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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
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"We are in this for the long haul with activists, advocates and all communities grappling with multiple pandemics, including COVID-19 and HIV, and with many of the issues addressed in news stories below. In the coming weeks we will be launching an “action alert” update and building resources for sharing local solutions and global priorities." - AVAC
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Latest Global Stats
July 2, 2020
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Confirmed Cases
10,719,286
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Recovered
5,504,493
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Deaths
516,786
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Take Action!
This week, learn about US legislation to ensure COVID-19 research funding is well spent and drugs and vaccines are accessible; and demand Congress increase funding for PEPFAR.
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Read how COVID threatens global health gains and call Congress before July 6 to demand increased funding for HIV, TB and malaria treatment and prevention.
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The world reached a grim milestone this week, passing 500,000 dead from COVID-19 and more than 10 million infections. While many politicians continue to downplay or ignore the severity of the pandemic, public health officials’ warnings have become increasingly dire. In a press briefing WHO chief Dr. Tedros said, "We all want this to be over. We all want to get on with our lives. But the hard reality is that this is not even close to being over. Although many countries have made some progress globally, the pandemic is actually speeding up,” Times of India and other outlets reported. CNBC reported that Tedros warned, “The single most important intervention is... tracing and quarantine contacts. Six months since the virus started, it could be like a broken record to say exactly the same thing, but the same thing works. Test, test, isolate, quarantine cases.”
Reuters reports, “In a move sought by the WHO’s biggest critic, the United States, Dr. Tedros announced that a team would be sent to China next week to investigate the origins of the outbreak.”
Gizmodo reports Dr. Anne Schuchat, Principal Deputy Director of the CDC, who has been largely out of the media spotlight since warning about the need for an early response to the pandemic, warned, “This is just the ‘beginning’ of a dangerous new wave of coronavirus cases that could become more deadly as it reaches an older population in the US…. The US has identified at least 2.59 million cases and over 126,000 deaths, the highest numbers in the world by far, with states like Florida, Texas, Arizona, California, and others experiencing record numbers of new cases each day.” CNN reports that Fauci told a senate committee “he wouldn't be surprised if the US sees new cases of coronavirus rising to a level of 100,000 a day…. Fauci expressed dismay over people congregating in crowds and not wearing masks and inadequate attention being paid to guidelines on reopening.”
Elsewhere, The Washington Post reports, “For months, experts have warned of a potential nightmare scenario: After overwhelming health systems in some of the world’s wealthiest regions, the coronavirus gains a foothold in poor or war-torn countries ill-equipped to contain it and sweeps through the population. Now some of those fears are being realized…. Cases are soaring in India and Pakistan, together home to more than 1.5 billion people and where authorities say nationwide lockdowns are no longer an option because of high poverty…. The first reports of disarray are also emerging from hospitals in South Africa, which has its continent’s most developed economy. Sick patients are lying on beds in corridors as one hospital runs out of space. At another, an emergency morgue was needed to hold more than 700 bodies.”
Dangers for Healthcare Workers
NPR’s Goats and Soda blog reports on a “trend of attacks on health workers worldwide…[with]…more than 400 reported global incidents of COVID-19-related violence affecting health care workers and facilities since January.” The threats include family members threatening doctors to try to force more or different treatment and using force to escape quarantine.
Bhekisisa reports that in South Africa “hospital porters may account for up to one in 10 COVID-19 hospitalisations among healthcare workers, second only to nurses, according to the National Institute of Occupational Health (NIOH). But workers and unions say support staff like this, as well as cleaners and security guards, are last in line for the masks, gloves and gowns they need to protect them from the new coronavirus.”
According to The Guardian, a Kaiser Health News investigation found that 35 or more US healthcare workers died of COVID after complaints about lack of PPE were made to Occupational Safety and Health Administration offices. “Yet by 21 June, the agency had quietly closed almost all of those complaints, and none of them led to a citation or a fine. About 1,300 of the healthcare-related COVID-19 complaints remain open and about 275 fatality investigations are continuing, according to public records.”
