The twin stories of hope and despair continue to dominate the COVID news cycle—increased hope as more people in a few countries get access to one vaccine and a second one moves closer to approval in select countries and despair as virus numbers and deaths continue to climb in more and more countries.
 
The US continues to lead the world in COVID deaths, crossing the 300,000 mark earlier this week with no end in sight, despite the beginning of vaccine rollout. South Africa registered a rise in cases as did many European countries.
 

If You Are in a Hurry

• Read the inspiring words of the first American vaccinated.
• Read Thompson Reuters Foundation’s story about an Ebola survivor who is telling communities to trust COVID vaccines.
• Read POZ on why the current COVID vaccines are safe for people living with HIV.
• Read Science on whether mRNA could be used to treat other diseases.
• Read Dr. Rochelle Walensky and colleagues in a New York Times op-ed about the urgent need to reach young people with effective COVID messages.
• Read the New York Times report on a paper from Science that looked at the vast spread of COVID from the Biogen conference in February in Boston.
• Check out this video of the Indian girl superhero who knows about COVID and rides a tiger.
• Watch healthcare workers dance for joy as the vaccine arrives. 

 

Equitable Vaccine Access in the Spotlight

 
With at least two highly effective vaccines expected to continue or begin rolling out in coming weeks, the end of the pandemic can at least be imagined. Yet concerns remain for equitable access for those and other vaccines that may prove effective later. Reuters reports that a review of WHO internal documents showed that COVAX “promoters say the programme is struggling from a lack of funds, supply risks and complex contractual arrangements which could make it impossible to achieve its goals. ‘The risk of a failure to establish a successful COVAX Facility is very high,’ says an internal report to the board of Gavi…. The failure of the facility could leave people in poor nations without any access to COVID-19 vaccines until 2024, one of the documents says.”
 
NPR reports that some in California are calling for indigenous people to be moved closer to the front of the line for a COVID vaccine—because of both historical injustices and increased risk for COVID. One American Indian advocate calling for this says, “When we think about the historical injustice of this nation, of California, isn't now the time to say that for the first time we prioritized Indigenous people? We started to make reparations in the way that we handled and treated the Indigenous people of this continent?"
 

Approvals of Chinese Vaccine

 
Nature reports “The United Arab Emirates (UAE) approved a vaccine developed by Chinese state-owned Sinopharm on 9 December, and Bahrain followed days later. But researchers say a lack of public data on the safety and efficacy of the vaccine could hinder the company’s plans to distribute the vaccine in a range of other countries…. UAE regulators said in a press release that they had approved an inactivated vaccine developed by Sinopharm’s Beijing Institute of Biological Products. The approval was based on company data stating that the efficacy of the two-dose vaccine was 86 percent in final-stage testing, including a trial in 31,000 people in the UAE…. But scientists not involved in developing and approving the Chinese vaccines are finding it hard to make sense of the data behind the latest announcements…. Neither the UAE, Bahrain nor Sinopharm have released the data used to make the 86 percent efficacy claims.”
 
Meanwhile, Reuters reports, “Brazil’s health regulator Anvisa said on Monday China’s health authorities are not transparent in their authorization of COVID-19 vaccines for emergency use, a statement that may further inflame political tension in the South American country. ‘The vaccine has had an emergency use authorization in China since June of this year. The Chinese criteria for granting emergency use authorization are not transparent, and there is no available information about the criteria currently in use by Chinese authorities to make these decisions.’”
 

Building Trust in Vaccines

 
One of the next big hurdles in vaccine deployment in the US is building trust in vaccines, especially in communities where there is long held distrust of the medical establishment and/or the US government. That’s one reason there was so much media coverage of healthcare workers getting the vaccine this week. The New York Times reports on the first person in the US to be vaccinated with an approved vaccine: Sandra Lindsay, the director of critical care nursing in a Queens hospital, “said she wanted to lead by example—particularly as a Black woman who understands the legacy of unequal and racist medical treatment and experimentation on people of color.” Ms. Lindsay said, “That was the goal today. Not to be the first one to take the vaccine, but to inspire people who look like me, who are skeptical in general about taking vaccines…. It is rooted in science, I trust science, and the alternative and what I have seen and experienced is far worse. So, it’s important that everyone pulls together to take the vaccine, not only to protect themselves but also to protect everyone they will come into contact with.”
 
