The US government this week committed to buying and distributing through COVAX 500 million doses of the Pfizer vaccine to 100 low- and middle-income countries over the next two years. Reuters (UK) reports the G7 “is expected to pledge 1 billion doses during its three-day summit….”
 
The largest donation to date of vaccines will add much-needed doses for countries where vaccines remain incredibly scarce. AP (US) reports, “In South Africa, which has the continent’s most robust economy and its biggest coronavirus caseload, just 0.8 percent of the population is fully vaccinated…. And hundreds of thousands of the country’s health workers, many of whom come face-to-face with the virus every day, are still waiting for their shots. In Nigeria, Africa’s biggest country with more than 200 million people, only 0.1 percent are fully protected. Kenya, with 50 million people, is even lower. Uganda has recalled doses from rural areas because it doesn’t have nearly enough to fight outbreaks in big cities.” But 500 million doses falls far short of what is needed to end the pandemic. To date only just over six percent of the global population has been fully vaccinated.
 
The G7 are not the only countries donating vaccines. Nature (UK) reports “China has already supplied 350 million doses of the two vaccines to more than 75 nations, and WHO approval should now trigger the further distribution of both vaccines to low-income countries…. China’s current vaccine production rate could potentially make a significant dent in global demand….”
 
Ahead of the G7 meeting this week, Africa CDC’s John Nkengasong said, “I’d like to believe that the G-7 countries, most of them having kept excess doses of vaccines, want to be on the right side of history. Distribute those vaccines. We need to actually see these vaccines, not just...promises and goodwill.”
 

If You Are in a Hurry

• Read an assessment of the US CDC directors first few months in office in the New York Times.
• Read about kids and long COVID in STAT.
• Read Nature’s assessment of what is known and not known about the lab leak theory.
• Understand what’s happening with the Delta variant in STAT.
• Read Ken Mayer on what lessons the HIV response has for COVID STAT.
• Read a Nature editorial on why it’s important to use the new WHO naming format for variants.

 

The Delta Variant

 
Vaccine equity and fairness should be reason enough for rich countries to do all they can to vaccinate the world, but that doesn’t seem to be the case. The other reason to race to vaccinate the world is to stop new and potentially dangerous variants from spreading and breaking through the fence of vaccinations that are bringing cases and deaths down in many rich countries. Reuters (UK) reports, “The Delta coronavirus variant of concern, first identified in India, is believed to be 60 percent more transmissible than the Alpha variant which was previously dominant in Britain, a prominent UK epidemiologist said…. But it was unclear how any spike in hospitalisations would translate into a rise in deaths, as more detail was needed on how well the vaccine protects against serious illness from Delta.”
 
STAT (US) reports the Delta variant “seems to be the most transmissible version of the coronavirus seen thus far, but also carries some ability to get around the body’s immune protection generated after vaccination or an initial infection. (There’s also some evidence that it is more likely to cause severe disease, though researchers are still trying to confirm that.) … Globally, the variant’s march around the world could ignite major epidemics, given vaccine shortages in many nations. In unvaccinated populations, experts generally have greater fears about more transmissible variants than ones that are, say, just deadlier, because by causing more cases than would have occurred otherwise, the faster spreading strains can result in greater hospitalizations and deaths overall. Delta appears to be able to do that and more.”
 

COVID Deaths

 
The Wall Street Journal (US) reports, “More people have died from COVID-19 already this year than in all of 2020, according to official counts, highlighting how the global pandemic is far from over even as vaccines beat back the virus in wealthy nations. It took less than six months for the globe to record more than 1.88 million COVID-19 deaths this year…[the] count for 2021 edged just ahead of the 2020 death toll on Thursday.”
 
ITV (UK) reports, “India on Thursday reported a record 6,148 COVID-19 deaths in the last 24 hours, the highest-ever single-day death toll from the virus across the world since the outbreak of the pandemic. However, the number of new cases had started decreasing and remained fewer than 100,000 daily cases for three straight days.”
 

