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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
"If you have 75–80 percent of the people get vaccinated, you create an umbrella of herd immunity—that even though there is virus around, it is really almost inconsequential because it has no place to go, because almost all of the people are protected.”
-- Dr. Anthony Fauci in Axios Science ([link removed])


** Latest Global Stats
------------------------------------------------------------
December 11, 2020
Confirmed Cases
69,788,140 Recovered
45,020,900 Deaths
1,585,727
Source: Center for Systems Science and Engineering, Johns Hopkins University ([link removed])


** Table of Contents
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* If You Are in a Hurry (#hurry)
* Pfizer Vaccine Moves into Arms (#pfizer)
* Countries Locked Out of Widespread Vaccine Access (#poor)
* What is Biden’s Global Plan? (#biden)
* Keep Your Mask (#keep)
* J&J Cuts Size of Vax Trial (#jandj)


* Australia Vaccine Candidate Scrapped (#australia)
* Vaccines and HIV Risk (#vaccines)
* Herd Immunity When? (#herd)
* Trump Friends Get Access to Rare Treatment (#trump)
* Longhaulers Need Attention (#long)
* A Swiss Cheese Model (#swiss)
* Journalism Without Fear or Favor (#journo)

This is a historic week. Vaccinations against COVID-19 began in the UK earlier this week and on Thursday an independent advisory board recommended the US FDA grant an Emergency Use Authorization for the Pfizer COVID vaccine. Canada, Saudi Arabia and other countries have or soon will clear this first vaccine for use. By the end of the year a small number of the elderly and healthcare workers in a few rich countries will be vaccinated. 2021 will bring a cascade of vaccine rollout—at firs at least primarily in rich countries. Many people have called this the end of the beginning of the pandemic. It’s very clear that despite this good news, he beginning of the end of the pandemic is still not in sight.

In the US, this was a historic week in COVID cases and COVID deaths as the pandemic continues to rage out of control across the country. The US has logged more deaths than any other country and is closing in on 300,000 deaths. The Washington Post ([link removed]) reports, “By Thursday evening, the daily US toll topped 3,300.… The steadily rising fatality numbers also come after weeks of soaring levels of infection and coronavirus patients in need of hospitalization. Public-health experts anticipate that the country will soon exceed the week’s death milestones nearly every day in the coming two to three months.”

VOA ([link removed]) reports, “Nigeria may be on the verge of a second wave of COVID-19 infections, the health minister warned Thursday, as another official said the country expects to roll out a vaccine by April next year. Osagie Ehanire, speaking at a news conference in the capital, Abuja, said 1,843 cases were recorded last week compared with 1,235 two weeks before that.”

The Sowetan ([link removed]) reports, “Medical experts have predicted that the highest rise in COVID-19 infections will be seen after the December holidays. This comes after health minister Dr Zweli Mkhize on Wednesday announced that SA is now in its second wave ([link removed]) of COVID-19 infections.”

Reuters ([link removed]) reports COVID “is spreading into rural areas where the public health system is creaking and scarce ICU units are full and turning patients away, medics round the nation told Reuters. Christmas travel may worsen the problem…”

Reuters ([link removed]) reports a surge in cases in South Korea “has delivered a blow to South Korea’s vaunted pandemic-fighting system, which successfully used invasive tracing, testing, and quarantines to avoid lockdowns, blunt previous waves, and keep infections below 50 per day for much of the summer.”

A study published in Science ([link removed]) found that “three quarters of the population of Manaus in Brazil's Amazon have been infected with coronavirus since the city's first outbreak in March” according to an article from Imperial College ([link removed]) , which helped conduct the research. “The authors say ([link removed]) that these results are a data-based warning of what may be the extent of SARS-CoV-2 transmission in the absence of effective mitigation.”

The early rollout of the Pfizer, and possibly the Moderna vaccine, will not blunt the numbers in the US for possibly months. And there is no clear global plan for achieving global equity in COVID vaccine development, so people in low- and middle-income countries may be waiting much longer for their shots.



** If You Are in a Hurry
------------------------------------------------------------

* Read Axios ([link removed]) on when we might see herd immunity and what it will take to get us there. (Spoiler: good communication is key).
* Read about a “swiss cheese model of pandemic protection” in the New York Times ([link removed]) .
* Read MSF’s Candice Sehoma in Bhekisisa ([link removed]) on why more developing countries need to sign on to South Africa and India’s call for patent and IP waivers for COVID interventions.
* Read The Atlantic ([link removed]) on what the FDA advisory board recommendation means for the US and what the next steps are.
* Read a Devex ([link removed]) profile of Africa CDC’s Nkengasong and how he is leading an African response to COVID.
* Read STAT ([link removed]) on why rising COVID rates in the US led J&J to cut the size of its vaccine trial.




