COVID has now touched every continent on the globe. BBC reports, “The Chilean army has reported 36 cases at its Bernardo O'Higgins research station on the Antarctic Peninsula. The 36, 26 of whom are military personnel and 10 maintenance workers, have been evacuated to Chile…. The news means that COVID cases have now been recorded on all seven continents.” The Americas remain the hardest hit, but cases are rising around the world. NPR reports, “COVID-19 has become the leading cause of death in five Latin American nations and the second most common cause in six others. The World Health Organization's "Americas Region," which stretches from the Canadian Arctic to Cape Horn in Chile, has been hit harder by the pandemic than any other part of the globe. The region currently accounts for 48 percent of the 1.65 million COVID-19 deaths reported to WHO so far worldwide.”
 
US President-elect Joe Biden said in an address to the nation that “Our darkest days in the battle against COVID are ahead of us, not behind us,” according to CNN. But Biden also pledged more economic help for Americans and more support for rolling out vaccines and other health support. Vaccines continue to be hailed as the light at the end of the tunnel and as FiercePharma reports more interventions are on the horizon for 2021: “drugmakers are hard at work bolstering the defenses mounted in 2020—and they're looking at new formulations and delivery methods to bring vaccines and therapies to more people around the world.“ These may include one dose vaccines, oral vaccine and ones that don’t require cold chains as well as treatments that target the site where the disease hits hardest, including a nasal spray antibody.
 

If You Are in a Hurry

• Read a commentary in The Atlantic about what we all need to understand and do to counter vaccine misinformation.
• Listen to an NPR interview on race and the roots of vaccine skepticism with ethicist Harriet Washington, author of Medical Apartheid.
• Check out STAT’s memorable photos from 2020 that show the effect of COVID, racism and other issues on healthcare.
• Read Lifehacker’s roundup of vaccine rumors and the corresponding truths.
• Get the scoop on vaccine side effects in The Atlantic.
• Read Science on the issues around access to vaccines to trial placebo recipients.
• Find out if Santa had a vaccine at CNN.

 

Mutations Raise Concern

 
Vaccine were knocked out of the top headlines this week by concerns over mutated stains of the virus in the UK and South Africa. Health Policy Watch reports “In the past few days, there have been reports of new variants of the COVID-19 virus in South Africa and the UK, particularly around London. While these variants have developed independently of each other, they are both similar in that they appear to be more transmissible. WHO has reported that the UK’s new variant’s transmissibility is up an estimated increase of between 40 percent and 70 percent. Even so, WHO officials have stressed that there was no evidence that these variants would result in more severe illness or have an impact on vaccine efficacy….”
 
Vox has a nice explainer about these mutations (and viral mutations in general) and what they may mean, but underscores a key message: “The good news is that we already know how to respond to these new variants: in the same way we’ve been responding to the pandemic overall. The virus still transmits primarily through viral-laden breaths in the air. Mask-wearing, social distancing, and good indoor ventilation are as critical as ever.”
 
NIAID’s Fauci told PBS “[RNA] viruses tend to mutate a lot. Most of the mutations have no function or relevance. This one has a suggestion that it might allow the virus to spread more readily. We're still seeking out evidence to prove or disapprove that. But let's make an assumption that it is, in fact, making the virus more transmissible, even though it hasn't been proven yet. It doesn't seem at all to have any impact on the virulence or what we call the deadliness of the virus. It doesn't make people more sick. And it doesn't seem to have any impact on the protective nature of the vaccines that we're currently using. So, it's something you take seriously, you keep your eye out on it, and you do tests to determine if there is more functional relevance than we seem to believe that there is.”
 
CNN reports “Pfizer and Moderna are testing their coronavirus vaccines to see if they work against the mutated version of the virus found in the United Kingdom and other countries, the companies said….’ We expect that the Moderna vaccine-induced immunity would be protective against the variants recently described in the UK; we will be performing additional tests in the coming weeks,’ Moderna said. Pfizer is ‘generating data,’ it said, on how well blood samples from immunized people ‘may be able to neutralize the new strain.’”
 

Vaccine Rollout

 
Vaccines continue to be rolled out in a small number of countries. The EU approved the Pfizer-BioNTech vaccine this week. The New York Times reports the approval sets “off a logistical marathon the likes of which most of the authorities in the region have not had to contend with before.” Vaccinations are expected to begin December 27^th. European regulators will consider the Moderna vaccine in early January.
 
In the US, vaccinations of frontline healthcare workers continued. In a widely covered livestreamed event Dr. Anthony Fauci and other officials were vaccinated with the Moderna vaccine. AS AFP reports, “The widely-respected scientist rolled up his left shirt sleeve, and said he was taking the shot ‘as a symbol to the rest of the country that I feel extreme confidence in the safety and the efficacy of this vaccine. I want to encourage everyone who has the opportunity to get vaccinated so that we could have a veil of protection over this country, that would end this pandemic.’”
 
