Our weekly roundup of all things COVID.

View this email in your browser ([link removed])
AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.


** Latest Global Stats
------------------------------------------------------------
August 14, 2020
Confirmed Cases
21,010,700 Recovered
13,047,560 Deaths
761,260
Source: Center for Systems Science and Engineering, Johns Hopkins University ([link removed])
These numbers that we share every week go in one direction only for the moment. If we didn’t understand exponential growth going into this, we certainly do now. (If you still have questions on that check out this YouTube video ([link removed]) from an Oxford mathematician.) Looking at the COVID news every week is a balancing act with new research for solutions to highlight, new insights from scientists about the virus to absorb, new political stratagems to dissect and an attempt to find the human story that ties it all together. Through all of these we come back to these ever-growing numbers and to the charts that point ever upward.

This week Fast Company ([link removed]) looks at the brains behind the main numbers tracking database: Lauren Gardner, an engineer and epidemiologist at Johns Hopkins University. “In a matter of weeks, the user-friendly dashboard had attracted users not just in pandemic command centers around the world—from Italy’s health ministry to Connecticut’s governor’s office to the White House—but on social media, where fellow scientists, journalists and armchair virus trackers followed its rising case counts with growing alarm. As of mid-June, the dashboard has garnered 650 million cumulative page views, making it one of the most popular sites in the world… In the absence of strong, centralized public health leadership—and in the presence of digital platforms that thrive on misinformation—Gardner increasingly believes that it is the role of individual scientists to speak up, whether on TV or on Twitter. ‘While it is super time-consumin
g and distracting, I feel like it’s my responsibility to share things that I know, rather than just watching [celebrities like] Jenny McCarthy tell people they shouldn’t get vaccinated,’ she says. ‘You have to put yourself out there.’ Now more than ever, she believes it is critical for scientists to use statistics—the right, contextualized statistics—to paint a picture that the public can understand.”

The numbers are instructional and absolutely necessary to guide our response, but it’s humanity that will save us.


** Table of Contents
------------------------------------------------------------
* If You’re in a Hurry... (#hurry)
* Vaccine Research Barrels Ahead (#barrels)
* Mitigating Against an October Surprise (#october)
* Putin’s August Surprise (#august)
* Racial Disparities (#disparities)
* Prisons (#prisons)
* Healthcare Workers and PPE (#PPE)
* Winter is Coming to the US and It’s Not Pretty (#winter)
* COVID and Children (#children)
* Airborne (#airborne)
* Fear of Hospitals in Mexico (#mexico)
* “Peter Navarro Still isn’t Anthony Fauci.” (#navarro)


* Release the Data (#data)
* Monoclonal Antibody Research Moves Forward (#monoclonal)
* Vaping and COVID (#vaping)
* Brazil Crosses 100,000 Deaths (#brazil)
* What We Know about Immunity this Week (#immunity)
* Not So Fast with the UV Light (#UV)
* Combating Misinformation with Empathy (#empathy)
* The Basics of Antibody Tests (#antibody)
* This Week in Hydroxychloroquine (#hydroxychloroquine)
* What Does the Future Hold? (#future)
* Can We Mitigate the Impact on HIV, TB, Malaria? (#mitigate)


** If You're in a Hurry...
------------------------------------------------------------
* Read a thoughtful commentary by CNN’s ([link removed]) Dr Sanjay Gupta about making the best decision possible about his children returning to school
* And see a CDC MMWR ([link removed]) about pediatric infections in the US
* Read a Health Affairs ([link removed]) commentary on how we can apply lessons from global health to address health disparities laid bare by COVID in the US
* Get the scoop on Putin’s August surprise from The Washington Post ([link removed]) and the New York Times ([link removed])
* Then read about how public health experts are calling for steps to guard against a Trump October surprise in the New York Times ([link removed])
* Read a NEJM ([link removed]) perspective that argues, “as we strive to overcome the social and structural causes of health care disparities, we must recognize the underrepresentation of minority groups in COVID-19 clinical trials
* Read Helen Branswell’s report in STAT ([link removed]) about the narrow window of opportunity the US has to avoid a “Dickensianly bleak” winter
* Read Ryan Panchadsaram’s tweets ([link removed]) calling for US data to be released


** Vaccine Research Barrels Ahead
------------------------------------------------------------

With much of the world waiting breathlessly for a vaccine that many still believe is the path back to normal (whatever that is now), vaccine research has amped up, with multiple efficacy trials underway or imminent across the globe.