Counting Cases
The New York Times reports the CDC says, “The prevalence of infections is more than 10 times higher than the counted number of cases in six regions of the United States…. The results confirm what some scientists have warned about for months: that without wider testing, scores of infected people go undetected and circulate the virus.”
COVID-19 and Race
An op-ed in The Star (Canada) says, “Toronto Public Health reported that COVID-19 is more common in areas with bigger Black populations. And Public Health Ontario reports that the rate of COVID-19 is three times higher in areas where there are more racialized people; the hospitalization rate and ICU rate are four times higher; and death rates are doubled.” The authors argue, “We have legislation for things we care about. We do not leave them to the largesse of professionals, public servants or politicians. If we want our public responses to crises to be equitable, if we want them to be anti-racist, and, if we want them to meet the challenge of anti-Black racism, then we should enshrine this in law.”
NBC News reports, “Protests over the killing of George Floyd have pushed to the forefront a particular fact long known by medical professionals: Racism kills, and it may be the main cause of health disparities between whites and Blacks. The story quotes an essay from Dr. Nadine Burke Harris, who says “the images of masked protesters carrying ‘Black Lives Matter’ signs… is also a reminder that the disproportionate death rate of black and brown people from COVID-19 is no coincidence. It is directly related to the history of racial oppression in our nation."
Los Angeles Times reports Latinx and Black Californians are hit hardest by COVID-19. “The two groups now have double the mortality rate from the virus in Los Angeles County than white residents, the latest troubling sign of the deep health inequity that has come with COVID-19…. ‘Pandemics exploit the existing inequities in society, putting a larger health and economic burden on communities who already face structural disadvantages such as income inequality, crowded housing conditions, systemic racism and discrimination,’ Dr. Grant Colfax, San Francisco’s director of public health, said in a statement.”
Many public health experts say that robust contact tracing is the best way to combat the continuing rising rates of COVID-19 in many communities and countries. An essay in VOX argues that evidence has shown, “for any large-scale digital contact tracing system to work, people need to trust that their data will be handled safely.” But the author argues, “protests against police violence and racism have highlighted that trust in authorities isn’t something that is widely felt in America right now. Protesters aren’t especially eager to hand over their personal information. Then there is a significant and longstanding distrust of public health authorities in Black communities, dating back to racist medical experiments and unequal health care systems.” To help address this, “Public health agencies around the country should also be working with trusted community organizers to spread the message that getting tested is important, and to build trust that private information will not be misused. In New York City, they have clearly determined that not asking people at all about whether they have been to a protest is one way to limit suspicions that public health agencies are acting in concert with law enforcement.
Overwhelmed Healthcare Facilities
Reports of overwhelmed hospitals and clinics are becoming a major story as COVID cases peak in communities around the world. CityPress reports that doctors and HC workers say, “The Eastern Cape healthcare system has collapsed….” An official quoted says, “The Reverend Dr Elizabeth Mamisa Chabula-Nxiweni Field Hospital, which will officially open on July 1, will be able to accommodate a further 1,485 general beds for COVID-19 patients. But they still do not have all the equipment they need, or the necessary personnel to care for all the patients. Most of the hospitals in the Eastern Cape are already full.”
Chasing Immunity
CBC and other outlets report on new data on possible immunity. “A closer look at people who tested positive for COVID-19 but never developed symptoms has found that such asymptomatic carriers have few to no detectable antibodies just weeks after infection, suggesting they may not develop lasting immunity…. There's growing evidence that a significant proportion of people who test positive for COVID-19 never show symptoms, although it's not clear what percentage of people that is and what role they play in spreading the disease.” The information comes from a study published in Nature which “followed 37 people in Wanzhou District in China who did not show any outward signs of the disease, despite testing positive when their respiratory tracts were swabbed and being kept in hospital for observation.”