A commentary in The Atlantic argues “To succeed in vaccinating the population against COVID-19, the United States must draw on the resources we already have: a population that generally supports vaccination and networks of trust that connect health-care professionals with their patients and people with their communities… deploying a COVID-19 vaccine successfully will not be easy, the history of public health suggests that it is possible. Reductions in vaccine-preventable disease are one of the great achievements in human history. Stopping COVID-19 could be our next great accomplishment if we can build and maintain public faith in vaccines while limiting the politicization and misinformation that afflict so many other topics in our lives."
 
A Kaiser Family Foundation survey  found “an increase in the share of the public saying they would definitely or probably get a vaccine for COVID-19 if it was determined to be safe by scientists and available for free to everyone who wanted it. This share now stands at 71 percent, up from 63 percent in a September survey… About a quarter (27 percent) of the public remains vaccine hesitant, saying they probably or definitely would not get a COVID-19 vaccine even if it were available for free and deemed safe by scientists. Vaccine hesitancy is highest among Republicans (42 percent), those ages 30-49 (36 percent), and rural residents (35 percent). Importantly, 35 percent of Black adults (a group that has borne a disproportionate burden of the pandemic) say they definitely or probably would not get vaccinated, as do one third of those who say they have been deemed essential workers (33 percent) and three in ten (29 percent) of those who work in a health care delivery setting.”
 
POLITICO reports, “President-elect Joe Biden and Vice President Mike Pence intend to get the COVID-19 vaccine in the near future. Biden plans to get the vaccine in public as early as next week, a transition official confirmed to POLITICO on Wednesday. Pence will get his vaccine publicly at the White House on Friday to "promote the safety and efficacy of the vaccine and build confidence among the American people," his office announced. Pence will be joined by second lady Karen Pence and Surgeon General Jerome Adams, who will also both get vaccinated.”
 
Thompson Reuters Foundation reports on health worker Sherry Bangura, an Ebola survivor, who works to share accurate information in communities in Sierra Leone. He says, “Ebola survivors have a responsibility to step up and play a role in getting the COVID-19 vaccine to communities. We are the people to encourage others to take the vaccine. People don't easily trust the medical system. You have to do serious engagement with communities and training. There is a lot of misinformation and misconception about the vaccine. People are afraid and are confused about vaccines. I have been to almost every corner of my local district. I'm well-known in the community. People have trust and confidence in what I say.”
 
POZ reports, “Many people living with HIV are wondering whether the vaccines are appropriate for them and where they will end up in the queue. Reassuringly, current evidence indicates that vaccination is safe for this population, and advocates are asking that HIV-positive people be considered a priority group.” Dr. Monica Gandhi is quoted: “There is no reason to believe that people with HIV should not get the vaccine. It is not a live vaccine, and it is safe and efficacious across diverse groups. I will be encouraging my patients with HIV, especially those on antiretroviral therapy, to get the vaccine. I totally recommend it.”
 
Africa CDC reports “A survey conducted by the Africa Centres for Disease Control and Prevention (Africa CDC), in partnership with the London School of Hygiene & Tropical Medicine (LSHTM) has shown that a predominant majority (79 percent average) of respondents in Africa would take a COVID-19 vaccine if it were deemed safe and effective…. Prior to the COVID-19 pandemic, there has been a global decline in vaccine acceptability and uptake because of doubts about efficacy and safety and the spread of misinformation about vaccines. The pandemic has further exacerbated controversies around vaccines as a preventive measure against infectious diseases.”
 

COVID Disrupted Science

 
In a long think piece in The Atlantic, Ed Yong looks at the scientific pivot that COVID has caused. “Thousands of researchers dropped whatever intellectual puzzles had previously consumed their curiosity and began working on the pandemic instead. In mere months, science became thoroughly COVID-ized. As of this writing, the biomedical library PubMed lists more than 74,000 COVID-related scientific papers—more than twice as many as there are about polio, measles, cholera, dengue, or other diseases that have plagued humanity for centuries.” Yong lays out the good and bad in this pivot to COVID and concludes, “The scientific community spent the pre-pandemic years designing faster ways of doing experiments, sharing data, and developing vaccines, allowing it to mobilize quickly when COVID‑19 emerged. Its goal now should be to address its many lingering weaknesses. Warped incentives, wasteful practices, overconfidence, inequality, a biomedical bias—COVID‑19 has exposed them all. And in doing so, it offers the world of science a chance to practice one of its most important qualities: self-correction.”
 
