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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time. 
“You cannot force public trust; you have to earn it by being humble and transparent, and by listening. And you can’t fake that care and maintenance — it’s the grueling and deeply human work of democracy, which is never finished."

Latest Global Stats

July 30, 2020
Confirmed Cases
17,061,855 		Recovered
9,990,348 		Deaths
667,808

Table of Contents

As total global cases climbed toward 17 million, Latin America now leads the world in COVID cases. Reuters reports, “Coronavirus cases in Latin America for the first time have surpassed the combined infections in the United States and Canada, a Reuters tally showed on Sunday, amid a surge of infections in Brazil, Mexico, Peru, Colombia and Argentina. The quickly growing number of cases make Latin America the region most impacted by the pandemic globally, with 26.83 percent of worldwide cases.” An interactive feature in the New York Times, reports on the impact of the pandemic on people who live along the Amazon. “As the pandemic assails Brazil, overwhelming it with more than two million infections and more than 84,000 deaths—second only to the United States—the virus is taking an exceptionally high toll on the Amazon region and the people who have depended on its abundance for generations.”

In the US, more than 150,000 are dead. In perhaps one of the greatest indicators of how dire the situation is in many communities, The Guardian reports, “A surge in coronavirus cases in rural Texas has forced one hospital to set up “death panels” to decide which patients it can save and which ones will be sent home to die. Doctors at Starr County Memorial hospital, the only hospital in Starr county, have been issued with critical care guidelines to decide which COVID-19 patients it will treat and which ones will be sent home because they are likely to die. The committee is being formed to alleviate the hospital’s limited medical resources so doctors can focus on patients with higher survival rates.”
 

If You're in a Hurry...

  • Read about what activist Rob Newells is concerned about with COVID vaccine trials and community engagement in the Washington Post.
  • Then read about the start of efficacy trials in the New York Times.
  • And follow that with The Atlantic on the challenges around deploying vaccines.
  • Read Jon Cohen’s Science Interview with “Bat Woman,” the virologist heading a group that studies bat coronaviruses at the Wuhan Institute of Virology.
  • Read Essence’s take on how structural White supremacist capitalist patriarchy drives the disproportionate impact of COVID on Black communities in the Southern United States.
  • Read a Vox commentary that examines antivaccine fears and misinformation
  • Scroll through Akiko Iwasaki’z immunology 101 tweetorial for non-immunologists.
  • If you are confused and concerned about the viral video of doctors endorsing hydroxychloroquine that twitter removed from the US President’s twitter feed, read a twitter thread about it and see what the Daily Beast has to say about one of the chief hydroxychloroquine proponents.
  • Read an opinion piece in the Washington Post about how to talk to antimaskers.
 

Testing Challenges

 
One abiding problem in the US (and some other countries) has been a lack of testing capacity and testing supplies that has led to delays of up to 2 weeks in getting tests results back. NBC News reports, “The enormous number of Americans getting swabbed for the coronavirus has overwhelmed every step of the COVID-19 testing process, creating shortages of critical supplies in laboratories and inundating them with more specimens than they can process…. While some COVID-19 tests are done by a more rapid, cartridge-based method in hospitals for patients who are admitted, a much larger percentage in the US are done by commercial labs.”
 
Reuters asks, in the US, “why have we seen laboratories overwhelmed and many patients again waiting a week or more for [COVID test] results? At the heart of the crisis is a reliance by public and private labs on automated testing equipment that locks them in to using proprietary chemical kits and other tools made by a handful of manufacturers. The result: as infection rates spike nationwide, many labs aren't running anywhere near capacity because of supply-chain bottlenecks….”
 
Contagion Live reports, “The faster people who test positive or who are identified as contacts of people who test positive are able to isolate themselves, the less likely the infection will be passed around.” In a Lancet modelling study, “the investigators found that time is of the essence when it comes to testing and tracing, which ideally work in tandem. When 4 out of 5 symptomatic people are tested and self-isolate within 1 day of symptoms appearing, the reproduction number should drop from 1.2 to 1.0. Quick contract tracing can further lower that number to 0.8.”

 

COVID and the Black South

 
In the first of a 3 part series on COVID-19 in Black communities Essence looks at the Southern United States and reports, “Black people are still disproportionately dying from the coronavirus. The primary comorbid condition is not drug or alcohol abuse, nor poor health, as anti-Black narratives suggest, but structural White supremacist capitalist patriarchy, the ways that it targets and decimates Black communities on all fronts and in all sectors, and how its adherents and perpetuators endanger and disregard anything and everyone that stands in the way of it flourishing. This is especially evident in southern states that have opted not to expand Medicaid, but whose governors rushed to reopen businesses even though no vaccine or herd immunity had been established. The areas have experienced a surge in new COVID-19 cases as a result. In May, Montgomery, Alabama, was down to one ICU bed and forced to send patients to Birmingham. At the beginning of July, Mississippi’s five largest hospitals were out of ICU beds, with four other hospitals in the state having 5 percent or fewer beds available.”
 
