for Future Responses)
• Adult Vaccines Are Cost-Effective (#Adult Vaccines Are Cost-Effective)
• Global Health Finance Alarm (#Global Health Finance Alarm)
• Pandemic Accord Remains Uncertain (#Pandemic Accord Remains Uncertain)
• Study Documents More Severe COVID in Africa (#Study Documents More Severe COVID in Africa)
• COVID and Doctor’s Duty to Provide Car (#COVID and Doctor’s Duty to Provide Car)
• Dengue Surges in Sudan (#Dengue Surges in Sudan)
• WHO Redefines Airborne (#WHO Redefines Airborne)
We could have led with any number of stories to cause concern this week. And you’ll see those below focusing on avian flu, mpox and more. This week we’re leading with news about the power of vaccines. WHO this week published a study in The Lancet that found at least 154 lives – mostly those of infants – have been saved by vaccines over the last 50 years. AFP ([link removed]) (France) reports, “That is the equivalent of six lives saved every minute of every year of the half century… Thanks to these vaccines, ‘a child born today is 40 percent more likely to see their fifth birthday than a child born 50 years ago’, WHO chief Tedros Adhanom Ghebreyesus told reporters. ‘Vaccines are among the most powerful inventions in history, making once-feared diseases preventable,’ he said…. The study also showed that when a vaccine saves a child's life, that person goes on to live an average of 66 years of full hea
lth on average -– with a total of 10.2 billion full health years gained over the five decades. ‘Vaccines cause adults,’ Tedros said.”

* Read WHO’s press release ([link removed]) .
* Read WHO’s History of Vaccination ([link removed]) .


If You Are in a Hurry

* Read The New York Times ([link removed]) on avian flu moving into mammals and what that could mean.
* The read STAT ([link removed]) on what it would take to make pandemic flu vaccines.
* Read HIV Plus ([link removed]) on a report that documents US government failures in the mpox response and what it could mean for future outbreaks.
* Read Healio ([link removed]) on an Ebola response in Uganda that could be a blueprint for future outbreak responses.
* Read a long piece in Washington Post ([link removed]) on the pandemic accord negotiations and what’s at stake.
* Read Nature ([link removed]) on WHO’s redefining of “airborne” and what that could mean for responses to future outbreaks.


Concerns Rise Around Avian Flu

Experts have been closely following avian flu outbreaks around the globe for the last few years, first among both domestic and wild birds, and increasingly among mammals. There have been a handful of crossover infections into humans, but the virus so far not been shown to easily spread between humans. That is still the case, but concerns are rising as the H5N1 virus has been found in dairy cattle in the US and traces of the virus has been found in the milk supply. Experts say there isn’t yet evidence that the virus is mutating in ways that will make human to human transmission easy or likely. There is plenty of good and careful news coverage of the current status of H5N1, but there is also growing panic-inducing headlines and conspiracy theories across social media platforms.

The New York Times ([link removed]) (US) reports, “There has been no stopping H5N1. Avian flu viruses tend to be picky about their hosts, typically sticking to one kind of wild bird. But this one has rapidly infiltrated an astonishingly wide array of birds and animals, from squirrels and skunks to bottlenose dolphins, polar bears and, most recently, dairy cows. ‘In my flu career, we have not seen a virus that expands its host range quite like this,’ said Troy Sutton, a virologist who studies avian and human influenza viruses at Penn State University…. A human pandemic is by no means inevitable. So far at least, the changes in the virus do not signal that H5N1 can cause a pandemic, Dr. Sutton said.”

In a separate article The New York Times ([link removed]) (US) reports, “The bird flu outbreak in American dairy cattle may have begun in January, or even as early as December, a new analysis of genetic data suggests…. Scientists in the United States and elsewhere have criticized federal agencies for withholding key information about the outbreaks, including genetic sequences of the virus from infected cows… The data may hold valuable clues to the evolution of the virus and the extent of the outbreak.”

