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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
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"Right now, rich countries are hoarding vaccines, poor countries are paying higher prices for them and the central lesson of the HIV epidemic—that if one person is vulnerable, everyone is vulnerable—seems lost.”
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Latest Global Stats
February 19, 2021
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Confirmed Cases
110,439,431
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Recovered
62,221,533
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Deaths
2,444,329
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New COVID diagnoses trended down in much of the US and other parts of the world after peaks that were driven at least in part by holiday travel, but the virus continues to ravage communities around the world, with global deaths attributed to COVID approaching 2.5 million. Vaccines and variants continued to be the major news stories of the week. More vaccines doses were administered in the richest countries while other countries continue to wait for vaccine access. More variants were identified and research continued to determine how well current vaccines will protect against the variants.
If You're in a Hurry
- Listen to Kenyan activists Maurine Murenga and Allan Maleche on NPR discussing how delayed COVID vaccine access mirrors the delays with HIV treatment coming to Africa.
- Find out about new variants discovered in the US from ABC News.
- Read encouraging news from Israel that shows Pfizer’s vaccine is highly effective in community rollout at BBC.
- Listen to an NPR story about how a nurse in Tuskegee, Alabama is helping to allay fears about COVID vaccines.
- Read about the safety profile of COVID vaccines that have been rolled out to millions of people in Nature.
- Read Science on the devastating loss of African healthcare workers to COVID as countries wait for vaccine access.
- Read Contagion Live’s review of what is known about COVID in PLWHIV.
- Read a NEJM perspective on vaccinating children.
More on Variants
This week brought the identification of more variants and more information about how well vaccines could protect against the variants.
One of the biggest concerns with variants is that more people could be reinfected with a new variant. The Washington Post (US) reports, “Israel's Health Ministry says two more Israelis who had recently recovered from the coronavirus were reinfected by the variant first identified in South Africa [B.1.351 or 501Y.V2], bringing the total of such cases to three…. The variants have spurred concerns that vaccination campaigns might not be enough to stem future, potentially more severe waves of infection, and might further delay countries’ plans to lift restrictions on public life.”
The Washington Post (US) reports, “The two coronavirus vaccines developed by Pfizer-BioNTech and Moderna appear to be highly effective against the more transmissible variant of the virus first detected in Britain [B1.1.7], according to newly published studies in the New England Journal of Medicine, in a potential boost for vaccination efforts around the globe. The vaccines, however, showed a decreased ability to neutralize the strain now dominant in South Africa [B.1.351 or 501Y.V2], worrying some researchers and prompting Pfizer and BioNTech to announce they were taking necessary steps to develop a booster shot or updated vaccine. A day after Pfizer’s announcement, a top White House coronavirus adviser said each vaccine developer is planning to update shots to address variants.”
ABC News (US) reports, “Scientists have identified seven new coronavirus variants that have emerged in the United States, according to a study awaiting peer review. All seven variants contained a similar mutation and were found to have emerged as early as July 2020. Scientists say it's not surprising that they're just now identifying new viral variants in the US, but it's too soon to know what, if anything, these variants mean for Americans…. In a paper published Sunday, researchers attempted to ease the confusion by naming the seven newly identified variants after bird species, like Robin and Pelican, akin to the way storms are named. No matter their names, scientists said a growing number of variants are sure to be identified in the US and in parts of the globe where the virus is spreading rapidly.”
Medscape (US) reports US CDC director Rochelle Walensky “walked through a multiagency attack plan for halting the spread of three COVID-19 variants…. Public health leaders are working on a surveillance system to better understand the SARS-CoV-2 variants. That will take ramping up genome sequencing of the SARS-CoV-2 virus and ensuring that sampling is geographically representative…. She said the CDC is partnering with state health labs to obtain about 750 samples every week and is teaming up with commercial labs and academic centers to obtain an interim target of 6000 samples per week. She acknowledged the United States ‘is not where we need to be’ with sequencing but has come a long way since January. At that time, they were sequencing 250 samples every week; they are currently sequencing thousands each week.”
Vaccine Deployment
BBC (UK) reports on data from Israel about efficacy of the Pfizer vaccine outside of a clinical trial (Israel is sharing key data on vaccinated individuals with Pfizer): “More data from Israel's vaccination programme is suggesting the Pfizer jab prevents 94 percent of symptomatic infections. This indicates the vaccine is performing just as well in a larger population as it did in the clinical trials. It is proving highly effective at preventing illness and severe disease among all age groups… Israel's largest health fund Clalit looked at positive tests in 600,000 vaccinated people and the same number of unvaccinated people, matched by age and health status. It found 94 percent fewer infections among the vaccinated group.”