BioSpace reports, “The jury is still out whether people who had COVID-19 can get it again, but animal studies are suggesting they can’t.” A study out of the University of Wisconsin-Madison in hamsters demonstrated that previous infection with SARS-CoV-2 provided protection against getting infected again. And experiments with convalescent serum—using the blood serum from previously infected patients—limited viral replication in the lungs. The research was published in the Proceedings of the National Academy of Sciences and in Science.
COVID-19 in Children
Reuters reports on research published in NEJM from New York and elsewhere in the US documents “nearly 300 cases of a rare, life-threatening syndrome in children and adolescents associated with the novel coronavirus…. A consistent picture is emerging of the syndrome occurring two to four weeks after infection by the coronavirus, Michael Levin, professor of pediatrics and international child health at Imperial College London, said in an accompanying editorial.” Levin writes that “a relatively high proportion of cases have occurred among black, Hispanic, or South Asian persons…. There is concern that children meeting current diagnostic criteria for MIS-C are the ‘tip of the iceberg,’ and a bigger problem may be lurking below the waterline.”
Vaccine Approval of a Sort
In a somewhat surprising move the New York Times updated it’s COVID-19 vaccine tracker to note that one vaccine is “approved for limited use.” The vaccine in question is named Ad5-nCoV and was developed by Chinese company CanSino Biologics; the Chinese military announced a one-year program to use the vaccine candidate based on published ph1 safety data and unpublished ph2 immune response data; there is no known ph3 efficacy data of this or any C19 candidate. The South China Morning Post reports, “China has approved military use of an experimental coronavirus vaccine developed by the People’s Liberation Army and a Chinese pharmaceutical company, in a first for the armed forces of any country. A commentary in Science Speaks raises some concerns about the move and quotes from the Lancet article reporting the Phase I results: ”However, aside from pre-existing anti-Ad5 immunity, there is concern about the increased risk of HIV-1 acquisition associated with Ad5 activated CD4 T-cells. Although the association between HIV-1 acquisition risk and Ad5 vectored vaccine is controversial and its mechanism is unclear, the potential risks should be taken into account in studies with this viral vector delivery platform.”
How Good is Good Enough?
CNN reports, “Dr. Anthony Fauci says he would ‘settle’ for a COVID-19 vaccine that's 70 percent to 75 percent effective, but that this incomplete protection, coupled with the fact that many Americans say they won't get a coronavirus vaccine, makes it ‘unlikely’ that the US will achieve sufficient levels of immunity to quell the outbreak…. Fauci noted that ‘there is a general anti-science, anti-authority, anti-vaccine feeling among some people in this country -- an alarmingly large percentage of people, relatively speaking.’ He said given the power of the anti-vaccine movement, ‘we have a lot of work to do" to educate people on the truth about vaccines.’”
Meanwhile, FiercePharma reports the FDA has said “any vaccine must be at least 50 percent more effective than placebo in preventing the disease” to be approved. According to The Wall Street Journal, “That 50 percent benchmark is used routinely for flu vaccines. The FDA said it wouldn’t approve—or give emergency-use authorization—to any coronavirus vaccine unless the maker had clearly demonstrated proof of its safety and effectiveness in a clinical study.” WSJ says in the new guidance FDA says “it wouldn’t approve a vaccine simply if it leads to antibodies in patients’ bloodstreams, because it isn’t known what level of antibodies confers protection.” The FDA press release on the guidance quotes Commissioner Hahn: “While the FDA is committed to expediting this work, we will not cut corners in our decisions and are making clear through this guidance what data should be submitted to meet our regulatory standards. This is particularly important, as we know that some people are skeptical of vaccine development efforts. We have not lost sight of our responsibility to the American people to maintain our regulatory independence and ensure our decisions related to all medical products, including COVID-19 vaccines, are based on science and the available data. This is a commitment that the American public can have confidence in and one that I will continue to uphold.”
