Pandemic Watch: The US avain flu response, what went wrong with the Pandemic Treaty, and more ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌

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[link removed] June 20, 2024
AVAC's weekly Pandemic Watch is a curated news digest on the latest pandemic prevention, preparedness and response (PPPR) news and resources.


There were lessons to be learned from Ebola in West Africa. Just five years later, having not applied those lessons, there were lessons to be learned again from COVID. There is no need to keep learning. Instead of gambling, leaders can make practical decisions and apply those lessons.” - Ellen Johnson Sirleaf in The Guardian ([link removed])
• If You Are in a Hurry (#If You Are in a Hurry)
• GAVI Announces New Vaccine Programs for Ebola and Other Diseases (#GAVI Announces New Vaccine Programs for Ebola and Other Diseases)
• Global Health Leaders Critique US Avian Flu Response (#Global Health Leaders Critique US Avian Flu Response)
• More on Avian Flu (#More on Avian Flu)
• What Went Wrong with the Pandemic Treaty and What’s Next (#What Went Wrong with the Pandemic Treaty and What’s Next)
• Mpox Spreads in DRC; Kills Two in South Africa; Rising in Los Angeles (#Mpox Spreads in DRC; Kills Two in South Africa; Rising in Los Angeles)
• Lessons from Community Led Health Promotion for Mpox (#Lessons from Community Led Health Promotion for Mpox)
• Deadly Bacteria Infection Spreads in Japan (#Deadly Bacteria Infection Spreads in Japan)
• WHO Says Antibiotic Pipeline is Too Small (#WHO Says Antibiotic Pipeline is Too Small)
• Can Presidents Model Good Vaccine Uptake? (#Can Presidents Model Good Vaccine Uptake?)
• US Ran Propaganda Campaign Against Chinese Vaccines (#US Ran Propaganda Campaign Against Chinese Vaccines)
• Long COVID Updates (#Long COVID Updates)
• Fauci on COVID and More (#Fauci on COVID and More)
Where does the world stand now in preparation for the next pandemic? It’s an important question following the failure to achieve a global pandemic treaty. One group of experts say we’re likely to be overwhelmed by another pandemic. Ellen Johnson Sirleaf and Helen Clark, co-chairs of The Independent Panel for Pandemic Preparedness and Response ([link removed]) issued a new report ([link removed]) that “proposes actions that must be implemented to help make the world safer,” according to a press release ([link removed]) . The Guardian ([link removed]) (UK) reports, “Amid surging cases of H5N1 bird flu in mammals, and an mpox outbreak in central Africa, [Johnson Sirleaf and Clark] have said the
lack of preparation had left the world vulnerable to ‘devastation.’” Clark is quoted: “The funds now available pale in comparison to the needs, and high-income countries are holding on too tightly to traditional charity-based approaches to equity.” Johnson Sirleaf says, ““There were lessons to be learned from Ebola in West Africa. Just five years later, having not applied those lessons, there were lessons to be learned again from COVID. There is no need to keep learning. Instead of gambling, leaders can make practical decisions and apply those lessons.”

If You Are in a Hurry

* Read The Independent ([link removed]) on plans for new vaccine programs for Ebola and other infectious diseases from GAVI.
* Read STAT ([link removed]) on what Michigan is getting right in the response to avian flu.
* Read Seth Berkley’s critique of the US response to avian flu in STAT ([link removed]) .
* Read a Euro News ([link removed]) analysis of what went wrong and what’s next for the pandemic treaty.
* Read Reuters ([link removed]) on a US military-run propaganda campaign against China’s COVID vaccines.
* Read STAT ([link removed]) on key science and health takeaways from the nee Fauci memoir.