The Daily Maverick ([link removed]) (SA) reports, “Dr Glenda Gray, president and CEO of the South African Medical Research Council (MRC), has confirmed to Spotlight that a Johnson & Johnson product called Ad26.COV2-S ([link removed]) and a Novavax product called NVX-CoV2373 ([link removed]) will be trialled in the country starting next month.” The Maverick reports Gray “was injected on Tuesday 11 August, with either a placebo or the potential vaccine against the SARS-CoV-2 virus at a trial site at the Cape Town Lung Institute. She saw many people from all walks of life signing up when she was screened on Friday. ‘We are all citizens of this country and we are all
affected by Covid-19. Scientists need to roll up their sleeves in more ways than one. We are usually at one end of the needle and we are never at the shooting (receiving) end of the needle,’ she says.”

In a wide-ranging interview with Wired ([link removed]) , Bill Gates worries about a vaccine being rushed: “In China and Russia they are moving full speed ahead. I bet there’ll be some vaccines that will get out to lots of patients without the full regulatory review somewhere in the world. We probably need three or four months, no matter what, of phase 3 data, just to look for side effects. The FDA, to their credit, at least so far, is sticking to requiring proof of efficacy. So far they have behaved very professionally despite the political pressure. There may be pressure, but people are saying no, make sure that that’s not allowed. The irony is that this is a president who is a vaccine skeptic. Every meeting I have with him he is like, “Hey, I don’t know about vaccines, and you have to meet with this guy Robert Kennedy Jr. who hates vaccines and spreads crazy stuff about them.”


** Mitigating Against an October Surprise
------------------------------------------------------------

Amid concerns of an “October surprise,” Reuters ([link removed]) reports, “US regulators have assured scientists that political pressure will not determine when a coronavirus vaccine is approved even as the White House hopes to have one ready ahead of the November presidential election, the country’s leading infectious diseases expert Anthony Fauci said… ‘We’ve spoken explicitly about that, because the subject obviously comes up, and the people in charge of the regulatory process assure us that safety and efficacy is going to be the prime consideration,’ he said.

The New York Times ([link removed]) reports, “A letter signed by nearly 400 health experts asked the US FDA to use its vaccine advisory panel when reviewing data on coronavirus trials… ’We must be able to explain to the public what we know and what we don’t know about these vaccines,’ noted the letter, which was organized by the nonprofit Center for Science in the Public Interest. ‘For that to happen, we must be able to witness a transparent and rigorous FDA approval process that is devoid of political considerations.’”


** Putin's August Suprise
------------------------------------------------------------

Several outlets reported Russian President Putin’s announcement of Russia’s COVID vaccine, named “Sputnik 5,” according to The Washington Post and other outlets. The Post reports Putin said Russia, “has become the first to approve an experimental coronavirus vaccine and that his own daughter has already taken a dose.” The New York Times ([link removed]) reports on concerns voiced by numerous experts, including virologist John Moore, “This is all beyond stupid. Putin doesn’t have a vaccine, he’s just making a political statement.” The Times notes, “In June, the Gamaleya Research Institute of Epidemiology and Microbiology at the Health Ministry of the Russian Federation registered ([link removed]) a combined Phase 1 and 2 trial on a vaccine called Gam-COVID-Vac Lyo. The researchers planned to test it on 38 volunteers. They said that the vaccine was made from an aden
ovirus — a harmless cold virus—carrying a coronavirus gene, similar to what AstraZeneca and Johnson & Johnson are using in their vaccines. The technology is still relatively new: The first adenovirus vaccine for any disease was approved for Ebola in June.” The early phase data have not been published.

National Geographic ([link removed]) reports, “Concocting a vaccine is not the same thing as proving a vaccine is safe and effective. That’s Anthony Fauci’s take on the news out of Moscow that Russia has approved and is ready to market a coronavirus vaccine.” Fauci said, “I hope that the Russians have actually definitively proven that the vaccine is safe and effective. I seriously doubt that they've done that.”