Nature reports “The COVID-19 pandemic disrupted science in 2020—and transformed research publishing, show data collated and analysed by Nature. Around 4 percent of the world’s research output was devoted to the coronavirus in 2020, according to one database. But 2020 also saw a sharp increase in articles on all subjects being submitted to scientific journals—perhaps because many researchers had to stay at home and focus on writing up papers rather than conducting science…. More than 30,000 of the COVID-19 articles published in 2020 were preprints—between 17 percent and 30 percent of total COVID-19 research papers (depending on database searched). And, according to Dimensions, one-tenth of all preprints this year were about COVID-19.”
 
POZ looks at why a COVID vaccine could be developed so quickly when a HIV or cancer vaccine has not yet been developed and seeks to respond to misleading social media posts about the timing of vaccine development. “In short, each of these illnesses has its own unique challenges and cannot be compared against one another…. One reason scientists struggle to develop a vaccine for HIV is that the virus mutates rapidly and can evade treatment by hiding out in cells—other viruses are not this sneaky.”
 
Science asks if messenger RNA can also be used to treat diseases, reporting “long before the pandemic, mRNA tantalized pharma, promising a simple and flexible way to deliver both vaccines and drugs. One mRNA sequence might mend a damaged heart by producing a protein that stimulates blood vessel growth. Another might encode a missing enzyme to reverse a rare genetic disease. Now, the vaccine wins have created a ‘tsunami’ of enthusiasm around the concept, says pharmaceutical scientist Gaurav Sahay of Oregon State University, Corvallis…. But mRNA medicines—especially those that replace beneficial proteins for chronic disease—have a tougher road to the clinic than vaccines. These drugs face the challenges of targeting mRNA to specific tissues and giving strong, lasting benefits without excessive side effects. Few have made it to clinical trials.”
 
Quartz looks at whether the pace of the COVID vaccine development might affect other timelines, noting “After the COVID-19 vaccine’s extraordinarily rapid development, it may be hard for the public to go back to waiting years for a new vaccine. Yet that is likely what will happen, even when dealing with pathogens that are, like COVID-19, not especially complex.” But the unprecedented collaboration around a COVID vaccine is likely to spread to other projects. The article quotes Lynda Stuart of the Gates Foundation, who says “Many people are looking for the next thing that will allow them to collaborate and work in that way. And it’s very, very different from the way they have worked before because it wasn’t so competitive…. We have that young energy, mid-career people who are hooked on the type of work and the way of working and so I think it’s going to be an exciting next 10 years for vaccines.” 
 

Politics and the US CDC

 
The New York Times reports on two former Trump political appointees at the US CDC who have “decided to go public with their disillusionment: what went wrong, and what they believe needs to be done as the agency girds for what could be a years long project of rebuilding its credibility externally while easing ill feelings and self-doubt internally.” Kyle McGowan, a former chief of staff told the Times: “Everyone wants to describe the day that the light switch flipped and the CDC was sidelined. It didn’t happen that way. It was more of like a hand grasping something, and it slowly closes, closes, closes, closes until you realize that, middle of the summer, it has a complete grasp on everything at the CDC.” The Times also reports, “Last week, the editor in chief of the CDC’s flagship weekly disease outbreak reports—once considered untouchable—told House Democrats investigating political interference in the agency’s work that she was ordered to destroy an email showing Trump appointees attempting to meddle with their publication.”
 

Politics and Herd Immunity

 
POLITICO reports, “A top Trump appointee repeatedly urged top health officials to adopt a "herd immunity" approach to COVID-19 and allow millions of Americans to be infected by the virus, according to internal emails obtained by a House watchdog and shared with POLITICO…. ‘Infants, kids, teens, young people, young adults, middle aged with no conditions etc. have zero to little risk…so we use them to develop herd…we want them infected…’ Alexander added…. Public health experts have decried calls to deliberately infect younger, healthier Americans with COVID-19, saying that it would unnecessarily put millions of people at risk of long-term complications and even death.”
 