More Results by Press Release
STAT and other outlets report that vaccine developer Inovio “said that its investigational COVID-19 vaccine had ‘positive’ results in a small trial. But the company, which has gained more than $4 billion in value since the coronavirus pandemic began, provided none of the details necessary to determine whether the vaccine is working… The company said it would advance its vaccine into larger trials later this summer ‘upon regulatory concurrence.’”
Balancing Risk and Speed
In an interview for The Human Vaccine Project, Paul Offit says about vaccine distrust: “I think the focus by the media has been wrong to some extent. When people say there’s a distrust of vaccines, I don’t think that’s true. What worries me is that people do trust vaccines. Very much so. Parents in this country are asked to give children 14 different vaccines in the first years of life—that can be as many as 27 inoculations during that time period and as many as five shots at one time—to prevent diseases most parents have never seen, using biological fluids most parents don’t understand. They do trust us. I think we risk that trust if we rush this along and don’t do the type of Phase III testing that we need to do for this vaccine. We also need to manage expectations when we do release a vaccine to say that we don’t know if it causes rare side effects, but we’re looking, and we don’t know how long the duration of immunity will be because we’ll learn as we go. You will never, ever convince the anti-vaccine people because data doesn’t convince them.”
Remdesivir Gets a Price
In an open letter Gilead CEO writes of the company’s decision about pricing: “we have set a price for governments of developed countries of $390 per vial. Based on current treatment patterns, the vast majority of patients are expected to receive a 5-day treatment course using 6 vials of remdesivir, which equates to $2,340 per patient. Politico reports, “private insurers will pay $520 per vial, or $3,120 for five days of treatment, the company said Monday. The US is the only country for which Gilead has set tiered pricing…. Gilead is expected to make about $1.3 billion from the drug in 2020…The drugmaker has said it spent about $1 billion to develop remdesivir.”
NewNowNext reports, “After news of remdesivir’s pricing broke, Twitter users denounced Gilead for ‘price-gouging’ amid a global pandemic. Vermont Sen. Bernie Sanders also chimed in, demanding that the company’s greed ‘must be stopped.’” ACT-UP NY tweeted: Gilead continues their greedy price-gouging, hiding behind meaningless platitudes of “equity” and “responsibility.” You would think that a global pandemic might spur a change of heart, but Big Pharma has never had a heart to begin with #GileadGreed.
The Guardian reports, “The US has bought up virtually all the stocks for the next three months of one of the two drugs proven to work against COVID-19, leaving none for the UK, Europe or most of the rest of the world. Experts and campaigners are alarmed both by the US unilateral action on remdesivir and the wider implications, for instance in the event of a vaccine becoming available. The Trump administration has already shown that it is prepared to outbid and outmanoeuvre all other countries to secure the medical supplies it needs for the US.”
Hydroxychloroquine Prevention Trial Back On
“A global trial designed to test whether the anti-malaria drugs hydroxychloroquine and chloroquine can prevent infection with COVID-19 is to restart after being approved by British regulators,” according to Reuters. The COPCOV trial is “a randomised, placebo-controlled trial that is aiming to enrol 40,000 healthcare workers and other at-risk staff around the world…. Nicholas White, who is co-leading the COPCOV trial, said studies of the drugs as a potential preventative medicine had not yet given a conclusive answer.” Trials of the drug as treatment have been stopped after it showed no efficacy.
HIV Drug Pulled from COVID Trial
Daily Mail and other outlets report, “Oxford University scientists pulled lopinavir/ritonavir from the RECOVERY Trial today after results showed it had no benefit on people hospitalised with the virus.”
Economic Impacts
New York Times reports on the impact of COVID-19 on Africa’s middle class: “As the coronavirus surges in many countries in Africa, it is threatening to push as many as 58 million people in the region into extreme poverty, experts at the World Bank say. But beyond the devastating consequences for the continent’s most vulnerable people, the pandemic is also whittling away at one of Africa’s signature achievements: the growth of its middle class…. About 170 million out of Africa’s 1.3 billion people are now classified as middle class. But about eight million of them could be thrust into poverty because of the coronavirus and its economic fallout, according to World Data Lab, a research organization.”