GAVI Announces New Vaccine Programs for Ebola and Other Diseases

The Independent ([link removed]) (Uganda) reports, “In a historic step, preventive Ebola vaccination will become the norm in the highest-risk countries, courtesy of GAVI…. Gavi will also support lower-income countries for routine administration of human rabies vaccine for post-exposure prophylaxis, as well as multivalent meningococcal conjugate and hepatitis B birth dose vaccines…. The additional support for preventive vaccination of those at highest risk is significant, as data increasingly indicates that, in addition to risk of spillover events from infected animals to humans, viral resurgence in survivors of Ebola virus disease can also trigger new outbreaks several years later. Preventive vaccination will ensure critical frontline professionals are already protected against infections and death before outbreaks begin – saving lives and avoiding the disruption of services in health care facilities – thus decreasing the
risk of further spread among communities.” Read GAVI’s press release ([link removed]) .

Global Health Leaders Critique US Avian Flu Response

There is growing global concern over increasing cases of avian flu in dairy cows in the US and what many see as an inadequate response from the US government. STAT ([link removed]) (US) reports, “Seth Berkley, a longtime and widely respected global health leader, said Thursday that it has been ‘shocking to watch the ineptitude’ of the US response to the avian influenza outbreak among dairy cattle, adding his voice to a chorus of critics…. ‘Are we better prepared?’ he said. ‘We could have a long discussion about this, but I would make an argument that H5N1 has suggested that we’re not…. [In the] United States, it’s been shocking to watch the ineptitude of just doing the surveillance, being able to talk about it, tracking the infections, understanding where we are. Do we have vaccines? Are they the right vaccines? It is really a challenge. So I’m not sure we have learned anythin
g.’”

More on Avian Flu

Most experts still say the chance of H5N1 mutating enough to spark human to human spread and outbreaks or a pandemic is low. But there is growing concern. AP ([link removed]) (US) looks at why avian flu is so lethal in some species and not in others (including humans.) “[I]t seems to have hardly touched people.... It could have to do with how infection occurs or because species have differences in the microscopic docking points that flu viruses need to take root and multiply in cells, experts say. But what keeps scientists awake at night is whether that situation will change. Dr. Tom Frieden is quoted: “There’s a lot we don’t understand. I think we have to get over the ‘hope for the best and bury our head in the sand’ approach. Because it could be really bad.”

STAT ([link removed]) (US) reports on what the US state Michigan is doing right in responding to avian flu. The state has the a third of the country’s confirmed cases and two of the three cases confirmed in humans. “But the reason Michigan has become such an apparent hotspot is because its public health response has been uniquely robust…. Pandemic playbook authors like [Lauren] Sauer have long been preparing for almost exactly this scenario — an H5N1 bird flu strain makes its way into a population of animals that have a lot of contact with humans and then some of those humans get sick. Without broad testing to provide adequate visibility into that human-animal interface, we risk missing the next step in a pathogen’s path to pandemic potential: evolving to more easily transmit between people.” Reuters
([link removed]) (UK) reports, “Michigan will offer dairy operations with bird flu up to $28,000 to work with federal and state government agencies to investigate how the virus got onto their operations…. The funded farmers would need to work with the state agriculture department and USDA’s Animal and Plant Health Inspection Service’s Veterinary Services (APHIS) to complete epidemiological investigations on their farms.”

A group of public health and infectious disease experts write in a STAT ([link removed]) (US) opinion, “As leaders in health care and public health, we recognize the important role hospitals play in outbreak detection and response, and mitigating the spread of infectious diseases. With H5N1 posing a potentially significant public health threat, hospitals must adopt proactive, comprehensive strategies to prepare for, reduce the threat of, and respond to potential cases.” They make four key recommendations to prepare and conclude, “Ongoing vigilance and readiness are crucial to protecting public health and health care workers.”

CBS News ([link removed]) (US) reports, “India has had its second-ever human avian influenza infection confirmed by the World Health Organization. The U.N. health agency confirmed that a suspected case, a 4-year-old child in the eastern state of West Bengal, was infected with the H9N2 avian flu virus…. The cases in India involve a different bird flu virus than the one infecting animals and several people in the US, where it is the H5N1 strain spreading through herds…. [WHO] has urged people to ‘minimize contact with animals’ where infections are suspected….”