NPR (US) reports, “A lingering mistrust of the medical system makes some Black Americans more hesitant to sign up for COVID-19 vaccines. It has played out in early data that show a stark disparity in whom is getting shots in this country—more than 60 percent going to white people, and less than 6 percent to African Americans. The mistrust is rooted in history, including the infamous US study of syphilis that left Black men in Tuskegee, Ala., to suffer from the disease…. In Tuskegee today, that 20th century tragedy is still very relevant, according to nurse Cheryl Owens, who grew up in the town. She's been talking with friends and elderly relatives who say they're afraid to get the COVID-19 vaccine. ‘So, I asked why?’ she says. ‘And it was like, ‘Well, you remember that Tuskegee syphilis study. That's why.'" To help dispel [continuing concern], Owens penned an op-ed, published in the local newspaper The Tuskegee News, including a photo of her getting a shot of the COVID-19 vaccine.
Bhekisisa (South Africa) looks at how the J&J vaccine was able to begin roll out so quickly in South Africa. “The 80,000 Johnson & Johnson vaccines that arrived in South Africa this week are registered for use within a research setting. This means they can only be used within the context of a research study — so we can’t use some of the jabs for a wider roll-out. Up to 500,000 doses of Johnson & Johnson jabs will arrive in South Africa under this type of registration.… Johnson & Johnson is providing the 500 000 jabs to South Africa for free. We’re using the vaccines in something called an implementation study, which is research that looks at aspects relating to the real-life implementation of medical interventions…. The government has also procured 9-million additional Johnson & Johnson doses for which we will pay and which will arrive later in the year—but these doses will be used for a general vaccine roll-out (so not as part of a study) and will therefore require an entirely different type of registration than the first 500 000 jabs and be subjected to different rules.”
DW (Germany) reports, “Researchers have urged national governments to delay administering the second dose of the BioNTech-Pfizer vaccine after a month, citing "strong data." The researchers, Danuta Skowronski and Gaston De Serres, said there appeared to be very little advantage in administering the dose in the short term. The team said the shot had an efficacy of 92.6 percent after the first dose. Given the shortage of vaccines globally, they said, it would be better to distribute first doses of the vaccine to more people…. ‘Given the current vaccine shortage, postponement of the second dose is a matter of national security that, if ignored, will certainly result in thousands of COVID-19–related hospitalizations and deaths this winter in the United States,’ the authors warned in the New England Journal of Medicine.”
KBC (Kenya) reports, “Kenya joined the list of various African nations that have expressed frustration in gaining access to supplies of COVID-19 vaccines as the global scramble by the world’s richest countries continues. Health CS Mutahi Kagwe said that until today (February 17,) the country is yet to receive the coronavirus AstraZeneca vaccine doses ordered early this year, attributing the long wait to failure by World Health Organization (WHO) to approve other promising vaccines…. According to the health ministry vaccine deployment plan, health care workers and those offering essential services were among 1.25 million people to be vaccinated in phase one drive that was to kick off between the end of this month and June this year.”
Nature (UK) looks at the safety of COVID vaccines now that millions of people have received shots. “There is no question that the current vaccines are effective and safe. The risk of severe reaction to a COVID-19 jab, say researchers, is outweighed by the protection it offers against the deadly coronavirus.” For the two mRNA vaccines, “a significant portion of people experience non-serious reactions, such as injection-site pain, headache and fatigue….” According to one specialist, “At least for the mRNA vaccines, physicians are seeing more side effects than for flu shots…. The mRNA COVID-19 vaccines generate a particularly strong immune response that increases the risk of side effects, although this also means that the vaccines are working…. Although some have questioned whether the vaccines have led to deaths, none have been directly attributed to a COVID-19 jab.”
The Herald (Zimbabwe) reports, “The Government plans to vaccinate 10 million people against the COVID-19 virus for free, as the health system battles to reduce the threat of the global pandemic. Zimbabwe is expected to receive vaccines donated by The People's Republic of China next week, while negotiations are ongoing with Russia for procurement of their Sputnik V. India has also promised to donate some vaccines and the country is also joining the African Union (AU) vaccination programme.