Africa’s Third Wave

 
Times Live (South Africa) reports “Fourteen African countries are ‘aggressively’ heading into a third wave of COVID-19 infections, and the delta variant, first identified in India, has now been detected in 13 states to date, said Africa CDC director Dr John Nkengasong at his weekly briefing on Thursday…. Nkengasong said: ‘The continent as a whole is moving towards a third wave, there is no doubt about that. This is unfortunate, but it is what you expect in a pandemic. We need to roll out vaccines at speed and scale, that is the only way (to stop the virus).’”
 
Esther Nakkazi reports in Health Policy Watch (Switzerland), “Uganda has imposed more stringent measures to control COVID-19 transmission after it recorded over 1000 new cases per day on 2 June—its highest tally ever, mostly among people aged between 20 and 39 years. On Sunday, President Yoweri Museveni instituted a 42-day lockdown during which time all schools and institutions of higher learning will be closed. Teachers will also have to be fully vaccinated before they are accepted back to the classrooms.”
 
UN News reports, “At 32 million doses, Africa accounts for less than one per cent of the more than 2.1 billion doses administered globally. Just two per cent of the continent’s nearly 1.3 billion people have received one dose, and only 9.4 million Africans are fully vaccinated.” A WHO Afro (DRC) press release  warns, “As COVID-19 cases in Africa rise for the third week running and vaccines are increasingly scarce, 47 of Africa’s 54 countries—nearly 90 percent—are set to miss the September target of vaccinating 10 percent of their people unless Africa receives 225 million more doses.”
 

African Vaccine Trial Stalled

 
Science (US) reports, “The questions are urgent, and the funding is in place. But a highly anticipated, $130 million clinical trial, meant to test the efficacy of the novel messenger RNA (mRNA) vaccines for COVID-19 against a key variant of the pandemic coronavirus as well as in people living with HIV and pregnant women, is stalled. It is ready to launch in eight countries in sub-Saharan Africa, yet neither maker of the vaccines, Pfizer and Moderna, wants to participate—or even provide their vaccines…. The proposed trial would involve 14,000 people in South Africa, Botswana, Zimbabwe, Eswatini, Malawi, Zambia, Uganda, and Kenya, where adult HIV prevalence ranges from 4.5 percent to 27 percent. Half the participants in the study, dubbed CoVPN 3008, would receive the current Moderna vaccine, which contains mRNA that codes for the surface protein, spike, of SARS-CoV-2. The other participants initially would receive placebo shots. But as soon as clear evidence emerged that the current vaccine protects against COVID-19, the placebo group would be offered a new ‘bivalent’ vaccine Moderna has developed. It contains mRNA for the original spike protein as well as mRNA for the slightly mutated version in the Beta variant.”
 

US CDC Meeting on Heart Inflammation

 
CBS News (US) reports the CDC “will convene an 'emergency meeting' of its advisers on June 18th to discuss rare but higher-than-expected reports of heart inflammation following doses of the mRNA-based Pfizer and Moderna COVID-19 vaccines.... The CDC previously disclosed that reports of heart inflammation were detected mostly in younger men and teenage boys following their second dose, and that there was a ‘higher number of observed than expected’ cases in 16- to 24-year-olds. Last month, the CDC urged providers to ‘ask about prior COVID-19 vaccination’ in patients with symptoms of heart inflammation.”
 

Long COVID

 
STAT (US) reports, “No one really knows how common the collection of lingering post-infection symptoms might be in adults; even less is known about its prevalence or course in children and adolescents…. Like long COVID in adults, there is no way now to predict who might be vulnerable to later difficulties. Among children and adolescents, there are varying degrees of impairment in long COVID. To pick just the neurological, the spectrum of troubles spans headache to brain fog to numbness that leaves children unable to walk.”
 
Nature (UK) reports, “long COVID has moved from a curiosity, dismissed by many, to a recognized public-health problem. In January, the World Health Organization revised its guidelines for COVID-19 treatment to include a recommendation that all patients should have access to follow-up care in case of long COVID.”
 