In a New York Times oped, CDC director nominee Dr Rochelle Walensky and colleagues write that “Young adults are dying at historic rates. In research published on Wednesday in the Journal of the American Medical Association, we found that among US adults ages 25 to 44, from March through the end of July, there were almost 12,000 more deaths than were expected based on historical norms. In fact, July appears to have been the deadliest month among this age group in modern American history. Over the past 20 years, an average of 11,000 young American adults died each July. This year that number swelled to over 16,000.” The authors argue, “what we believed before about the relative harmlessness of COVID-19 among younger adults has simply not been borne out by emerging data. In the past, it took us too long to respond to the epidemics of opioids and HIV/AIDS when the young started dying in large numbers. Now that we have similar information about COVID-19, we must immediately address it. We need to amend our messaging and our policies now. Outreach in the coming weeks and months is imperative. We know it can help…. We need to tell young people that they are at risk and that they need to wear masks and make safer choices about social distancing.”
 

Over the Counter Test for the US

 
AP reports the US FDA approved a “rapid coronavirus test, which can be done entirely at home. The announcement by the Food and Drug Administration represents another important—though incremental—step in efforts to expand testing options…. Ellume’s test looks for viral proteins shed by COVID-19, which is different from the gold standard tests that look for the genetic material of the virus. Like other tests that scan for proteins, FDA officials noted that Ellume’s test can deliver a small percentage of false positive and false negative results. People who get a negative result but have coronavirus symptoms should follow up with a health professional, the agency said.”
 

Pregnant People Excluded from Treatment Trials

 
Lancet Global Health has published a review and call to action on inclusion of pregnant women in COVID treatment trials, arguing that “Inclusion of pregnant women in COVID-19 clinical trials would allow evaluation of effective therapies that might improve maternal health, pregnancy, and birth outcomes, and avoid the delay of developing treatment recommendations for pregnant women.” A press release about the review notes “three-quarters of COVID-19 trials reviewed specifically excluded expectant mothers, even though they were investigating medications and vitamins that already have a relatively favourable safety profile during pregnancy, or that are already used in pregnant women.” The authors argue, “Considering the scale of this global epidemic and future epidemics, a public health obligation exists to include pregnant women in treatment and vaccine trials to adequately identify and implement appropriate prevention and care.”
 

Contact Tracing Wins and Losses

 
Nature looks at why so many rich nations have done so poorly at contact tracing—a basic of way of controlling infectious diseases. The article quotes Tolbert Nyenswah, former director of Liberia’s public-health institute who led a successful contact tracing program that helped extinguish Ebola in the country: “By now, what I was expecting is that 100 percent of people coming in contact with COVID-19 would have been traced.” Yet contact tracing programs in the US, UK and other western countries has failed.
 

The Pandemic and Mental Health

 
Vox reports, “It is well documented that the coronavirus pandemic has taken a serious toll on emotional well-being. Rates of depression and anxiety in June were three to four times higher than at the corresponding point in 2019, according to the CDC, and deteriorating mental health outcomes have been similarly observed in nations across the world, among them the UK, India, and China. Rates of suicidal ideation, substance abuse, and alcohol consumption are rising steadily. But the connection is even stronger than you might think in the US: As the number of new cases of the virus fluctuates week to week, our mental health moves in lockstep.
 

Exponential Spread

 
The New York Times reports on a paper from Science that looked at the spread of COVID from the Biogen conference in February in Boston. The number was thought to be 99 initially, but “by the end of October, it was feared that the number had grown as high as 300,000…. The virus strains spread to at least 29 states. They were found in Australia, Sweden and Slovakia. They wended their way from a room packed with biotechnology executives to Boston homeless shelters, where they also spread widely among occupants…. ‘It’s a cautionary tale,’ said Bronwyn MacInnis, a genomic epidemiologist at the Broad Institute of Harvard and MIT ‘When we hear these stories of clusters where 20 or 50 or 100 were affected, that does not account for what happens after.’”
 

Immunity Passports?