COVID-19 and HIV
POZ’s July-August issue’s cover story on COVID-19 and HIV and includes a roundup of what is known about HIV and COVID-19, reporting that “so far, experts agree that people on antiretroviral treatment who have an undetectable HIV viral load and a near-normal CD4 count do not appear to be at higher risk than their HIV-negative counterparts.”
A study published in Clinical Infectious Disease, COVID-19 and People with HIV Infection: Outcomes for Hospitalized Patients in New York City found “no differences in adverse outcomes associated with HIV infection for hospitalized COVID-19 patients compared to a demographically similar patient group.”
An article in The Body Pro “consolidates the most recent provider-focused information available regarding the intersection between HIV and SARS-CoV-2, the novel coronavirus behind the COVID-19 pandemic.”
Complications from COVID-19
Medscape reports “A large study from the United Kingdom reveals the breadth of neurologic and neuropsychiatric complications of COVID-19 infection, including stroke, psychosis, altered mental state, and dementia-like syndrome.”
Global Health Now reports, “How many people suffer long-term effects, and for how long, is COVID-19’s biggest mystery. Search the word ‘sequelae’ (after-effects of a disease) in WHO’s global coronavirus literature database, and you get more than 800 results connecting COVID-19 to all sorts of problems—everything from anosmia to gambling, depression, and pneumonia. But no epidemiological study following thousands of people over time has yet revealed the long-term impacts on health and their duration.”
The Guardian reports, “Tens of thousands of COVID-19 survivors should be screened for post-traumatic stress disorder because of their experiences in fighting for their lives, mental health experts have urged…. Everyone treated for COVID-19 in an intensive care unit, high- dependency unit or hospital ward should be assessed for symptoms of PTSD and other mental disorders before they leave hospital and again within a month, the experts say.”
Another Pandemic?
BBC and other outlets report: “A new strain of flu that has the potential to become a pandemic has been identified in China by scientists. It emerged recently and is carried by pigs, but can infect humans, they say…. The scientists write in the journal Proceedings of the National Academy of Sciences that measures to control the virus in pigs, and the close monitoring of swine industry workers, should be swiftly implemented.”
Herd Immunity
Medical News Today reports on a modeling study published in Science. “The classical model that epidemiologists use to predict herd immunity estimate that the threshold for COVID-19 is around 60 percent of the population.” However, when researchers “updated the classical model to take into account rates of transmission in different age groups and among people with varying levels of social activity, the threshold for herd immunity fell to 43 percent.” The study authors believe, “the herd immunity level is lower when immunity is caused by disease spreading than when immunity comes from vaccination.”
New Insights into the Virus
New York Times reports, “In many patients hospitalized with the coronavirus, the immune system is threatened by a depletion of certain essential cells, suggesting eerie parallels with HIV. The findings suggest that a popular treatment to tamp down the immune system in severely ill patients may help a few, but could harm many others. The research offers clues about why very few children get sick when they are infected, and hints that a cocktail of drugs may be needed to bring the coronavirus under control, as is the case with HIV.”
This Week in Dis/Mis-information
A commentary in The American Journal of Public Health calls COVID-19 the first post-truth pandemic, arguing that “the barrage of false information has helped to erode trust in public health leaders and hinder efforts to contain the pandemic. Unless the public trusts that public health measures are grounded in the best available science, even if that science is incomplete and changing, individuals cannot be expected to follow public health recommendations, such as to shelter in place.”
New York Times reports that US officials warned, “Cards for sale that claim to exempt people from wearing masks during the coronavirus pandemic are fraudulent.” The card is sold by a group calling itself the “Freedom to Breath Agency.” Websites and Facebook pages associated with the group were taken down.