** Racial Disparities
------------------------------------------------------------

A NEJM ([link removed]) perspective notes, “despite disproportionately higher rates of Covid-19 infection, hospitalization, and death in racial and ethnic minority groups, the direct effects of genetic or biologic host factors remain unknown.” The piece argues, “as we strive to overcome the social and structural causes of health care disparities, we must recognize the underrepresentation of minority groups in Covid-19 clinical trials… To provide the necessary data for generalizing efficacy and safety outcomes across racial groups, Covid-19 clinical trials must prioritize inclusion of patient populations that reflect the demographics of the ongoing pandemic, especially in the United States, and funding for scientists from underrepresented ethnic groups must be increased. Appropriate random sampling and the expansion of clinical trial sites to vulnerable communities with high-risk patients would improve the representativeness of samples.
Furthermore, standardized reporting of race and ethnicity categories would allow for improved assessment of the generalizability of evidence-based interventions.”

The Guardian ([link removed]) reports on COVID outbreaks in California’s Central Valley, where “hundreds of thousands of workers wash the vegetables, debone the meat, sort the nuts and package the produce that finds its way into kitchens throughout the United States.” Many of these workers are Latinix and they have been disproportionately affected by the virus. “Workers and workers’ rights organizations say these outbreaks and the subsequent swell of infections in the Central Valley point to a devastating truth: that we are each only as protected as our least protected; as vulnerable as our most vulnerable. ‘You can appear to contain the spread among middle-class workers but when it reaches those workers who are furthest on the margins, who are most disadvantaged, the virus is going to spread,’ said Edward Flores, a sociology professor at the University of California, Merced.”

The Washington Post ([link removed]) looks at the outsize impact of COVID on people who work at meat processing plants in the US. “The nature of work in the plants presents clear risks for workers, many of whom are immigrants, and their advocates complain that JBS and other companies have sacrificed employee health and safety for profits. Those same advocates argue that the low-income workers on whom meat plants rely often lack a basic understanding of their rights as employees, making them vulnerable to abuse.”

The Guardian ([link removed]) also reports on “a combination of poor access to healthcare, failed political leadership and the endurance of segregation and generational racism has contributed to a surge in Covid-19 deaths in recent months” in several counties in the Southern US.


** Prisons
------------------------------------------------------------

The Nation (Kenya) ([link removed]) reports, “Health officials are grappling with Covid-19 containment measures in congested prisons across the country with the effects of infections in the correctional facilities spiralling to courts. Court proceedings have been disrupted in various parts of the country as the Covid-19 situation gets worse in most counties.”



** Healthcare Workers and PPE
------------------------------------------------------------

AP ([link removed]) reports, “As India hit another grim milestone in the coronavirus pandemic Friday, crossing 2 million confirmed cases and more than 41,000 deaths, community health volunteers went on strike complaining that they are ill-equipped to respond to the wave of infection in rural areas. Even as India has maintained comparatively low mortality rates, the disease has spread widely across the country, with the burden shifting in recent weeks from cities with robust health systems to rural areas, where resources are scarce or nonexistent.”



** Winter is Coming to the US and It’s Not Pretty
------------------------------------------------------------

Helen Branswell reports in STAT ([link removed]) that, “Unless Americans use the dwindling weeks between now and the onset of “indoor weather” to tamp down transmission in the country, this winter could be Dickensianly bleak, public health experts warn… ‘We should be aiming for no transmission before we open the schools and we put kids in harm’s way — kids and teachers and their caregivers. And so, if that means no gym, no movie theaters, so be it,’ said Caroline Buckee, associate director of the Center for Communicable Disease Dynamics at Harvard’s T.H. Chan School of Public Health. ‘We seem to be choosing leisure activities now over children’s safety in a month’s time. And I cannot understand that tradeoff.’” Branswell quotes Fauci on the need to get young people to understand the need for continued caution: “’It’s not them alone in a vacuum. They ar
e spreading it to the people who are going to wind up in the hospital.’ Everyone has to work together to get cases down to more manageable levels, if the country hopes to avoid ‘a disastrous winter,’ he said.”