Vaccine Equity
Access to COVID-19 vaccines continues to be inequitable, with citizens of rich countries making up the bulk of those with access to vaccines. A vaccination campaign began this week in South Africa and a few other countries moved closer to having at least limited vaccine access.
Science (US) reports that African healthcare workers are dying from COVID in part because African countries aren’t getting access to vaccines. “Countries in Europe, Asia, and the Americas have administered more than 175 million shots to protect people against COVID-19 since December 2020, with most countries giving priority to medical workers. But not a single country in sub-Saharan Africa has started immunizations—South Africa will be the first, this week—leaving health care workers dying in places where they are scarce to begin with…. The exact toll of COVID-19 among health workers is hard to gauge, but [Zimbabwean doctor James] Hakim was one of several prominent doctors to succumb in recent weeks in Africa, which has suffered a second pandemic wave…. The equity gap could soon extend to COVID-19 therapeutics, as well. The first drug convincingly shown to cut the death rate from the virus, a steroid named dexamethasone, is cheap and used around the world; Hakim received it before he died. But tocilizumab, shown to further reduce mortality in a UK study released on 11 February, is an antibody that’s about 100 times more expensive than dexamethasone and not widely available. ‘The [pandemic’s] second wave, and potentially the third, is fought with a combination of public health measures and biomedical interventions, and that will increase the inequities,’ [Africa CDC’s] Nkengasong says.”
The Washington Post (US) reports,” The White House is throwing its support behind a global push to distribute coronavirus vaccines equitably, pledging $4 billion to a multilateral effort the Trump administration spurned. At a Group of Seven meeting of leaders of the world’s largest economies Friday, President Biden will announce an initial $2 billion in funding for GAVI, the Vaccine Alliance, to be used by the COVAX Facility, senior administration officials said in a briefing. The United States will release an additional $2 billion over two years once other donors have made good on their pledges and will use this week’s G-7 summit to rally other countries to do more.”
BBC (UK) reports, French President Emmanuel Macron has called on Europe and the US to urgently send up to 5 percent of their coronavirus vaccine supplies to developing nations. Mr Macron told the Financial Times the failure to share vaccines fairly would entrench global inequality. The vast majority of vaccinations have been administered by high-income countries so far. Mr Macron proposed his plan to address the imbalance ahead of a G7 virtual summit of world leaders on Friday.
SABC (South Africa) reports, “In an analysis of current supply deals for COVID-19 vaccines, the ONE Campaign said wealthy countries, such as the United States and Britain, should share the excess doses to ‘supercharge’ a fully global response to the pandemic. Rich countries are on course to have over a billion more doses of COVID-19 vaccines than they need, leaving poorer nations scrambling for leftover supplies as the world seeks to curb the coronavirus pandemic, a report by anti-poverty campaigners found on Friday.”
The Washington Post (US) reports “developing nations from North Africa to the Andes [are] counting on China for help. For these customers, the vaccines developed in Chinese laboratories and now being distributed globally could hold the solution to a massive problem: how to inoculate their populations after bigger and richer nations have pushed them to the back of the line for the more reliable vaccines developed in the West…. But the opacity of the Chinese operations and the lack of published clinical data on the vaccines are raising questions about effectiveness and safety—and about the ability of Chinese laboratories to deliver millions of doses in double-quick time. In some countries, complaints over delays are already building.”
NPR (US) reports, “Millions of Americans have already received their coronavirus vaccines, but poor countries in sub-Saharan Africa have managed to administer only a handful. The disparity is bringing back memories of the AIDS epidemic, when hundreds of thousands of Africans died because lifesaving drugs were delayed,” interviewing Kenyan activist Maurine Murenga: “Murenga says, as the coronavirus spread, she thought the West would have learned from the HIV experience, but… ‘As usual, we are waiting for them to finish vaccinating their people so that they can now bring aid to the people of Africa.’…Allan Maleche, who advocates for the legal rights of Kenyans with HIV. He says right now, rich countries are hoarding vaccines, poor countries are paying higher prices for them and the central lesson of the HIV epidemic—that if one person is vulnerable, everyone is vulnerable—seems lost.”