Politico reports, “In late April, a coronavirus research team from the Centers for Disease Control fanned out across two predominantly Black counties in Georgia, going door to door in face shields asking for samples of blood with little prior warning. The plan backfired. Community advocates said they fielded call after call from scared Black residents who were reminded of the Tuskegee syphilis study conducted on African Americans from 1932 to 1972. Fewer than one in four households approached took part in the antibody research, which may have diminished its accuracy and value, the CDC revealed this week. The episode was emblematic of the federal government’s ongoing failures to address the huge racial and ethnic disparities that have persisted throughout the coronavirus pandemic.”
 

Vaccine Efficacy Trials Start


A highly anticipated efficacy trial of the Moderna vaccine started on Monday. NBC News reported that “as many as 30,000 volunteers will be recruited at nearly 100 research sites across the country in Moderna's phase 3 trial.” A trial participant says, “"This research study is something that I can do personally to benefit not only my family and my friends, but also humanity." NBC reports, “What these trials won't be able to answer, however, is how long immunity might last. "’It's one of the great unknowns,’ Hoge [of Moderna] said. Moderna's vaccine is likely to require two doses, but it's possible a third will be necessary.”
 
The New York Times reports “A second company, Pfizer, announced late Monday afternoon that it had also begun a late-stage study of a coronavirus vaccine. Pfizer has been working with a German company, BioNTech. Their study will also include 30,000 people, from 39 states in the United States, and from Brazil, Argentina and Germany.” According to the Times, “Dr. Francis Collins, the director of the National Institutes of Health, said the US government was reaching out to groups hit hardest by COVID—older people, those with chronic diseases, Blacks, Latinx and Native Americans—to encourage them to participate in the study. He said that the pandemic had put health disparities into ‘sharp relief’ and that extra efforts were needed to gain the trust of people in those groups who might be reluctant to sign up for a medical experiment.”
 
The Times of India reports, “Serum Institute of India (SII), which has partnered with AstraZeneca for manufacturing the Oxford vaccine candidate for COVID-19, has sought permission from the Drugs Controller General of India (DCGI) for conducting phase 2/3 human clinical trials of the potential vaccine
 
The Wall Street Journal asks how long immunity from a vaccine might last, reporting that effective vaccines “may protect people for months or years rather than the rest of their lives, according to emerging science and health experts…. Vaccine-makers usually learn how long a shot protects during a second-phase study in hundreds of patients that may require months or years to complete. However, to save time for COVID-19 vaccines, trial phases are being compressed or combined, so less is known about durability near the end of the testing process than normal.
 
Global Health Now looks at recruitment efforts for COVID vaccines, reporting that “More than 195,000 Americans have already volunteered online to participate in the Warp Speed trials, but ‘the bad news is that most of the people who signed up are in their 20s and 30s. The median age is 30. So, they're kind of too young and too healthy,’ says Chris Beyrer, MD, MPH, COVID-19 Vaccine Prevention Network co-lead for Community Engagement. And only 10 percent of enrollees so far are from a minority group. Beyrer is working to ensure the enrollment of vulnerable populations including older adults, people with underlying conditions, Native Americans, African Americans, and Latino Americans.”
 
STAT reports, “…experts say the data [on vaccines] so far suggest one important possibility: The vaccines may carry a bit of a kick. In vaccine parlance, they appear to be “reactogenic,” meaning they have induced short-term discomfort in a percentage of the people who have received them in clinical trials. This kind of discomfort includes headache, sore arms, fatigue, chills, and fever…. But experts say it makes sense to prepare people now for the possibility that Covid-19 vaccines may be reactogenic.”
 
MedPage Today says, “Several COVID-19 vaccines currently under development may require more than one dose in order to be effective, pharmaceutical company executives told a House subcommittee….”
 
Regulatory Affairs Professional Society reports, “…US Food and Drug Administration (FDA) Commissioner Stephen Hahn repeated assurances that his agency would not cut corners in approving a COVID-19 vaccine…. Hahn’s remarks come as some observers have raised concerns that FDA might be pressured to approve a vaccine before the November election without adequate evidence of safety and efficacy. Officials have also sought to reassure the public that an eventual vaccine will be held to rigorous standards as recent polls have found a significant number of Americans are hesitant about getting a coronavirus vaccine…. ‘In this situation, these trials have been compressed, so Phase 1 and Phase 2 could be done together. You generate the appropriate information, and FDA is doing what’s called a real-time review. We’re not just waiting for the end of the trial; we’re reviewing in real time so that we can look at the data in real time and then come to a quicker decision at the end of the trial,’ Hahn said.”
 