** Pfizer Vaccine Moves into Arms
------------------------------------------------------------

The Atlantic ([link removed]) reports that in the US, “The vaccine will be distributed under an emergency-use authorization, which fast-tracks drugs still under investigation because of extenuating circumstances—in this case, a pandemic that is now claiming the lives ([link removed]) of more than 2,000 Americans each day. The agency’s criteria ([link removed]) for such authorizations require ‘reasonable’ evidence that the vaccine is effective, and that the ‘known and potential benefits…outweigh its known and potential risks.’”

The New York Times ([link removed]) reports, “advocates also asked [FDA] regulators to be transparent about potential safety issues and to closely track the vaccine once it becomes available. Several said such measures were necessary to reassure a public that is hesitant to take a new vaccine, particularly Black and Native American people who have historically been mistreated by the medical community.”

The UK became the first country to roll out a vaccine vetted by stringent regulatory authorities. The Washington Post ([link removed]) notes, “China and Russia have been marketing vaccines of their own around the world, but they have not been subject to the rigorous standard of testing that many governments require.” The Post notes that in the UK, “The initial wave of inoculations could provide protection against a winter spike in cases among the most vulnerable.” AP ([link removed]) reports the first recipient of the vaccine outside of a trial, 90-year-old Margaret Keenan said, “It’s the best early birthday present I could wish for because it means I can finally look forward to spending time with my family and friends in the New Year after being on my own for most of the year.”

The New York Times ([link removed]) reports on data from documents released by the FDA ahead of the Pfizer vaccine hearing: “The coronavirus vaccine made by Pfizer ([link removed]) and BioNTech provides strong protection against COVID-19 within about 10 days of the first dose…. What’s more, the vaccine worked well regardless of a volunteer’s race, weight or age. While the trial did not find any serious adverse events caused by the vaccine, many participants did experience aches, fevers and other side effects.”

AP ([link removed]) reports, “Britain’s medical regulator warned Wednesday that people with a history of serious allergic reactions shouldn’t get the COVID-19 vaccine from Pfizer and BioNTech, and investigators looked into whether two reactions on the first day of the UK’s vaccination program were linked to the shot.” The New York Times ([link removed]) reports that during the FDA hearing, advisory committee member “Dr. Paul Offit of the Children’s Hospital of Philadelphia, said he feared that statements by British regulators as well as remarks by Moncef Slaoui, a top US vaccine official, could lead ‘tens of millions’ of people with severe allergies to reject the vaccine even though evidence of a link to the shots was unclear. He asked Pfizer to conduct a separate study of people with a history of severe allergies, because ‘this issue is not going to di
e until we have better data.’”



** Poor Countries Locked Out of Widespread Vaccine Access
------------------------------------------------------------

The Guardian ([link removed]) reports, “Rich countries with just 14 percent of the world’s population have secured 53 percent of the most promising coronavirus vaccines ([link removed]) , according to an alliance of campaigners which this week warned that deals already done could leave nine out of 10 of the world’s poorest unvaccinated next year. Canada has secured enough doses to vaccinate its citizens many times over ([link removed]) .”

AP ([link removed]) quotes Africa Centers for Disease Control and Prevention director John Nkengasong, who “has warned that Africa might not see vaccines until after the second quarter of 2021. Nkengasong urged the United Nations to summon a special session to discuss the ethical, fair distribution of vaccines to avoid ‘this North-South distrust in respect to vaccines, which is a common good.’”

A Devex ([link removed]) profile of Nkengasong notes that despite overwhelming odds, “the Africa CDC and its partners have managed an effective continentwide response involving initiatives such as the pooled procurement and distribution of tests, strengthening laboratory capacity, building structures to increase the number of clinical trials, and working to lay the groundwork for the rollout of a vaccine. While the international community feared the worst for Africa, the continent has fared far better than many parts of the world in terms of confirmed cases, deaths, and overwhelmed health facilities.”