But there were problems with the rollout as ProPublica reports, “Stanford Medicine residents who work in close contact with COVID-19 patients were left out of the first wave of staff members for the new Pfizer vaccine. In their place were higher-ranking doctors who carry a lower risk of patient transmission…. An algorithm chose who would be the first 5,000 in line. The residents said they were told they were at a disadvantage because they did not have an assigned “location” to plug into the calculation and because they are young….”
 
AP reports in the US, “a federal advisory panel recommended Sunday that people 75 and older and essential workers like firefighters, teachers and grocery store workers should be next in line for COVID-19 shots….” Read the full recommendations here.
 
The Guardian reports that in the UK, “Women’s rights and breastfeeding organisations are challenging government and NHS guidance that the groups say forces mothers to choose between feeding their infants in the way that they choose and protecting themselves from COVID by being vaccinated. The NHS website advises lactating mothers to wait until they have stopped breastfeeding before having the COVID-19 vaccine. It adds: ‘There’s no evidence it’s unsafe if you’re pregnant or breastfeeding. But more evidence is needed before you can be offered the vaccine.’”
 
The Scientist Collective looks at vaccines through a South African lens in The Daily Maverick, noting that vaccines have been found safe and effective, but their availability for South Africans is not certain. “At this time, there is a lack of information from the government on detailed plans to procure and distribute COVID-19 vaccines. The development of a safe and effective vaccine is only the first step. The trial results are better than we dared hope for (so far), but that is only the first step in what is a massive project, possibly greater than anything the country has attempted before. The scale rivals that of the preparations for the FIFA World Cup of 2010 and the rollout of ARVs for HIV-positive people. But our experience and the know-how we developed there should stand us in good stead. We are concerned that there is insufficient planning by the government thus far, considering the magnitude of the project ahead and an inadequate sense of urgency regarding the vaccination project….”
 
The Washington Post reports “Officials at the National Institutes of Health are rushing to devise a study to find out why, in a few rare cases, people have had severe allergic reactions to the Pfizer coronavirus vaccine…. This is a challenging task for researchers, who hope to get an answer within a matter of weeks. The study will recruit volunteers who have had a history of severe allergic reactions and who will receive the vaccine under close clinical supervision….”
 
The Atlantic looks at the side effects of the vaccines. “For a fraction of people, getting these first COVID-19 vaccines could be unpleasant—more than the usual unpleasantness of getting a shot. They might make you feel sick for a day or two, even though they contain no whole viruses to actually infect you. Both the Pfizer/BioNTech and Moderna vaccines are quite ‘reactogenic’—meaning they stimulate a strong immune response that can cause temporary but uncomfortable sore arms, fevers, chills, and headaches. In other words, getting them might suck a little, but it’s nowhere near as bad as COVID-19 itself.”
 
Science asks now that EUAs have been issued for some vaccines, “a theoretical debate that has simmered for months has become a pressing reality: Should ongoing vaccine efficacy studies inform their tens of thousands of volunteers whether they were injected with a placebo or the vaccine, and also offer an already authorized vaccine to those who got the placebo?... At the heart of the dilemma is a balancing act. On the one hand, unblinding a vaccine efficacy trial compromises the ability to gather robust scientific data on important issues, such as how long a vaccine protects a person against COVID-19. On the other, withholding a working vaccine from a trial participant who could get it elsewhere is ethically dicey.”
 
STAT warns of the danger of “vaccine euphoria,” quoting Global Fund head Peter Sands: “We get so kind of blinded by vaccine euphoria—the light at the end of the tunnel—that we underestimate how long that tunnel is, and how dangerous that tunnel is.”
 

Vaccine Trust/Hesitancy

 
A commentary in The Atlantic notes “The misleading claims Americans will soon hear about the newly released COVID-19 vaccines are nearly identical to claims made about smallpox immunizations 120 years ago: The ingredients are toxic and unnatural; the vaccines are insufficiently tested; the scientists who produce them are quacks and profiteers; the cell cultures involved in some shots are an affront to the religious; the authorities working to protect public health are guilty of tyrannical overreach… Today’s anti-vaccine activists, however, enjoy a speed, scale, and reach far greater….” The author, Renée DiResta of the Stanford Internet Observatory, argues that a “whole-of-society approach” is needed to counter the misinformation, including transparent communication from officials and involvement of trusted influencers in communities. “And finally: All Americans have to be cognizant of what we share. Each of us has remarkable power to amplify content. That comes with a commensurate responsibility that most users haven’t yet fully internalized.”
 
AP reports, “The Vatican on Monday declared that it is ‘morally acceptable’ for Roman Catholics to receive COVID-19 vaccines based on research that used cells derived from aborted fetuses, guidance that came after some churchmen in the United States argued that such products were immoral.” PBS reports on concerns from some Muslims and orthodox Jews about the use of pork gelatin in COVID vaccines. “Spokespeople for Pfizer, Moderna and AstraZeneca have said that pork products are not part of their COVID-19 vaccines. But limited supply and preexisting deals worth millions of dollars with other companies means that some countries with large Muslim populations, such as Indonesia, will receive vaccines that have not yet been certified to be gelatin-free.” While the majority consensus in both religions from past debates allows for use of vaccines with pork products, there are still concerns in many communities. Dr. Salman Waqar, general secretary of the British Islamic Medical Association says, “The more [vaccine companies] are transparent, the more they are open and honest about their product, the more likely it is that there are communities that have confidence in the product and will be able to have informed discussions about what it is they want to do.”
 