 
Bloomberg reports on the many issues that come along with the idea of using so-called immunity passports or proof of vaccination for COVID, reporting that “With no time to waste, governments in the US and the UK are moving ahead with decidedly low-tech solutions such as paper vaccination cards.” The CEO of one airline has said he believes some kind of proof of vaccination will become required for boarding planes. “For now, there’s no international system for verifying that someone has had a jab. The World Health Organization is working on an e-vaccination certificate. But this will take time, because there are myriad issues to sort out. Here’s one: If countries require vaccination for entry—the likely scenario for any future travel—what happens when a Russian citizen lands in London claiming to have been inoculated with the Sputnik V vaccine, which hasn’t been approved in the UK?”
 

A Pandemic Year in Perspective

 
As 2020 comes to an end (finally!) several media outlets are, as usual, looking back over the year for lessons learned and highlights and lowlights.
 
Politifact calls COVID downplaying and denial “the lie of the year,” writing that “Lies infected America in 2020. The very worst were not just damaging, but deadly…. It was a symphony of counter narrative, and Trump was the conductor, if not the composer. The message: The threat to your health was overhyped to hurt the political fortunes of the president.”
 
The Mail & Guardian reports on Google’s “Year in Search, showing some of the most popular searches for the annum. It comes as no surprise that 2020’s overarching ones were COVID-19 related—both serious questions about the virus and lighter ones, such as how to bake sourdough (which beat banana bread it turns out), how to brew pineapple beer, how to do fractions or how to cut hair…. Quite comfortingly, many of us looked for ‘a better future more than we wished to return to the past. How to change the world was searched twice as much as how to go back to normal.’” 
 
In a Nature commentary WHO’s chief scientist Soumya Swaminathan reflects on the efforts of WHO to respond to the new corona virus and looks ahead to what is needed both to address this pandemic and to prepare for others: “As I have sought ways to make good decisions quickly, the lesson that repeats itself is how important it is to have thoughtful plans prepared and in place. The countries that have best protected the lives and livelihoods of their citizens have also demonstrated strong, compassionate leadership, at political and technical levels, and generally have health-care systems that engage local and global communities. These qualities require long-standing investments in people and relationships, as well as in research and development.”
 
Nature picks 10 people who shaped science in 2020 and several are, of course related to COVID-19. They include WHO’s Tedros Adhanom Ghebreyesus, who “says his focus remains on the COVID-19 ‘end game’—ensuring that all countries enjoy the same access to vaccines. As the world enters that stage, and the political headwinds that might ensue, Tedros promises to ‘just put my head down and power through.’” Gonzalo Moratorio is Uruguay’s coronavirus hunter who, with colleagues, “designed a coronavirus test and a national programme for administering it that has helped to keep COVID-19 cases at bay as outbreaks have swept through Latin America—including Uruguay’s closest neighbours, Argentina and Brazil. Uruguay continues to record one of the world’s lowest death tolls—only 87 people by 10 December.” Kathrin Jansen of Pfizer “led a whirlwind, record-setting effort to show that the company’s COVID-19 vaccine was safe and effective in people.” Virologist Zhang Yongzhen, who “agreed to post online the genome of the virus that was causing pneumonia-like illness in Wuhan, China. His sharing showed the world that this was a new coronavirus, and similar to the one that caused the deadly 2003 outbreak of SARS (severe acute respiratory syndrome).” Epidemiologist Li Lanjuan, the architect of the Wuhan lockdown. New Zealand’s Prime Minister Jacinda Ardern, whose science-based decision have kept New Zealand relatively free of COVID. NIAID’s Anthony Fauci, who has offered guidance on the US response to the outbreak, often in conflict with the wishes of President Donald Trump, and he has made time to treat individuals with COVID-19 and HIV in the clinic. ‘Seeing the patient really gives you a different feel for what the disease is,’ says Fauci, who works 18 hours a day, 7 days a week.”
 

The Superhero We Need Now 

 
The Washington Post reports on a new Indian superhero profiled in “Priya’s Mask,” a comic book and a short animated film that aims to combat the spread of COVID and of misinformation. In a story headlined “She is the Brown girl superhero the world needs right now,” the Post looks at how Priya is helping children cope with the fears and loneliness that often comes with the pandemic. Watch the video featuring Priya and her flying tiger here.
 

#PledgetoPause

 
A new series of films from young African filmmakers encourages people to pause and take care before they share information online. See the first of these videos here.
 

Dancing for Joy

 
A video of Boston healthcare workers dancing for joy when the first doses of the Pfizer vaccine arrived went viral for good reason—they can dance and there is reason for joy.