HIV and COVID
Contagion Live (US) looks at what is known about COVID among people living with HIV, noting that “Although there is still much to learn, some preliminary conclusions can now be made based on the accumulated global experience to date. The authors look at the data on “4 key questions: 1) Are PWH at increased risk for SARS-CoV-2 infection; 2) Are they at higher risk for hospitalization after diagnosis; 3) Is HIV status or degree of HIV-related immune deficiency a risk for severe outcomes; and 4) Do antiretrovirals used for HIV have activity against SARS-CoV-2…. From the extensive global experience reported to date, risk for severe COVID-19 is largely driven by age and non-HIV comorbidities, similar to what is seen for people without HIV. However, those with CD4 cell counts under 200 may be at elevated risk for worse outcomes. Infection risk is driven by similar social determinants of health that define risk for HIV infection. Study findings have inconsistently shown increased rates of hospitalization, but this is more likely due to a lower threshold for admission for PWH. There is no evidence for clinically meaningful activity of any HIV antiretrovirals against SARS-CoV-2. One area of possible significant impact on PWH, but with too little data to date, concerns the effects of pandemic-related care disruption on HIV outcomes.”
GMA (US) looks at how activists pushed for PLWHIV to be a part of COVID vaccine trials: Activists led by Lynda Dee, executive director of AIDS Action Baltimore, sent a letter to the National Institutes of Health arguing there was "no clinical justification" for excluding the HIV-positive population, and that people of diverse backgrounds—including Black and Latino Americans more likely to be affected by HIV—should be included in the trials. On Aug 5—about a week after the letter was posted—Moderna announced plans to drop the exclusion, saying the company had ‘heard the preference of the community.’ Pfizer also amended its protocol to include people living with HIV.”
UK Challenge Study Starting
BBC (UK) reports, “Healthy, young volunteers will be infected with coronavirus to test vaccines and treatments in the world's first COVID-19 "human challenge" study, which will take place in the UK. The study, which has received ethics approval, will start in the next few weeks and recruit 90 people aged 18-30. They will be exposed to the virus in a safe and controlled environment while medics monitor their health… The Human Challenge study is being delivered by a partnership between the UK government's Vaccines Taskforce, Imperial College London, the Royal Free London NHS Foundation Trust and the company hVIVO, which has pioneered viral human challenge models.”
COVID Cuts US Life Expectancy
PBS Newshour (US) reports, “In the first six months of 2020, life expectancy in the United States dropped by a full year, according to new federal data. Released Thursday, these latest figures offer a staggering glimpse at the cost of the first surge of the COVID-19 pandemic, said Elizabeth Arias, a demographer with the National Center for Health Statistics who served as the report’s lead author….” The data also highlight racial disparities tied to COVID: “while the life expectancy of a white man dipped by eight-tenths of a year during the first six months of 2020, three years were shaved off the life of a Black man.” AP reports, “Minorities suffered the biggest impact, with Black Americans losing nearly three years and Hispanics, nearly two years… ‘This is a huge decline,’ said Robert Anderson, who oversees the numbers for the CDC. ‘You have to go back to World War II, the 1940s, to find a decline like this.’”
COVID and Excess Deaths
Epidemiologist and Health Economist Eric Feigl-Ding tweets several graphics and information about “excess deaths” during the pandemic, writing “EXCESS deaths soaring in many countries faster than official #COVID19 deaths…. Besides US with big population, Russia and Mexico and South Africa definitely have large excesses.”
COVID and Pregnancy
CIDRAP (US) reports Pregnant women in Washington state were infected with COVID-19 at a 70 percent higher rate than others of similar ages, with nonwhite women shouldering a disproportionate burden, according to a study published yesterday in the American Journal of Obstetrics & Gynecology…. “Pregnant women were not protected from COVID-19 in the early months of the pandemic with the greatest burden of infections occurring in nearly all racial/ethnic minority groups," the authors wrote. "This data coupled with a broader recognition that pregnancy is a risk factor for severe illness and maternal mortality strongly suggests that pregnant people should be broadly prioritized for COVID-19 vaccine allocation in the US similar to some states.’"
CBS News (US) reports, “Pfizer and BioNTech say the first US participants have been given shots in a large-scale clinical trial to assess the safety and efficacy of their COVID-19 vaccine for pregnant women. The companies are aiming to enroll some 4,000 pregnant women in the trial around the world…. The companies estimate this trial will wrap up by January 2023. Moderna, maker of the only other COVID-19 vaccine to receive emergency use authorization so far in the United States, has launched a registry to track pregnant women receiving the shot.”