Strong Calls for Community Engagement and Education

 
A Washington Post article looks at concerns about education and inclusion of Black people and other racial minorities around COVID vaccine trials. Activist Rob Newells is concerned.  “[W]ith the first massive coronavirus vaccine trial in people set to start Monday, Newells finds himself in an unfamiliar place: on the fence about what to tell his colleagues, his community, his cousins. Biomedical research, Newells knows, is a long and painstaking process—and he is concerned about a vaccine campaign that seems so narrowly focused on speed. ‘What are we doing that we haven’t done before? I haven’t got good enough answers for me to tell my community, ‘This is just like we have been doing in HIV, where I’m comfortable there’s community at the table.” What are we sacrificing for the speed, and if we’re not sacrificing anything, why couldn’t we move at this speed with other studies?’” The Post also quotes research Jeanne Marrazzo, who “said the HIV community has learned how to do the hard work of bringing minority communities in to trials. But she is worried diversity could be sacrificed amid competitive pressures between companies jockeying to be the first to develop a coronavirus vaccine. And there are concerns about researchers lacking experience with vulnerable communities and trying to meet aggressive timelines to deliver results within a few months. ‘It’s much faster to take the path of least resistance and sign up the people who have access to health care and everything—they have cars, they can pay for parking,’ Marrazzo said.”
 
A commentary in Vox argues, “Whenever I read news articles where officials tentatively promise a coronavirus vaccine late this year or early next year, I worry about how this messaging will be received by both existing vaccine critics and newcomers. I understand the desire to calm an anxious public with good news—and, to be clear, many objections about the potential future vaccine are inaccurate and risk undermining a much-needed public health intervention. But in order for a vaccine to be broadly accepted to provide some community-level protection, we must explore the questions and assertions driving skepticism about a COVID-19 vaccine among those who already oppose them, as well as those who are still uncertain.
 

When There Is a Vaccine, Who Gets It and Who Pays?

 
Researchers are optimistic that one or more of the COVID vaccines will work. The big question after that is who gets it and when? The answer to when you might have access to a vaccine likely depends on a number of factors, including where you live and what your level of risk is.
 
Science looks at how “vaccine nationalism” may affect who gets the first shots. “As soon as the first COVID-19 vaccines get approved, a staggering global need will confront limited supplies. Many health experts say it’s clear who should get the first shots: health care workers around the world, then people at a higher risk of severe disease, then those in areas where the disease is spreading rapidly, and finally, the rest of us. ‘It would be ludicrous if low-risk people in rich countries get the vaccine when health care workers in South Africa don’t,’ [says] Ellen Hoen, a Dutch lawyer and public health activist…. Yet money and national interest may win out. The United States and Europe are placing advance orders for hundreds of millions of doses of successful vaccines, potentially leaving little for poorer parts of the world.” WHO and others hope the COVAX facility will address these issues, but many are skeptical. “What’s needed most for COVAX to work is political commitment at the highest levels of government, says Alexandra Phelan, a lawyer at Georgetown University who specializes in global health. Without ‘a really big international effort,’ for instance at the United Nations or the G-20, the early doses of vaccines are unlikely to go to those who need them most, Phelan says. ‘It will be slow, it will be inadequate, and there will be unnecessary deaths.’” 
 
The Atlantic reports, “so much hope is riding on a breakthrough, but a vaccine is only the beginning of the end.” The long article lays out many of the issues with vaccine development and deployment and notes even if vaccine efficacy trials go well and “the earliest candidates are effective, the trials conclude quickly, the technology works—another huge task lies ahead: When vaccines are approved, 300 million doses will not be available all at once, and a system is needed to distribute limited supplies to the public. This is exactly the sort of challenge that the US government has proved unprepared for in this pandemic…. The CDC’s Advisory Committee on Immunization Practices…which is composed of outside experts, last met in late June, when they discussed prioritizing vaccines for health-care workers, the elderly, and those with underlying conditions. They also considered prioritizing vaccination by race, given the racial disparities in COVID-19 cases. But now the National Academy of Medicine is convening a panel on the same topic, which is again causing confusion about who is responsible for making these decisions.”
 
CNN reports, “Chinese Foreign Minister Wang Yi announced a $1 billion loan to Latin America and the Caribbean for COVID-19 vaccine access…. ‘China's Foreign Minister said that the vaccine developed in his country will be a public benefit of universal access, and that his country will designate a loan of $1 billion to support access [to the vaccine] for the nations of the region.’”
 
Financial Times reports, “Moderna is pitching its coronavirus vaccine at about $50 to $60 per course, according to people familiar with talks between the company and potential buyers—higher than other vaccine makers have agreed to charge governments. The price would apply to the US and other high-income countries, which the company intended to prioritise, said other people familiar with its plans…. The price Moderna is seeking is not likely to be final. In a range of about $50 to $60 for a course—that is, $25-$30 per dose—it appears to be higher than that agreed by Pfizer and its German partner BioNTech last week in a pre-order deal with the US government at $19.50 per dose.”
 