An article in The Atlantic ([link removed]) underscores this concern through interviews with experts, the author “caught glimpses of the winter to come, and what I saw was bleak, even compared with what Americans have already experienced. The winter will be worse—for the quality of daily life in America and, possibly, for the course of the pandemic itself.” The experts say the “apocalypse” of winter could be avoided with use of “widespread, affordable, and quick testing; strongly enforced masking mandates; and improved ventilation in classrooms and other indoor spaces.

In a Health Affairs ([link removed]) commentary Charles Holmes and Eric Goosby write that the US has been a leader in global health through programs like PEPFAR and support of GAVI, WHO and the Global Fund. “Yet, while the US has played a leadership role so many times in the past, we are at a critical juncture where we also need to heed the lessons learned from others as the US falls further behind in its COVID-19 response. Drawing from our experiences, we put forth seven lessons learned from efforts to protect global health that, if applied here at home, will help to reduce inequities and improve the health of all Americans.”


** COVID and Children
------------------------------------------------------------

An MMWR ([link removed]) report says, “Analysis of pediatric COVID-19 hospitalization data from 14 states found that although the cumulative rate of COVID-19–associated hospitalization among children (8.0 per 100,000 population) is low compared with that in adults (164.5), one in three hospitalized children was admitted to an intensive care unit.” The study authors conclude, “Children are at risk for severe COVID-19. Public health authorities and clinicians should continue to track pediatric SARS-CoV-2 infections. Reinforcement of prevention efforts is essential in congregate settings that serve children, including childcare centers and schools.”

An NPR ([link removed]) report on the data notes, “Hispanic and Black children in particular were much more likely to require hospitalization for COVID-19, with Hispanic children about eight times as likely as white children to be hospitalized, while Black children were five times as likely…. A separate study in the journal Pediatrics also found racial and socioeconomic disparities ([link removed]) in children and young adults tested for COVID-19 in Washington, DC Hispanic children were more than six times as likely as white children to test positive for the virus; Black children were over four times as likely.”

The Washington Post ([link removed]) reports, “More than 97,000 US children tested positive for the coronavirus ([link removed]) in the last two weeks of July, more than a quarter of the total number of children diagnosed nationwide since March, according to data from the American Academy of Pediatrics and the Children’s Hospital Association... Pediatric deaths from COVID-19, the illness caused by the coronavirus, remained rare, accounting for fewer than 1 percent of the national total, the report concluded.”

In a commentary on CNN ([link removed]) by Dr Sanjay Gupta lays out his rationale for not sending his daughters back to school in the Atlanta area. “This was not an easy decision, but one that we believe best respects the science, decreases the risk of further spread and follows the task force criteria.” As his family looks to reassess that he says, “full and honest transparency from everyone will be more necessary than ever… In the age of COVID-19, it seems we are all forced to become amateur epidemiologists, while also being the best parents we can be.”

Bhekisisa ([link removed]) looks at the “absolute nightmare” of children in state quarantine in South Africa, writing that “sending children into COVID-19 quarantine or isolation facilities without support may risk their mental health, experts warn. But there’s still no national guidelines on where, when or how state quarantine and isolation facilities should admit children — or how to support them… Without these kinds of regulations, individual quarantine or isolation facilities must decide on their own how to handle cases involving children, including whether or not to admit them and what support they offer. But research and experts say that during an outbreak, children in need of quarantine and isolation—especially those with special needs—may need extra care in these temporary homes away from home.”


** Airborne
------------------------------------------------------------

The New York Times ([link removed]) reports, “A research team at the University of Florida succeeded in isolating live virus from aerosols collected at a distance of seven to 16 feet from patients hospitalized with COVID-19—farther than the six feet recommended in social distancing guidelines… ’This is what people have been clamoring for,’ said Linsey Marr, an expert in airborne spread of viruses who was not involved in the work. ‘It’s unambiguous evidence that there is infectious virus in aerosols.’” The study has been posted online, but not yet peer reviewed.