STAT ([link removed]) (US) reports, “Testing conducted by the Food and Drug Administration on pasteurized commercially purchased milk has found genetic evidence of the H5N1 bird flu virus, the agency confirmed Tuesday. But the testing, done by polymerase chain reaction, or PCR, cannot distinguish between live virus or fragments of viruses that could have been killed by the pasteurization process…. The lengthy statement the agency released does not explicitly say FDA laboratories were unable to find live virus in the milk samples, but it does state that its belief that commercial, pasteurized milk is safe to consume has not been altered by these findings.”

Read an update ([link removed]) from the US FDA on H5N1 in dairy cows.

STAT ([link removed]) (US) reports, “The good news: The world makes a lot of flu vaccine and has been doing it for decades. Regulatory agencies have well-oiled systems to allow manufacturers to update the viruses the vaccines target without having to seek new licenses. The United States even has some H5 vaccine in a stockpile that it believes would offer protection against the version of the H5N1 virus infecting dairy cattle, though there would not be nearly enough doses for the entire country. The bad news: The current global production capacity isn’t close to adequate to vaccinate a large portion of the world’s population in the first year of a pandemic. And batches of flu vaccine, often (though not always) produced in hen’s eggs, take months to produce…. Experts STAT interviewed suggested that in some respects, the world is better positioned to produce pandemic flu vaccines, if the need arises. But a number warned that assuming
the successes of Covid vaccine production would automatically influence the speed and scale of pandemic flu vaccine production would be unwise.”

The Guardian ([link removed]) (UK) reports, “Influenza is the pathogen most likely to trigger a new pandemic in the near future, according to leading scientists. An international survey, to be published next weekend, will reveal that 57% of senior disease experts now think that a strain of flu virus will be the cause of the next global outbreak of deadly infectious illness. The belief that influenza is the world’s greatest pandemic threat is based on long-term research showing it is constantly evolving and mutating, said Cologne University’s Jon Salmanton-García, who carried out the study.”

Republic of Congo Declares Mpox Epidemic

Reuters ([link removed]) (UK) via Medscape reports, “Republic of the Congo has declared an epidemic of mpox after 19 cases were confirmed across five departments, including the capital Brazzaville. No deaths have yet been recorded, Health Minister Gilbert Mokoki said in a statement on Tuesday. He called on the public to take precautions including avoiding close contact with suspected cases, avoiding contact with animals and avoiding handling game meat with bare hands.”

In an early April media briefing ([link removed]) , WHO’s Tedros reported in the neighboring country, Democratic Republic of the Congoo “more than 4500 suspected cases and almost 300 deaths have been reported so far this year – triple the number of cases and deaths reported in the first quarter of last year.”

US Government Report Documents Failures in US Mpox Response

HIV Plus ([link removed]) (US) reports, “A new report from the Government Accountability Office highlights significant areas for improvement in the US Department of Health and Human Services’ response to the 2022 mpox (previously called monkeypox) outbreak, exposing a fragmented system lacking strategic coordination and effective communication. The deficiencies could lead to more severe outbreaks and a higher risk of global health crises. In response to these challenges, out US Rep. Ritchie Torres, a New York Democrat, has introduced the Coordinated Agency Response Enhancement (CARE) Act, striving to overhaul federal public health emergency management. The GAO report… criticized HHS for its poor internal communication, which hampered action and coordination during the outbreak. It highlighted the absence of a department-wide after-action program, essential for learning from past mistakes and preparing for future emergencies.”

Read the report ([link removed]) .

Uganda Ebola Plan Could Be Blueprint for Future Responses

Healio ([link removed]) (US) reports, “Uganda rapidly scaled up screening during a rare outbreak of Ebola virus in 2022 using a plan that researchers said could be a blueprint for future responses. The country’s rapid implementation of an infection prevention and control strategy successfully enhanced screening capacity in more than 1,000 health facilities during its first outbreak of Sudan ebolavirus in a decade, researchers reported during the Society for Healthcare Epidemiology of America Spring conference.”

Adult Vaccines Are Cost-Effective

CIDRAP ([link removed]) (US) reports, “Adult vaccination programs can return up to 19 times their initial government investment in healthcare savings and socioeconomic value, offering net benefits of up to $4,637 per full vaccination course, according to a new report from the Office of Health Economics (OHE). Researchers from the OHE, a UK charity and independent health economics research organization, analyzed the full value of four adult vaccines (against influenza, pneumococcal disease, respiratory syncytial virus [RSV], and shingles) available in Australia, Brazil, France, Germany, Italy, Japan, Poland, South Africa, Thailand, and the United States.”