What Went Wrong with the Pandemic Treaty and What’s Next

In a lengthy analysis Euro News ([link removed]) (Belgium) looks at what happened to the pandemic treaty and what might be next, reporting, “Negotiators have tried to work out the details of a pandemic agreement, but now with another delay and elections in many countries, some worry motivation may wane…. The extension of negotiations, for some, could also be seen as a win, as it shows that countries are still willing to continue discussing the treaty, even as it has come under attack from right-wing commentators falsely accusing the WHO of a power grab. Keeping engagement and the importance of the pandemic threat in the room is also key, campaigners said. ‘It's really important that no one has yet left the table. I'm not saying that this could not happen in the future, but it hasn't happened yet,’ said Vidal from Health Action International.”

Lawrence O. Gostin and Alexandra Finch write in Scientific American ([link removed]) (US), “Think of a pandemic treaty as a grand social bargain to protect future generations from the devastating and inequitable impacts of pandemics. The global social contract has two objectives: the open exchange of scientific information in real time, and the equitable allocation of medical countermeasures. These objectives are not opposed, but essential and interdependent. Each prong would make us all more secure, and the world fairer…. The biggest threat to global health now is indifference, inaction and a failure to learn the lessons of the COVID pandemic. Let’s adopt a pandemic treaty and codify a global social bargain where everyone wins.”

Mpox Spreads in DRC; Kills Two in South Africa; Rising in Los Angeles

CIDRAP ([link removed]) (US) reports, An mpox outbreak in the Democratic Republic of the Congo (DRC) continues to spread within the country, with the first case reported in North Kivu province, according to a recent update from [WHO]. The DRC's outbreak began in late 2022 and involves the clade 1 mpox virus, which is different from the clade 2 strain circulating globally…. So far in 2024, 7,851 mpox cases have been reported in the DRC, 384 of them fatal. With the case from Noth Kivu province, illnesses have now been reported in 23 of the country's 26 provinces. The disease is spreading through various contact forms, including sexual, nonsexual, household, and healthcare. Children are still the most affected age-group, with 39% of cases in kids younger than 5 years old. The disease was fatal in 240 of those cases. Read the WHO update ([link removed]) .

Health Policy Watch ([link removed]) (Switzerland) reports, “Seven cases of ‘severe Mpox’ have been confirmed in South Africa, and two of those diagnosed have since died. All cases involve men in their thirties living with co-morbidities – most notably HIV. Five of the seven identified as “men who have sex with men,” according to the South African Department of Health. None of the confirmed cases had travelled to countries with ongoing Mpox outbreaks.” A shipment of mpox vaccines, coordinated by WHO and GAVI is expected in the country soon. “Once these arrive, the health department intends to offer free vaccinations to four groups it regards as most at risk: men who have sex with men, sex workers, health workers and laboratory workers.” The strain circulating in South Africa is not the same as clade 1 mpox seen in the DRC outbreak.

CBS News ([link removed]) (US) reports, “The Los Angeles County Department of Public Health announced on Monday that there was a "concerning increase" of mpox, or monkeypox, cases that have been reported in the last two weeks. Officials say that 10 new cases have been reported, which is a troubling jump from the countywide average of less than two cases per week in recent months.”

Lessons from Community Led Health Promotion for Mpox

A study in BMC Public Health ([link removed]) (UK) found, “The LGBTQ + community and local sexual health clinics took crucial actions to counter stigma and support health seeking behaviour during the 2022–2023 UK mpox outbreak. Lessons from rights based and inclusive community-led approaches during outbreaks should be heeded in the UK, working towards more meaningful and timely collaboration between affected communities, primary healthcare, and regional and national public health authorities.”

Deadly Bacteria Infection Spreads in Japan

Washington Post ([link removed]) (US) reports, “A record number of cases of streptococcal toxic shock syndrome (STSS) in Japan this year has focused attention on the rare and potentially deadly bacterial infection. There have been 1,019 cases of STSS in the first six months of 2024, surpassing the total number recorded last year in the country…. Streptococcal toxic shock syndrome kills up to 30 percent of patients and is ‘highly associated’ with flesh-eating infections. Symptoms include fever and a red rash….. [Andrew] Steer said the cases in Japan should be seen in the context of a rise in Group A Strep infections of various kinds around the world after the pandemic. That could be because while people were taking precautions to avoid catching covid, they also avoided other diseases, lowering immunity.”