Axios ([link removed]) reports, “A growing body of research has made it clear that airborne transmission of the coronavirus is possible… That fact means indoor spaces can become hot spots. Those spaces also happen to be where most business and schooling takes place, so any hope for a return to normality will require better ways of filtering indoor air.” Another Axios ([link removed]) story reports, “The White House coronavirus task force will examine more closely just how much SARS-CoV-2 might be transmitted via aerosols, and not just from droplets, said NIAID director Anthony Fauci…”


** Fear of Hospitals in Mexico
------------------------------------------------------------

The New York Times ([link removed]) reports, “Mexico is battling one of the worst coronavirus outbreaks in the world, with more than 52,000 confirmed deaths, the third-highest toll of the pandemic. And its struggle has been made even harder by a pervasive phenomenon: a deeply rooted fear of hospitals… As the pandemic crushes an already weak health care system, with bodies piling up in refrigerated trucks, many Mexicans see the COVID ward as a place where only death awaits—to be avoided at all cost.”



** “Peter Navarro Still isn’t Anthony Fauci.”
------------------------------------------------------------

A Twitter thread ([link removed]) by Andy Slavitt, the former head of the Obama administration’s healthcare initiative, about expertise and uncertainty, noting, “It’s not just that we have a distrust of experts, it’s also that the people who dismiss experts think they’re experts themselves.” Slavitt hits on one of the key problems with public understanding of the virus and what it does: “As long as things are uncertain as they are with a novel virus, it’s a chance for everybody to weigh in with their opinions.”



** Release the Data
------------------------------------------------------------

Ryan Panchadsaram, who developed www.covidexitstrategy.org ([link removed]) , tweets ([link removed]) , “I hate being a broken record, I promise to stop once all COVID-response data is made public. Specifically the data-rich reports from the WH COVID Task Force and aggregated data from the HHS Protect System. Without these data we're flying blind… All the public wants is transparency. We want and need this data so we can fight this virus effectively. The data won't be perfect, it never is. But if made public, it at least can be scrutinized, fixed and improved.”



** Monoclonal Antibody Research Moves Forward
------------------------------------------------------------

Jon Cohen reports in Science ([link removed]) , “While the world is transfixed by the high-stakes race to develop a COVID-19 vaccine, an equally crucial competition is heating up to produce targeted antibodies that could provide an instant immunity boost against the virus. Clinical trials of these monoclonal antibodies, which could both prevent and treat the disease, are already underway and could produce signs of efficacy in the next few months, perhaps ahead of vaccine trials. ‘If you were going to put your money down, you would bet that you get the answer with the monoclonal before you get the answer with a vaccine,’ says Anthony Fauci…”

Nature ([link removed]) reports on a new report ([link removed]) from IAVI and Wellcome that “calls for boosting the global availability of therapeutic antibodies against COVID-19 and other diseases by developing regulatory pathways, business models and technologies to lower the cost of the pricey medicine…’It is a tall order, acknowledges Mark Feinberg, president of IAVI. “But COVID-19 really forces the issue in a major way,’ he says. ‘The pandemic demands that this dialogue take place, and that solutions for this challenge be created.’”


** Vaping and COVID
------------------------------------------------------------

A study in the Journal of Adolescent Health ([link removed]) found “COVID-19 is associated with youth use of e-cigarettes only and dual use of e-cigarettes and cigarettes, suggesting the need for screening and education.” The authors write, “Our population-based research provides timely evidence that youth using e-cigarettes and dual-users of e-cigarettes and cigarettes are at greater risk of COVID-19. Given the predominance of e-cigarette use among U.S. youth, our investigation informs public health concerns that the ongoing youth e-cigarette epidemic contributes to the current COVID-19 pandemic.

Axios ([link removed]) reports, “The European Centre of Disease Prevention and Control (ECDC) warned ([link removed]) on Monday that the continent is seeing a "true resurgence" in coronavirus cases and recommended that affected countries consider reimposing certain restrictions… The ECDC warned that the ‘recent increase’ in infections is a result of countries relaxing their social distancing and other mitigation measures.


** Brazil Crosses 100,000 Deaths
------------------------------------------------------------

The Guardian ([link removed]) reports, “On Saturday afternoon a coalition of Brazilian news outlets announced the number of deaths had risen by 538 to 100,240, the second highest number on earth after the US… On the eve of that milestone Bolsonaro urged his country’s 210 million citizens to put the unfinished tragedy behind them ([link removed]) . ‘We regret all of the deaths… But let’s get on with our lives, get on with our lives and try to find a way of getting away with this problem.’”