Vaccinating Children
A NEJM (US) perspective looks at vaccinating children against COVID. “Since nearly a quarter of the US population is under 18 years old—and the percentage is significantly higher in many other countries—effective herd immunity will require pediatric vaccination. Vaccinating children is likely to have benefits both direct (protecting children against rare severe pediatric cases of COVID-19 and postinfectious conditions such as multisystem inflammatory syndrome in children [MIS-C]) and indirect (protecting others by reducing spread). Those ‘indirect’ benefits also reduce the family toll of parental illness, failing economies, and chronic stress. So, we need to think creatively and empathically about what motivates parents to accept vaccination for their offspring…. We must minimize children’s risk, maximize their chances of returning to school, and mitigate the pandemic’s effects on their families. Measles and measles vaccination campaigns may offer relevant insights about parents’ decisions regarding vaccinating children they don’t believe are at serious risk; about trust, access, and equity; about using education campaigns and vaccination mandates to advance public health goals; and about how targeted disinformation about a safe and effective vaccine can endanger public health.”
The New York Times (US) reports on teens volunteering for vaccine trials, noting that “teenagers are harder than adults to enroll and keep in clinical trials. They are difficult to wrangle and not so great with compliance, which includes keeping a symptom diary and keeping appointments, as many as six a year, that include blood draws (for some, an instant deal breaker). To reach students, some researchers have tapped school connections, local pediatricians and social media campaigns. While waiting for appointments in the vaccine research clinics, some teenagers, ignoring advice to keep their vaccine volunteering off of social media, have posted TikTok videos, which have inspired friends to sign up.”
Call for More Guidance on Airborne Transmission
The New York Times (US) reports a group of experts are calling on the US CDC to provide more guidance to help “limit airborne transmission of the virus in high-risk settings like meatpacking plants and prisons…. In a letter to the administration, scientists detailed evidence supporting airborne transmission of the virus. It has become even more urgent for the administration to take action now, the experts said, because of the slow vaccine rollout, the threat of more contagious variants of the virus already circulating in the United States, and the high rate of infections and deaths, despite a recent drop in cases.”
Can Rapid Testing Help?
Nature (UK) looks at the debate among scientists about whether or not deploying millions of rapid tests will help control the pandemic. “These speedy tests, which typically mix nasal or throat swabs with liquid on a paper strip to return results within half an hour, are thought of as tests of infectiousness, not of infection. They can detect only high viral loads, so they will miss many people with lower levels of the SARS-CoV-2 virus. But the hope is that they will help to curb the pandemic by quickly identifying the most contagious people, who might otherwise unknowingly pass on the virus.” Yet some scientists are critical of plans to roll these tests out. “It’s hard to get reliable information on rapid tests because—at least in Europe—the products can be sold solely on the basis of manufacturer data, without independent evaluation. There are no standard protocols for measuring performance, making it hard to compare assays and forcing each country to do its own validation.”
Superspreaders of Conspiracy
Al Jazeera (Qatar) reports “The Associated Press collaborated with the Atlantic Council’s Digital Forensic Research Lab on a nine-month investigation to identify the people and organisations behind some of the most viral misinformation about the origins of the coronavirus. Their claims were explosive. Their evidence was weak. These are the superspreaders.” They range from lawyers and economists to leaders of “think tanks” and websites and include HIV co-discoverer Luc Montagnier, who “claimed the coronavirus did not originate in nature and was manipulated. Montagnier said in the process of making the vaccine for AIDS, someone took the genetic material and added it to the coronavirus.” Iranian Supreme Leader Ali Khamenei claimed the virus “might be the product of an American biological attack.”
Vaccine Emoji
BBC (UK) reports, “Apple is changing its syringe emoji to remove the dripping blood, as it becomes widely used to talk about the COVID-19 vaccine…. Emojipedia said that while the syringe was once associated with blood donation, it saw a noticeable shift to it being used for vaccinations, alongside other emoji such as a face mask or a microbe.”
I'm Gonna Fauci You!
According to Mashable (US), “As if modern dating wasn't exhausting enough, now singles worry about "Fauci-ing" someone....The term "Fauci-ing" was coined by dating site Plenty of Fish, and supposedly involves cutting someone off for not taking social distancing measures seriously enough. The phrase was added to Urban Dictionary in November 2020…. When Axios editor Margaret Talev asked Fauci about the term, he was unfamiliar with it. Fauci got a laugh out of it, exclaiming, ‘I'm gonna Fauci you!’"
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