WHO Says Antibiotic Pipeline is Too Small

CIDRAP ([link removed]) (US) reports, “The number of antibacterial agents in preclinical and clinical development worldwide rose from 80 to 97 from 2021 to 2023 and new antibiotics are urgently needed to combat severe infections and those tied to antimicrobial resistance (AMR), the World Health Organization (WHO) advises in a report released late last week. ‘Antimicrobial resistance is only getting worse yet we're not developing new trailblazing products fast enough to combat the most dangerous and deadly bacteria,’ Yukiko Nakatani, MD, PhD, interim WHO assistant director-general for antimicrobial resistance, said in a WHO news release. ‘Innovation is badly lacking yet, even when new products are authorized, access is a serious challenge.’" Read the WHO report ([link removed]) .

Can Presidents Model Good Vaccine Uptake?

A group of Dutch researchers write in The Conversation ([link removed]) (Australia) about their study that looked at whether seeing a country’s president publicly vaccinated can help vaccine uptake. They used DRC as their test case. “We concluded from our findings that it does, but under two conditions. Firstly, citizens must see the president as trustworthy. And secondly, the president’s vaccination must be communicated as widely as possible and include parts of the country or communities where there is low media access. Where these two conditions aren’t met, vaccinating public village leaders or respected older adult community members might be a more effective approach to increasing vaccine uptake.

US Ran Propaganda Campaign Against Chinese Vaccines

Reuters ([link removed]) (UK) reports, “At the height of the COVID-19 pandemic, the US military launched a secret campaign to counter what it perceived as China’s growing influence in the Philippines, a nation hit especially hard by the deadly virus. The clandestine operation has not been previously reported. It aimed to sow doubt about the safety and efficacy of vaccines and other life-saving aid that was being supplied by China, a Reuters investigation found. Through phony internet accounts meant to impersonate Filipinos, the military’s propaganda efforts morphed into an anti-vax campaign. Social media posts decried the quality of face masks, test kits and the first vaccine that would become available in the Philippines – China’s Sinovac inoculation.”

Long COVID Updates

The Washington Post ([link removed]) (US) editorial board writes, “Long covid, the symptoms that can linger for months or even years after infection with the pandemic virus, is still a subject of considerable uncertainty. The virus can damage the body in a multitude of ways, leading researchers to list more than 200 symptoms, and there is no single diagnostic test or cure. But even with the unknowns, evidence suggests that long covid could burden millions of people. Its effects — on individuals, but also on society at large — could be protracted and expensive…. [Two recent studies] are early warnings in what will probably be a long process. The nation must prepare to cope accurately and compassionately with a wave of illness and impairment that might come.”

Nature ([link removed]) (UK) reports, “Antibodies isolated from people with long COVID increase pain sensitivity and reduce movement in mice when transferred to the animals, research shows1. The findings suggest that antibodies might drive some symptoms of long COVID — although how that process works is unclear, and the results will need to be replicated in larger studies. ‘I think this will be a beacon of a paper that we can take forwards to further understand long COVID,’ says Resia Pretorius, an immunologist at Stellenbosch University in South Africa. Previous research has hinted that long COVID might be caused, at least in part, by autoantibodies — rogue antibodies that a person generates that attack their own immune system or tissues.” Read the preprint study ([link removed]) .

Fauci on COVID and More

Media outlets around the world are covering the publication of Anthony Fauci’s memoir. STAT ([link removed]) (US) looks at key health and science “takeaways” from the book, including that “The US response to the pandemic succeeded on science, and failed on public health…. The country developed safe and effective vaccines in record time, Fauci writes, along with effective antiviral drugs, mostly because of years of prior investment in basic and clinical research, particularly around HIV. ‘The lesson here is clear,’ he writes. ‘We must sustain this critical investment in the biomedical and health sciences and continue to nurture collaborations between the public and private sectors.’ Public health was another matter. The US had far too many deaths, in part because public health infrastructure, underfunded and antiquated, broke when put under stress, Fauci writes.”
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