Funding
The Telegraph reports, “Nearly $8.5 billion has so far been committed to finding diagnostics, treatments and vaccines to battle COVID-19, the fastest ever scale-up of research and development to fight an infectious disease. The COVID-19 R&D tracker, put together by the global health think tank Policy Cures Research, has identified more than 850 product candidates in development to fight the virus with by far the greatest investment being made in vaccines. Some $4.9bn has been committed to vaccines, compared to $1bn for therapeutics and $731m for diagnostics. The rest of the funding is not specified. Governments are the major funders with the single biggest donor to R&D efforts being the United States government which has pledged nearly $3.4bn.”
Impact on HIV Programs
The Chronicle (Zimbabwe) reports, “Zimbabweans living with HIV and on the Second regimen of the antiretroviral may be forced to default or change one of their drugs following an announcement that there is a nationwide shortage of second line medication.”
Mutations
The Washington Post reports on a mutation of the virus, “D614G but known more familiarly to scientists as ‘G’.” The mutation “has taken over the world. Now scientists are racing to figure out what it means…. At least four laboratory experiments suggest that the mutation makes the virus more infectious, although none of that work has been peer-reviewed. Another unpublished study led by scientists at Los Alamos National Laboratory asserts that patients with the G variant actually have more virus in their bodies, making them more likely to spread it to others. The mutation doesn’t appear to make people sicker, but a growing number of scientists worry that it has made the virus more contagious.”
Silent Spread Missed
The New York Times reports, “Symptomless transmission makes the coronavirus far harder to fight. But health officials dismissed the risk for months, pushing misleading and contradictory claims in the face of mounting evidence…. For two crucial months—and in the face of mounting genetic evidence—Western health officials and political leaders played down or denied the risk of symptomless spreading. Leading health agencies including the World Health Organization and the European Center for Disease Prevention and Control provided contradictory and sometimes misleading advice. A crucial public health discussion devolved into a semantic debate over what to call infected people without clear symptoms.”
Preprint Help is Here
A new journal “Rapid Reviews: COVID-19 is an open-access overlay journal that seeks to accelerate peer review of COVID-19-related research and prevent the dissemination of false or misleading scientific news. The editorial team identifies papers related to the novel coronavirus and its impacts that have been posted to preprint servers and commissions cross-linked, rapid peer reviews of these manuscripts. The journal also offers publishing options to the authors of papers that are positively reviewed, providing a vital outlet for research communications produced in the wake of the pandemic.” Inside Higher Ed reports, “For traditional publishers, speeding up prepublication peer-review processes is challenging. In recent months, more than 20 research papers on COVID-19 published in peer-reviewed journals have been taken down from public view, according to science publishing watchdog blog Retraction Watch. The reasons behind these retraction decisions are not always explained. Most of the time publishers retract articles following scrutiny and criticism of research methods and data. Sometimes authors themselves request retractions of their published works.” STAT reports, “The COVID-19 pandemic has produced a fire hose of preprints (papers posted to servers such as bioRxiv and medRxiv without peer review), many of questionable validity. The poster child for that is a bioRxiv preprint that suggested the new coronavirus had somehow been engineered from HIV; it was quickly withdrawn. But many other preprints, while not clearly wrong, used weak methodology, such as small numbers of patients or inadequate controls, as in an experiment concluding that a commercially available immunoglobulin might protect against the disease.
Resources of the Week
UNESCO has published two policy briefs offering critical insights into the fast-growing COVID-19-related disinformation that is impeding access to trustworthy sources and reliable information. These publications provide insights into the disinfodemic and tips for responding.
Harvard’s Coronavirus Resource Center provides plain language answers to many of the common questions about the virus. It’s frequently updated.
The African American Policy Forum’s COVID Resources page links out to a number of resources “covering general support and information, mutual aid support networks, emergency funds, and mental health details.”
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