BBC ([link removed]) reports, “The People's Vaccine Alliance says nearly 70 lower-income countries will only be able to vaccinate one in 10 people. This is despite Oxford-AstraZeneca pledging to provide 64 percent of its doses to people in developing nations…. The People's Vaccine Alliance is calling on all pharmaceutical corporations working on COVID-19 vaccines to openly share their technology and intellectual property so that billions more doses can be manufactured and made available to everyone who needs them. This can be done through the World Health Organization COVID-19 technology access pool, it says.”

In a commentary in Bhekisisa ([link removed]) , Candice Sehoma of Doctors Without Borders (MSF) in South Africa argues that “the battle lines of access to COVID-19 vaccines, diagnostics and treatment have been drawn between high-income countries and developing countries, which is why more African leaders need to endorse plans by South Africa and India to ensure equitable access—especially as their populations are most vulnerable…. The over-protection of IP by pharmaceutical corporations and their lobbies has historically created barriers to accessing lifesaving medicines used in the treatment of HIV, TB, cancer and a range of other diseases. Despite the COVID-19 pandemic, the pharmaceutical industry continues to follow a business-as-usual approach, maintaining rigid control over their proprietary IP rights, which prioritises profit maximisation over people’s lives.
This is a result of the current monopoly-based biomedical innovation system that allows exorbitant prices to be charged for medicines, without any checks or balances.”

Nigeria’s Punch ([link removed]) reports WHO’s Immunisation and Vaccines Development Programme Coordinator has said, “Africa will need at least $9bn to procure and distribute 1.4 billion doses of COVID-19 vaccines…. ‘First of all, we are not sure that we are going to get enough supply to immunise everybody by the end of 2021. This may spill over to the year after but also to mobilise such an amount of money, I think it will be an additional challenge.’”

Xinhua ([link removed]) reports “Uganda's ministry of health on Thursday said it has ordered 9 million doses of COVID-19 vaccine amid surging new infections in the country. The ministry said in a statement issued here that the vaccines will cover 20 percent of the country's total population of 45 million people.” The country has asked for doses through GAVI of the AstraZeneca vaccine. Africa News ([link removed]) reports the Ugandan Ministry of Health “cleared a community of Chinese nationals to import up to 4,000 doses of the coronavirus vaccine for their own use.” The Uganda MOH tweeted ([link removed]) “Gov’t is NOT importing the Chinese COVID-19 vaccine for use by Ugandans BUT for use by Chinese in Kapeeka who want to import it for Chinese nationals only.”

Bloomberg ([link removed]) report, “South Africa will probably take its first delivery of coronavirus vaccines by the middle of next year…. The government will take delivery of the vaccines under the COVAX initiative that will cover about 10 percent of the population after Solidarity Fund, a charity organization, agreed to make an initial payment of about 327 million rand ($22 million), the ministry said in a statement. The total cost of the vaccines could amount to more than 2 billion rand.” Reuters ([link removed]) reports that the country “intends to fast track regulatory approval for COVID-19 vaccines and expects the first applications within a fortnight, pharmaceutical regulator SAHPRA told Reuters, as the country faces a second wave of infections…. The regulator will
rely on guidance from the World Health Organization and work done by international counterparts, such as European and US pharmaceutical regulators, to avoid repeating work already done that could delay approvals.”

The Guardian ([link removed]) reports on India’s challenge of COVID vaccine roll out: India must vaccinate 1.3bn people against COVID-19 – twice and twice as fast. With more than 9 million confirmed cases ([link removed]) of coronavirus and a battered economy, how will the country meet this challenge?”


** What is Biden’s Global Plan?
------------------------------------------------------------

Devex ([link removed]) reports on what is known or speculated about Biden’s global COVID plans, including rejoining WHO and reestablishing a National Security Council directorate for global health security and biodefense.” Devex notes, “One of the biggest open questions, which is outside of the incoming administration’s direct control but will have significant implications for the scale and ambition of its global response, is funding.”



** Keep Your Mask
------------------------------------------------------------

The New York Times ([link removed]) reports, “The new COVID-19 vaccines from Pfizer ([link removed]) and Moderna seem to be remarkably good at preventing serious illness. But it’s unclear how well they will curb the spread of the coronavirus.” Because the trials only tracked how many people became symptomatic, “that leaves open the possibility that some vaccinated people get infected without developing symptoms, and could then silently transmit the virus—especially if they come in close contact with others or stop wearing masks. If vaccinated people are silent spreaders of the virus, they may keep it circulating in their communities, putting unvaccinated people at risk.”