Media Matters looks at how media outlets reported on adverse reactions to vaccines, noting that “The public has a right to know about problems with the vaccine rollout, and journalists have a responsibility to take extra care to not induce unwarranted panic…. While mainstream outlets may have published headlines that are inadvertently alarming, right-wing media organizations lean heavily into the chaos,” with headlines that were alarmist.
 
NPR reports race and the roots of vaccine skepticism in an interview with ethicist Harriet Washington, author of Medical Apartheid. Washington says, “If you only focus on African American behavior, it sounds like a pathological response by African Americans, when in reality, we've got a health care system that needs to be interrogated as well. We have to look at these two phenomena together in tandem rather than just one group's behavior. But certainly, there's a rich historical basis for the reticence shown by many African Americans. And that—when I say history, I'm referring to last week's history as well as what happened four centuries ago. We've got four centuries of abuse in the medical arena. And we also have—in context with the COVID vaccine determination, we also have very recent history.”
 
Lifehacker has a nice roundup of vaccine rumors and the corresponding truths. “If people in your life are doubting the safety of the vaccine, or still wondering if the coronavirus is a hoax, we have some tips on talking to them here. There are still a lot of unknowns about the vaccine, so just because somebody has doubts or questions does not mean they are an anti-vaxxer.”
 

Nigeria’s Fragile Health System

 
Vanguard reports the national coordinator of the Presidential COVID Task Force “said that the nation’s health system has become fragile and may not withstand the effect of a major outbreak of the pandemic or other infections…. Dr. Aliyu also said that COVID-19 will be in the country for a while and will continue to be deadly, adding that a lot more work needed to be done to enable the country transition back to normal.”
 

Healthcare Workers

 
Medscape reports “Trauma experts at Mount Sinai believe that, globally, up to 40 percent of first responders and healthcare workers—tens of thousands of people—will suffer from PTSD after witnessing the deaths of so many patients who were alone, without family. Mount Sinai has developed “resilience workshops” as part of a program to support healthcare workers. “In formulating the program's platform, Mount Sinai experts drew upon their extensive experience aiding 9/11 responders at the World Trade Center (WTC), as well as their systemwide wellness program that aids demoralized and burned-out physicians. While the reach of the pandemic is much broader than 9/11, experts see some commonalities in conditions that emerge after traumatic events, and they also discovered what can help.”

The Times reports “Western Cape health workers are exhausted by the burden of COVID-19 cases and are experiencing high rates of infection themselves. The province has 761 active infections among health workers, with 68 in hospital and five mortalities in the past fortnight…. It was vital that citizens played their part by wearing masks and staying away from crowds so health-care workers, who are the last line of defence, could be spared.”
 

Monoclonal Antibodies

 
NBC News reports on monoclonal antibodies, “the only therapy authorized by the Food and Drug Administration so far that is meant to prevent patients from being hospitalized in the first place.” There are two granted emergency use authorization in the US, “but many doses sit untouched at health care facilities across the country, with providers reluctant to them…. Some doctors on the front lines of treating COVID-19 patients have actually declined their allotments of the treatment, citing lack of evidence it really works.”
 
A NIH press statement says “Preliminary results of a Phase 3, randomized, placebo-controlled clinical trial testing the investigative monoclonal antibody LY-CoV555 in hospitalized COVID-19 patients were published today in the New England Journal of Medicine. The antibody did not provide clinical benefit compared to placebo.”
 

Memorable Photos of 2020

STAT shares memorable photos from 2020—most, but not all related to COVID. “This year was one that no one could have imagined—2020 has been marked by devastation, by passion, and by change. In a year when getting too close was dangerous, photographers still found ways to tell…stories.”
 

Does My Dog Need a COVID Vaccine?

 
Science asks, “are vaccines for pets and other animals necessary? How will they be developed? And how quickly could they become available?” The journal reports the available evidence, noting that “pet symptoms seem to be mild, if they appear at all. In addition, ‘Cats and dogs don’t play an important role in the maintenance or transmission of the disease to humans,’ says William Karesh, executive vice president for health and policy at EcoHealth Alliance, a nonprofit that tracks emerging diseases in animals. As a result, he says, ‘There’s no need for a vaccine from a public health standpoint.’” Other animals such as mink, ferrets and nonhuman primates may be at greater risk from COVID. Both Russia and a US vaccine company are working on COVCID vaccines for animals, including minks, that could be adapted for domestic pets.
 

Santa Claus Is Vaccinated

 
CNN reports, “Dr. Anthony Fauci [told] Elmo and his friends that he traveled to the North Pole and vaccinated Santa Claus himself so that he can safely deliver presents this Christmas.”