Reuters reports, “Moderna Inc and Merck & Co on Tuesday told a US Congressional panel that they expect to profit from their coronavirus vaccines once approved, amid concerns the vaccines may not be accessible to all. ‘We will not be selling our vaccine at cost, although it is premature for us as we’re a long way from understanding the cost-basis,’ Julie Gerberding, chief patient officer for Merck [said]…. Executives from Johnson & Johnson and AstraZeneca Plc testified that they will price their respective potential vaccines at no profit while the pandemic rages on.”
 
Financial Times reports, “A multibillion-dollar flurry of coronavirus vaccine dealmaking between rich countries and companies has exposed a lack of international co-ordination and threatens to leave poor nations out. The resulting patchwork of agreements has raised big questions about global vaccine access and stoked wrangles over pricing, supply security and liability for possible side-effects.”
 

And Who Profits from Vaccines?

 
The New York Times reports, “The race is on to develop a coronavirus vaccine, and some companies and investors are betting that the winners stand to earn vast profits from selling hundreds of millions—or even billions—of doses to a desperate public…. [Pharma executives and board members] are making millions of dollars after announcing positive developments, including support from the government, in their efforts to fight COVID-19. After such announcements, insiders from at least 11 companies—most of them smaller firms whose fortunes often hinge on the success or failure of a single drug—have sold shares worth well over $1 billion since March, according to figures compiled for the New York Times by Equilar, a data provider.”
 

Hydroxychloroquine, Back for All the Wrong Reasons

 
While science and the FDA has been clear that to date studies of hydroxychloroquine have not shown any benefit as treatment or prevention and there are serious side effects from the drug, some politicians and conspiracy theorists have different thoughts about the drug.
 
A group of doctors calling themselves "America's Frontline Doctors" held a press conference in front of the Supreme Court earlier this week and claimed that that Hydroxychloroquine cures COVID. A video of the event shared by the far-right Breitbart News went viral among antivaxxers and other conspiracy theorists. NBC News reporter Brandy Zadrozny tweeted about the video and provides some context for the group. “The leader, Dr. Simone Gold, is a pro-Trump doctor who has been embraced by Republican political operatives who admit to recruiting doctors to go on TV and radio to counter public health officials and defend Trump’s reopening push.”
 
The Washington Post reports that twitter “penalized Donald Trump Jr. for posting misinformation about hydroxychloroquine” after he tweeted out a link to the video. The tweet was removed. The Post reports, “The tweet, which featured a viral video showing a group of doctors making misleading and false claims about the coronavirus pandemic, was directly tweeted by Trump Jr.'s account. That contrasts with his father, who retweeted multiple tweets from others showing clips of the same video to his 84.2 million followers Monday night. Twitter removed the videos, deleting several of the tweets that President Trump shared, and added a note to its trending topics warning about the potential risks of hydroxychloroquine use.”
 
Daily Beast reports the video features, “A Houston doctor who praises hydroxychloroquine and says that face masks aren’t necessary to stop transmission of the highly contagious coronavirus has become a star on the right-wing internet, garnering tens of millions of views on Facebook on Monday alone.…. Immanuel…alleges alien DNA is currently used in medical treatments, and that scientists are cooking up a vaccine to prevent people from being religious. And, despite appearing in Washington, DC to lobby Congress on Monday, she has said that the government is run in part not by humans but by ‘reptilians’ and other aliens.”
 
Nigerian news site Punch reports, “The Guild of Medical Directors, a body of owners of private hospitals in Nigeria, has reacted to video claims by Dr. Stella Immanuel, a General Practitioner in the US that she has treated over 350 patients of COVID-19 with a combination of Hydrochloroquine, Zinc and Zithromax, saying it is her own personal, unsubstantiated claim. In a statement signed by the President of GMD, Prof. Olufemi Babalola in Abuja on Tuesday, the body said: ‘there is no scientific evidence to prove the claim.’”
 
Politco reports Trump said in a press briefing, “’Many doctors think it is extremely successful, the hydroxychloroquine coupled with the zinc and perhaps the azithromycin…’ though there is no evidence from at least five rigorous clinical trials that hydroxychloroquine has any impact in preventing the virus or treating mildly to severely ill cases. ‘I happen to think it works in the early stages. I think front-line medical people believe that, too—some. Many.’” The same story notes that earlier in the day, Fauci “repeatedly contradicted the president’s fervent defense of hydroxychloroquine…and agreed with the Food and Drug Administration’s decision last month to withdraw its emergency-use authorization for hydroxychloroquine. ‘The overwhelming prevailing clinical trials that have looked at the efficacy of hydroxychloroquine have indicated that it is not effective in [treating the] coronavirus disease,’ he said.”
 

What Do We Know About Immunity This Week?            

 
The New York Times reports, “It may be possible for the coronavirus to strike the same person twice, but it’s highly unlikely that it would do so in such a short window or to make people sicker the second time, they said. What’s more likely is that some people have a drawn-out course of infection, with the virus taking a slow toll weeks to months after their initial exposure.” Studies have shown that antibodies can wane relatively quickly and the Times reports, “Worries about reinfection have been fueled by recent studies suggesting that these antibody levels plummet.”
 