Global Health Finance Alarm

Experts are raising the alarm about falling health spending in low- and middle-income countries. Devex (US) reports, “The problem, [health economist David] Evans said, is particularly acute in a group of 28 low- and middle-income countries whose governments are spending less on health than they did before the COVID-19 pandemic, with no prospect — according to International Monetary Fund projections — of returning to those pre-pandemic levels in the next five years. At the same time that national governments confront fiscal constraints that create tradeoffs between health spending and other budget line items, international health and development organizations are competing with each other this year for donor funding that threatens a post-pandemic retraction.”

Pandemic Accord Remains Uncertain

Washington Post ([link removed]) (US) reports on last minute efforts to secure a pandemic accord, set to be voted on next month at the World Health Assembly. “The deadline for a deal? May 2024. The costs of not reaching one? Incalculable, experts say. An unknown future pathogen could have far more devastating consequences than SARS-CoV-2, which cost some 7 million lives and trillions of dollars in economic losses. But even as negotiators pack in extra hours, the goal of clinching a legally binding pact by next month is far from certain — despite a new draft document being delivered in recent days. The main sticking point involves access to vital information about new threats that may emerge — and to the vaccines and medicines that could contain that threat.

Study Documents More Severe COVID in Africa

A study in the journal Global Heart ([link removed]) (UK) found, " Overall, hospitalised African patients with COVID-19 had a higher mortality despite a lower mean age, contradicting literature that had previously reported a lower mortality attributed to COVID-19 in Africa. African sites had lower COVID-19 vaccination rates and higher [acute kidney injury] AKI rates, which were positively associated with increased mortality. In conclusion, African patients were hospitalized with more severe COVID-19 cases and had poorer outcomes.”

COVID and Doctor’s Duty to Provide Care

A press release ([link removed]) from Duke University outline findings of a peer reviewed study “assessing doctors’ tolerance for refusing care to COVID-19 patients.” Researchers found, “The unique circumstances arising from the COVID-19 pandemic altered a long-held convention that doctors provide care regardless of personal risk. Duke Health researchers identified a growing acceptance to withhold care because of safety concerns…. The authors noted that the COVID pandemic had several unique characteristics that collectively altered the social contract between doctors and patients, potentially driving changes in treatment expectations. Such factors included: Shortages of resources available to care teams, including personal protective gear, hospital rooms, respirators, treatments and vaccines; polarizing misinformation about vaccines, effective treatments and how the virus spread; increased rates of reported mistreatment against staff from patients and their
family members. The authors note the ongoing debate over whether vaccination status should be considered in the decision to treat a patient.” Read the study ([link removed]) in Clinical Infectious Diseases.

Dengue Surges in Sudan

The Telegraph ([link removed]) (UK) reports, “Dengue cases in Sudan’s war-ravaged capital are surging as the country’s healthcare system nears collapse. A hospital in Khartoum recently identified 720 new cases of the virus, which spreads mainly through mosquito bites. Healthcare workers suspect the new outbreak has been caused by the accumulation of medical waste, including human organs, outside of vital healthcare facilities, and a lack of sanitation.

WHO Redefines Airborne

Nature ([link removed]) (UK) reports WHO “has changed how it classifies pathogens that spread through the air, such as SARS-CoV-2. The redefinition has been two years in the making and comes after criticism that during the COVID-19 pandemic, the WHO was too slow to acknowledge that COVID was airborne. The change aims to provide clarity during pandemics, but some researchers are not convinced. Virologists now acknowledge that SARS-CoV-2 spreads mostly by airborne transmission of small particles that are inhaled and that can remain in the air for hours — a method that was previously called ‘aerosol’ transmission. It also spreads by larger ‘droplets’ of virus-containing particles on surfaces, including hands, or ejected over short distances. However WHO didn’t publicly acknowledge the importance of airborne transmission until October 2020, a decision that outgoing chief scientist Soumya Swaminathan said in November 2022 said should have been made much
earlier based on the available evidence.”
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