** What We Know about Immunity This Week
------------------------------------------------------------

Live Science ([link removed]) reports, “Previous infections with common cold viruses can train the immune system to recognize SARS-CoV-2, the virus that causes COVID-19, according to a new study. The study, published Aug. 4 in the journal Science ([link removed]) , found that immune cells known as T cells that recognize common cold coronaviruses ([link removed]) also recognize specific sites on SARS-CoV-2 — including parts of the infamous ‘spike’ protein ([link removed]) it uses to bind to and invade human cells. This existing immune system "memory" may explain why some people have milder COVID-19 infections compared with others; however, the authors stress that this hypothesis is "highly
speculative" and requires more research to confirm.”



** Not So Fast with the UV Light
------------------------------------------------------------

Fast Company ([link removed]) reports, “Airports and stores are starting to turn to ultraviolet radiation to disinfect surfaces as a means of curbing COVID-19’s spread. But this week three organizations devoted to supporting and developing standards for the lighting industry published a paper warning consumers and businesses ([link removed]) against buying UV products that claim to guard against COVID-19.”



** Combating Misinformation with Empathy
------------------------------------------------------------

In the Calgary Herald ([link removed]) , a Canadian public health specialist has tips for countering misinformation: “’I always tell people, do not target the person spreading misinformation. Target the information itself…’ An effective way to debunk misinformation, he said, is to provide accurate and highly engaging evidence to the contrary, such as a colorful social media post that catches the attention of users, memes or short videos from reputable sources… Even reminding friends to be cognizant of what they are reading and sharing can make a huge difference, he said, adding research has shown this simple action has a ‘profound effect’ on hindering the prevalence of misinformation.”



** The Basics of Antibody Tests
------------------------------------------------------------

The Daily Maverick ([link removed]) provides answers to key questions about antibody tests from the Scientist Collective. They write, “South Africa has seen a flurry of controversies about the possible role and place for antibody tests—also referred to as “serology” tests—in managing Covid-19. Some have argued that antibody tests are the missing weapon ([link removed]) , while others have countered that they provide little to no real-time value ([link removed]) or are a “blunt stick” ([link removed]) , offering false hope. Here, we try to help you unpack
what is going on, when antibody tests might be helpful to you, your doctors, scientists and policy leaders in South Africa’s response to COVID-19... and when they won’t be of help.”



** This Week in Hydroxychloroquine
------------------------------------------------------------

A post on Science Based Medicine ([link removed]) says, “Late last week, a “study” published on HCQTrial.com ([link removed]) by an anonymous source claiming to be a group of PhD scientists went viral. It claimed that countries that used hydroxychloroquine to treat COVID-19 had a 79% lower fatality rate than those who didn’t. It was horrible science and quickly debunked on Twitter by several epidemiologists. That didn’t stop it from going viral. Disinformation like this during a pandemic is one of the most dangerous challenges we face.” The post does a great job of dissecting claims from the so-called study while helping to explain the research process.



** What Does the Future Hold?
------------------------------------------------------------

Nature ([link removed]) reports, “Around the world, epidemiologists are constructing short- and long-term projections as a way to prepare for, and potentially mitigate, the spread and impact of SARS-CoV-2, the virus that causes COVID-19. Although their forecasts and timelines vary, modellers agree on two things: COVID-19 is here to stay, and the future depends on a lot of unknowns, including whether people develop lasting immunity to the virus, whether seasonality affects its spread, and—perhaps most importantly—the choices made by governments and individuals.”



** Can We Mitigate the Impact on HIV, TB, Malaria?
------------------------------------------------------------

A Nature ([link removed]) editorial argues, “Right now, with the total number of COVID-19 infections approaching 20 million and deaths standing at more than 700,000, we can’t say how bad the pandemic will get. But we can say that, without interventions, TB, AIDS and malaria are likely to take more lives.” The editorial calls for four action: “hospitals and health authorities in affected cities and regions must recognize that AIDS, malaria and TB are surging again… researchers must continue to refine their models using more real-world data… there is a need for public-information campaigns…” and there needs to be more funding and “alternative approaches [to funding] should be tried…”
Got this from a friend? Subscribe here. ([link removed])

============================================================
Our mailing address is:
** [email protected] (mailto:[email protected])

** unsubscribe from this list ([link removed])
** update subscription preferences ([link removed])