Yale professor Akiko Iwasaki has a twitter thread that is an “immunology 101 tweetorial for non-immunologists.” It’s well worth a scroll.
 

What Do We Know About How You Catch COVID-19?   

 
The Washington Post talks to experts about how the virus is transmitted. “The modus operandi is becoming clearer. For the most part, SARS-CoV-2, the coronavirus that causes COVID-19, spreads by close personal contact via tiny particles emitted when an infected person coughs, sneezes, speaks, sings—or even just breathes normally. These can infect another person by falling into an eye, nose or mouth, by being inhaled or getting stuck on a hand and transferred to one of these entry sites.” Other information to know: “The WHO has said it’s ‘highly unlikely’ that people could contract COVID-19 through food or food packaging…. Almost two dozen animal species are known to be susceptible to infection, and there have been numerous reports of infected people transmitting the virus to their pet cats and dogs, to farm animals and even to lions and tigers at the Bronx Zoo. Instances of people catching SARS-CoV-2 from animals, however, are extremely rare.”
 

COVID, Poverty and Conflict

 
The Guardian reports that, “almost a quarter of the population of Sudan are going hungry as conflict, rising food prices and the coronavirus take their toll…. The UN has also warned that it is unable to reach some of the most vulnerable because of COVID-19 restrictions and instability.” A farmer is quoted: “We sometimes have two meals, but very often only one meal a day. We prepared our land to plant sesame and sorghum but it hasn’t rained yet and we had to eat some of our seeds which were supposed to be planted.”
 
A new report from Medglobal and partners documents the devastating impact of the disease in Yemen. “There have been 1,610 confirmed cases and 446 deaths from COVID-19 according to official reports. This amounts to around a 27 percent mortality rate of Yemenis who are confirmed to have COVID-19 – more than 5 times the global average and among the highest COVID-19 mortality rate in the world. The COVID-19 outbreak is also disproportionately harming one of Yemen’s most critical human resources: health workers. This report documents 97 health workers—epidemiologists, medical directors, midwives, and other critical medical professionals—who have died in Yemen reportedly from COVID-19.”
 

Masks: A Public Health Good Often Turned Political      

 
CBC (Canada) reports, “As more regions across the country adopt mandatory masking policies in an effort to minimize the spread of COVID-19, some anti-masking groups are joining forces with anti-vaccination proponents and adopting their techniques to spread misinformation and amplify their message….At least one anti-masking group, Hugs Over Masks, actively partners with Vaccine Choice Canada, one of the country's most prominent anti-vaccination organizations.” One expert notes, “Mistrust of government and scientific authorities are key characteristics among both anti-vaccination and anti-masking advocates.”
 
Daily Beast reports, “A fake CDC notice, complete with a photoshopped CDC letterhead, is the latest anti-masking hoax making the rounds on social media. The forgery, which often takes the form of a picture of a printed-out CDC bulletin, falsely claims that the agency does not recommend people wear N95 respirator masks to protect themselves from COVID-19. The hoax comes after months of politicized debate over masks, with some opponents faking health issues or citing non-existent legal guidelines in order to avoid wearing personal protective equipment.”
 
Bloomberg reports on “a recently published study of an outbreak among passengers on a January flight, is one of the first to document a probable transmission on an airliner and is reviving calls for government rules requiring masks. It comes as safety concerns raise questions about whether passengers will return in sufficient numbers to keep airline companies from collapsing…. ‘This new study e underscores the urgent need for a single national policy that would mandate that masks be worn, and worn properly, on all commercial flights,’ said Julie Hedrick, president of the Association of Professional Flight Attendants at American Airlines Group Inc.”
 
An opinion piece in the New York Times gives advice on talking to antimaskers, drawing on advice from a Senegalese anthropologist who helped respond to the Ebola crisis. “You cannot force public trust; you have to earn it by being humble and transparent, and by listening. And you can’t fake that care and maintenance—it’s the grueling and deeply human work of democracy, which is never finished. ’An epidemic is not only technical and medical—they are not cured only by science or vaccines,’ Dr. Niang told me. His words have haunted me since. ‘Ebola was beaten back by many things, including building consensus inside communities and restoring dignity and trust. This is what we learned. Hopefully, it is not too late for you over there to learn it, too.’
 
The New York Times reports, “Researchers have long known that masks can prevent people from spreading airway germs to others. But now experts are pointing to evidence suggesting that masks also protect the people wearing them, lessening the severity of symptoms, or in some instances, staving off infection entirely. Different kinds of masks ‘block virus to a different degree, but they all block the virus from getting in,’ said Dr. Monica Gandhi, an infectious disease physician at the University of California, San Francisco. If any virus particles do breach these barriers, she said, the disease might still be milder.”
 