The Lab Leak Theory

 
Nature (UK) looks at what is known and not known about the lab leak theory. “Most scientists say SARS-CoV-2 probably has a natural origin, and was transmitted from an animal to humans. However, a lab leak has not been ruled out, and many are calling for a deeper investigation into the hypothesis that the virus emerged from the Wuhan Institute of Virology (WIV), located in the Chinese city where the first COVID-19 cases were reported….” Nature underscores that most researchers believe the virus evolved naturally, but, “In theory, COVID-19 could have come from a lab in a few ways. Researchers might have collected SARS-CoV-2 from an animal and maintained it in their lab to study, or they might have created it by engineering coronavirus genomes. In these scenarios, a person in the lab might have then been accidentally or deliberately infected by the virus, and then spread it to others—sparking the pandemic. There is currently no clear evidence to back these scenarios, but they aren’t impossible.”
 
A commentary in the Bulletin of the Atomic Scientists (US) argues, “We can state with certainty that human activities including deforestation, wildlife trade and consumption, and intensive animal agriculture increase the risk of deadly pandemics. Preventing the emergence of naturally occurring zoonotic diseases requires a One Health approach that integrates human, animal, plant, environmental, and ecosystem health….” The author looks at systems that need to be put into place to reduce risks of laboratory spillovers resulting from research on pathogens. “We don’t need scientists helping nature to make deadlier pathogens in a misguided effort to improve public health. Transparency, public communication and outreach, laboratory-acquired infection surveillance, public health partnerships, and institutionalized ethics would go a long way toward regaining the public’s trust.”
 

Building Back Trust at US CDC

 
Apoorva Mandavilli in the New York Times (US) looks at US CDC director Rochelle Wolensky’s first few months on the job: “Dr. Walensky’s appointment instantly made her one of the most influential women in the nation, and was greeted with enthusiasm by public health experts and CDC staff members. But that enthusiasm has been tempered by occasional missteps in communications, an aspect of the job that is more important and challenging than it has ever been…. COVID has taken up nearly all of Dr. Walensky’s attention, but she has a long list of ambitious goals for the agency post-pandemic, including modernizing the nation’s public health infrastructure, addressing the health impact of climate change and managing what she called the ‘collateral damage’ of the pandemic.”
 

HIV and COVID

 
Ben Ryan writes in The Guardian (UK), “As Anthony Fauci marks 40 years since HIV emerged, he regrets how the extraordinary disruptions that COVID-19 have wreaked upon society have hampered efforts to tackle the major pandemic that preceded it…. Fauci said he holds out hope that the three HIV vaccines in advanced clinical trials will prove at least 50 percent efficacious, justifying a global rollout. But he now hopes mRNA or other advanced technologies could yield even more powerful HIV vaccines. Then there’s Fauci’s hope of capping his storied career by the time he turns 90, by ending as a public health threat the epidemic that changed his life 40 years ago. ‘I hope that as we get the COVID-19 under control, we can play a bit of catch up with HIV and get the ship righted again. I still think there’s a good chance that we’ll get there.’”
 
Ken Mayer writes in a STAT (US) opinion piece that to succeed in the fight against COVID, we must learn key lessons from the HIV epidemic including: “Science matters…. Discrimination is toxic…. We are all in this together.”
 

Embrace the New Variant Names

 
A Nature (UK) editorial lays out why WHO’s new naming system for variants is important: “The new system is both a more user-friendly alternative and designed to reduce the geographical stigma and discrimination that can come from associating a virus with a place. It’s also important because, when countries are singled out by news organizations that have millions of readers and viewers, governments can become hesitant. They might delay collecting data on coronavirus strains, or announcing new variants, to avoid what they perceive as negative publicity or the risk of being blamed for creating a variant.” The editors note, “more than a week after the WHO’s announcement, some media organizations and prominent people are continuing to identify variants by geographical place names. That needs to end. The letters of the Greek alphabet are well known to international media and policymakers.”