** J&J Cuts Size of Vax Trial
------------------------------------------------------------

STAT ([link removed]) reports, “Johnson & Johnson is cutting the size of its pivotal US COVID-19 vaccine trial—the only major study testing a single dose of a COVID vaccine—from 60,000 volunteers to 40,000 volunteers. The change is being made possible by the fact that COVID-19 is so pervasive across the country, according to a person familiar with the matter. The more virus there is in the US, the more likely it is that participants will be exposed to it, meaning researchers will be able to reach conclusions based on a smaller trial.”



** Australia Vaccine Candidate Scrapped
------------------------------------------------------------

The Guardian ([link removed]) reports, “The Australian government has terminated its agreement with Australian biotech company CSL Limited to supply 51m doses of a Covid-19 vaccine being developed by the University of Queensland, after vaccine trial participants returned false positive test results for HIV.” The vaccine used “molecular clamp technology” to target the spike protein. “the clamp chosen comprises two fragments of a protein found in HIV, as those fragments provided the greatest stability to the vaccine. Adding those fragments to the spike protein is completely harmless. Trial participants were advised of the possibility that vaccine-induced HIV antibodies might be detected as a result, but it was nonetheless unexpected. Subsequent HIV tests provided definitive negative results in the trial participants.”



** Vaccines and HIV Risk
------------------------------------------------------------

The Body ([link removed]) looks at possible risks from adenovirus type 5 (Ad5) vaccine platforms for COVID, following up on a Lancet op-ed published in October ([link removed](20)32156-5/fulltext) by HIV vaccine researchers that expressed concerns about the vector based on issues with two stopped HIV vaccine trials that used that vector. One of the authors Susan Buchbinder “pointed to the many non-Ad5 COVID-19 vaccines that are in the works ([link removed]) and said that, even though the extent of the potential HIV risk associated with Ad5 vaccines is not known, other types of COVID-19 vaccines should be prioritized.



** Herd Immunity When?
------------------------------------------------------------

Axios Science ([link removed]) quotes Fauci on herd immunity: "If you have 75–80 percent of the people get vaccinated, you create an umbrella of herd immunity ([link removed]) —that even though there is virus around, it is really almost inconsequential because it has no place to go, because almost all of the people are protected.” But, Axios, reports there are several hurdles to get over before we are there and communication is key to getting there.



** Trump Friends Get Access to Rare Treatment
------------------------------------------------------------

The New York Times ([link removed]) reports several men close to Trump have received antibodies to treat COVID, the latest is Rudy Giuliani who has said his “’celebrity’ status had given him access to care that others did not have…. Mr. Giuliani’s candid admission once again exposes that COVID-19 has become a disease of the haves and the have-nots. The treatment given to Mr. Trump’s allies is raising alarms among medical ethicists as state officials and health system administrators grapple with gut-wrenching decisions about which patients get antibodies in a system that can only be described as rationing.” The Times reports, “the antibody treatments are so scarce that officials in Utah have developed a ranking system to determine who is most likely to benefit from the drugs, while Colorado is using a lottery system.”



** Longhaulers Need Attention
------------------------------------------------------------

The New York Times ([link removed]) reports, “There is an urgent need to address long-term symptoms of the coronavirus, leading public health officials said this week, warning that hundreds of thousands of Americans and millions of people worldwide might experience lingering problems that could impede their ability to work and function normally.”



** A Swiss Cheese Model
------------------------------------------------------------

The New York Times ([link removed]) reports on the “Swiss cheese model” of pandemic defense. “Multiple layers of protection, imagined as cheese slices, block the spread of the new coronavirus, SARS-CoV-2, the virus that causes COVID-19. No one layer is perfect; each has holes, and when the holes align, the risk of infection increases. But several layers combined—social distancing, plus masks, plus hand-washing, plus testing and tracing, plus ventilation, plus government messaging—significantly reduce the overall risk. Vaccination will add one more protective layer.”



** Journalism Without Fear or Favor
------------------------------------------------------------
In UN Secretary‑General António Guterres’ video message ([link removed]) to the closing session of the World Press Freedom Conference 2020 he told journalists, “COVID‑19 has given rise to a second lethal pandemic of misinformation, harmful health advice and wild conspiracy theories. The press can provide the antidote: verified, scientific, fact‑based news and analysis. But since the virus took hold, many media workers have been subjected to increased restrictions and punishments simply for doing their jobs…. Journalism without fear or favour is essential to get through the pandemic, and to build a future of peace and human rights for all.”

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