Human Rights

 
In The Monitor (Uganda) “Women human rights defenders share experiences of defending the rights of people during the lockdown.” Brenda Kugonza, Executive Director, Women Human Rights Defenders Network says, “The COVID-19 health crisis has had serious impact on our lives and strategies as women human rights in Uganda. The majority of women human rights organisation or community organisations have had to limit, restrict and suspend their planned activities such as provision of education for the children, support political activities, provide income generating activities for the women have all put to hold.”
 
The New York Times reports on the VotER program, an initiative begun in an emergency department at Massachusetts General Hospital which helps patients register to vote. “VotER is part of a larger movement that pushes medical professionals to address the underlying social conditions—such as hunger, drug addiction and homelessness—that make their patients sick in the first place. At its core, it amounts to nothing less than an effort to change the culture of medicine by getting doctors and nurses to view the “civic health” of their patients as part of their professional duties.”
 

Will “Ubuntu” Help South Africa Defeat COVID?

 
In a Nature interview Slim Abdool Karim says, “Since there are communities in South Africa where social distancing and frequent hand washing is not feasible, mainly in informal settlements, I am expecting the number of cases to rise substantially, possibly exceeding a million. I thought that this would occur within 2–3 months of the first case.” Karim addresses the issue of the slow spread of COVID in Africa, noting, “I never believed that Africa was exceptional. But I don’t have the answer. There is no reason why this epidemic should not have spread faster in some countries, such as Nigeria. Some people say it’s because those countries don’t test enough. But even if you don’t test, you still will see an increase of hospital admissions and deaths. So that’s not the real reason. At the moment, it’s an enigma. The reason will reveal itself in due course.” He argues, “I think we are going to realize pretty soon that the best protection we have from this virus is ubuntu—a South African word that means ‘I am because you are’. I am safe because you are safe. I saw that in HIV, when people saw the deaths of those close to them, it pushed a change in behaviour. We as a country are built on the principle of ubuntu. We have to rediscover that, or we won’t defeat this virus.”
 
A new series in the Maverick Citizen will publish expert advisories from “The Scientists Collective… some of South Africa’s leading medical scientists and academics, including some members of the Ministerial Advisory Committee (MAC) on COVID-19.” The first answers the question, “How long should I isolate or quarantine for?” The very thorough article defines terms, gives advice and looks at different scenarios that readers may face.
 

Back to School… or Not

 
NPR’s Goats and Soda Blog looks at concerns that girls in Malawi may not return to school. “’COVID has really derailed the education system—not in Malawi only. It's everywhere,’ says Grace Kafulatira Mulima. She works for Malawi's Ministry of Education, Science and Technology and focuses on girls' secondary education. [Malawi] has made great strides, nearly doubling the number of girls in high school…Current data show about the same number of girls and boys in high school. The pandemic threatens to undo some of this hard-earned progress, says Mulima…. There's another set of girls the educators worry about—those at risk of never returning to school again. Malawi has one of the highest rates of child marriage in the world—more than 40 percent of its girls marry before 18. And once they wed, many of these girls drop out of school. In addition, a crisis like the pandemic is likely to lead even more girls to give up on school.”
 
CNN reports, “Just weeks before schools must open across Florida, the numbers of new cases and hospitalizations due to COVID-19 have surged, [with] a 34 percent increase in new cases among children in eight days. And more children in Florida are requiring hospitalization…. The surges in child Covid-19 cases and hospitalizations come amid rampant debate over whether children should return to classrooms this fall, or if they should continue remote learning. They also directly contradict US Secretary of Education Betsy DeVos' claims that children are ‘stoppers of the disease’ who ‘don't get it and transmit it themselves.’"
 

“Bat Woman” Speaks Out

 
Science reporter Jon Cohen interviewed virologist Shi Zhengli, nicknamed “Bat Woman,” who heads a group that studies bat coronaviruses at the Wuhan Institute of Virology (WIV), in the city in China where the pandemic began, and many have speculated that the virus that causes COVID-19 accidentally escaped from her lab—a theory promoted by US President Donald Trump. Some have even suggested it could have been engineered there. Cohen reports, “Shi hit back at speculation that the virus leaked from WIV. She and her colleagues discovered the virus in late 2019, she says, in samples from patients who had a pneumonia of unknown origin. ‘Before that, we had never been in contact with or studied this virus, nor did we know of its existence…US President Trump’s claim that SARS-CoV-2 was leaked from our institute totally contradicts the facts. It jeopardizes and affects our academic work and personal life. He owes us an apology.’”
 

Co-morbidities

 
Medscape reports, “further refinement of data from patients hospitalized worldwide for COVID-19 disease showed a 12 percent prevalence rate of patients with diabetes in this population and a 17 percent prevalence rate for hypertension. These are lower rates than previously reported for COVID-19 patients with either of these two comorbidities, yet the findings still document important epidemiologic links between diabetes, hypertension, and COVID-19, said the study’s authors.” One of the authors says in an interview, “My current opinion, on the basis of the totality of data, is that hypertension does not worsen [COVID-19] outcomes, but patients who are elderly, obese, diabetic, or immunocompromised are susceptible to more severe COVID-19 and worse outcomes.”
 
BBC reports, “Being obese or overweight puts you at greater risk of serious illness or death from COVID-19, experts say after examining existing studies. The review of evidence by Public Health England found excess weight put people at greater risk of needing hospital admission or intensive care. And the risk grew substantially as weight increased.”
 
Health-e News (South Africa) publishes personal reflections from a journalist living with diabetes: “COVID-19 has powerfully illustrated how deadly the poor management of diabetes can be. But, while diabetics like me are able to mitigate that risk because of our access to private healthcare resources, the majority of South African diabetics have no real ability to protect themselves. They are deeply vulnerable—not just as a consequence of their condition, but also because of the stigma, ignorance and victim-blaming that surrounds having this condition.”
 

The Promise and Perils of Preprints       

 
STAT reports “Preprints are all the rage today among scientists conducting research on the novel coronavirus…especially when the topic is of great public interest, such as reassuring or frightening findings about a deadly pandemic, preliminary findings don’t tend to stay under cover. Scientists…increasingly share their preprint results on social media, where a single influencer can amplify a tentative observation into a market-moving headline seen by millions around the world. Journalists have their own incentives to rush stories based on preprints into production, partly because they serve a news-consuming public that demands new content by the hour (desperate for a hint of normalcy, how many of us hang breathlessly on every hint of a scientific “breakthrough”?) and partly because the competition to be first is fiercer than ever in today’s shrinking and economically strained world of journalism. Bottom line: preliminary, minimally reviewed information about COVID-19 is spreading as fast as the virus itself.” The author concludes, “Let’s revel in the knowledge that preprints today are helping researchers share—especially with each other—their latest advances with great ease and speed. At the same time, let’s impose some discipline on our own proclivities to celebrate prematurely or sink into despair. And let’s keep in mind that despite the turbulence at its leading edge, science does a great job, over time, of getting things right.”
 

The Toll on Healthcare Workers

 
The Baltimore Sun and other outlets reported, “Baltimore doctor Joseph Costa, a health care worker on the front lines of the COVID-19 pandemic, died Saturday after contracting the coronavirus he was working to treat. Costa, the chief of the critical care division at Mercy Medical Center was a scientist who ‘lived through his brain’ and loved his job more than anything in the world, said David Hart, his husband of 28 years. As he lay dying, about 20 colleagues held a vigil and placed their blue-gloved hands on him.” Costa is one of many frontline healthcare workers who have been killed by the virus.
 
Vice reports on the heavy toll on HC workers in Indonesia. “Nationwide, doctors, nurses, and other medical workers are dying at an alarming rate. The Indonesian Doctors Association (IDI) estimated that six out of every 100 deaths were medical workers, but in a country where COVID-19 has become heavily stigmatized and data is often inaccurate or not publicly available, that figure might only be a small fraction of the total problem.”
 
A press release from WHO says, “More than 10 000 health workers in the 40 countries which have reported on such infections have been infected with COVID-19 so far, a sign of the challenges medical staff on the frontlines of the outbreak face. This comes as COVID-19 cases in Africa appear to be gathering pace. There are now more than 750,000 cases of COVID-19, with over 15,000 deaths. Some countries are approaching a critical number of infections that can place stress on health systems. South Africa is now among the worst-hit countries in the world.”  
 

Long Haulers, Lasting Impact

 
STAT reports, “Two new studies from Germany paint a sobering picture of the toll that COVID-19 takes on the heart, raising the specter of long-term damage after people recover, even if their illness was not severe enough to require hospitalization…. Taken together, the two studies, published Monday in JAMA Cardiology, suggest that in many patients, COVID-19 could presage heart failure, a chronic, progressive condition in which the heart’s ability to pump blood throughout the body declines. It is too soon to say if the damage in patients recovering from COVID-19 is transient or permanent, but cardiologists are worried.”
 
USA Today reports, “An unknown but growing number of the 4 million US COVID-19 patients say they can't shake symptoms ranging from fatigue to serious respiratory or neurological problems, often for months after diagnosis. The ailments are all the more challenging because patients say they often face skeptical families, friends, employers and even doctors. Research is limited on these so-called ‘long haulers.’…. A study of 143 patients in Italy out this month in JAMA Network found 87 percent of patients who had recovered from COVID-19 reported at least one lingering symptom, notably fatigue and trouble breathing.”
 

Sing into the Funnel

 
The Guardian reports on efforts to understand how singing and blowing instruments might spread the virus and it involves people singing or blowing instruments into a funnel. “Serious outbreaks of the virus were linked to choirs from countries including South Korea and the Netherlands this spring. Most notable was the terrible case of a choir rehearsal in Skagit County, Washington state, on 10 March. Out of 61 attending practice, 52 people fell ill. Two died.” One researcher says, “The results of this study will be entirely objective and the process for peer review will mean that everything is open. Although I would be upset if singing were locked down even more, it’s my duty to make sure the results are as transparent as they can be. If it turns out singing is dangerous, we need to know about it.”
 

Little Flu in Southern Hemisphere

 
The Wall Street Journal reports, “From Argentina to South Africa to New Zealand, countries in the Southern Hemisphere are reporting far lower numbers of influenza and other seasonal respiratory viral infections this year. In some countries, the flu seems to have all but disappeared, a surprise silver lining that health experts attribute to measures to corral the coronavirus, like mask use and restrictions on air travel. The decline could be good news for health officials in the US and Europe worried about a possible second wave of coronavirus infections this fall and winter.”
 

Viral Misinformation Takes Over Social Media

 
STAT reports, “Since the outset of the pandemic, vaccine-related falsehoods have ballooned on [FaceBook]—and recent research suggests some of those inaccurate posts are gaining traction among people who weren’t previously opposed to vaccinations. Part of the problem appears to be the way Facebook’s algorithms capitalize on divisive or extremist content. Compounding the issue is Facebook’s history of hesitating to address misinformation until a particular subject has snowballed into an urgent problem. In the middle of a global measles outbreak last year spurred by low vaccination rates, Facebook rolled out a series of policies to curb vaccine misinformation. But the changes did little to prevent the problem from resurfacing again amid the COVID-19 pandemic.”
 
MediaMatters reported last week that, “baseless conspiracy theories about the novel coronavirus and Dr. Anthony Fauci, a prominent member of the White House coronavirus task force, found a platform on the new episode of Sinclair Broadcast Group’s America This Week. The episode is available for streaming on Sinclair-owned or -operated television station websites and is set to air on dozens of Sinclair stations over the weekend.”  Pushback on Sincliar led to them cutting an interview with conspiracist Judy Mikovits, saying that “Given the nature of the theories she presented we believe it is not appropriate to air the interview.”
 

This Week In Fauci

 
The Washington Post reports, “As coronavirus deaths in the United States neared 150,000, President Trump complained Tuesday about his approval ratings, asking reporters why his numbers are not as good as those for Anthony S. Fauci, the top infectious-disease expert and coronavirus task force member who Trump has criticized as a ‘bit of an alarmist.’ ‘He’s got this high approval rating,’ Trump said Tuesday at the White House coronavirus task force briefing, ‘so why don’t I have a high approval rating?’”
 
Newsweek reports, “Dr. Anthony Fauci said that he has received hate mail and death threats from US residents who disagree with his health recommendations to curb transmission of the novel coronavirus. Some individuals, conceivably frustrated over the infectious disease expert's ongoing push for virus mitigation—like widespread use of face masks, social distancing and adjusted reopening strategies—are harassing members of his family as well…. ‘There are people who get really angry at thinking that I'm interfering with their life because I'm pushing a public health agenda…. There is a big divisiveness in the country about politicizing this response to the COVID outbreak, where people feel that some of the public health measures that I've been advocating, which are purely for the purpose of preserving the health and safety of the American people, are interfering with their lives.’”
 
The Hill reports that Brad Pitt received an Emmy nomination for his portrayal of Fauci on Saturday Night Live. If you missed it, watch it here.
 
Meanwhile, USA Today reports a special edition baseball card featuring Fauci sold 51,402 cards in 24 hours, breaking records.
 

COVID, the Board Game

 
The New Yorker reports on a board game that is “a favorite among doctors battling the coronavirus, Pandemic has grown from curiosity to cathartic release, offering, in miniature, a finite version of our stricken world. Pandemic resembles the Parker Brothers classic Risk—there’s a world map and continents associated with different colors—but the goal is reversed. Instead of seeking world domination, as you raise and spread armies against your friends, you must work with other players to stop the march of multiple diseases that threaten to devastate the Earth.
 

Give the Data Back to CDC

 
An op-ed in USA Today from a group of HC workers says, “As physicians and licensed health care providers who have taken an oath to do no harm, we oppose this rule. During a pandemic, a robust public health response is critical to our ability to provide the best possible care to our patients. The CDC’s decades of experience, established infrastructure and apolitical nature position it to lead our COVID-19 response. When people continue to die from COVID-19, attempting to exclude the CDC from effective decision-making is not only misguided, it may cause more deaths that were otherwise preventable.”
 

Resource of the Week

 
TAG has unveiled a “dedicated resource hub on SARS-CoV-2 infection and COVID-19 disease represents a collaborative project of the COVID-19 Working Group NY, the PrEP4All Collaboration, AVAC, and Treatment Action Group” that aims “to provide here independent analysis and information resources with a particular focus on the research pipelines for the diagnosis, treatment, and prevention of SARS-CoV-2 infection and COVID-19 disease. Our main COVID-19 Pipeline page contains statements and resources on key topics. Our Myth Busters page debunks common and dangerous myths. For the latest public comments and publications on COVID-19 from TAG and partners, check out our Newsfeed, and for more on COVID-19 from external sources, please visit our Resources page.”
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