The Delta variant and vaccine apartheid are the key drivers of media coverage this week. And the two stories are intrinsically linked—the more contagious variant is ripping through populations that have low vaccination rates and ensuring that without more widespread vaccine access there is no end in sight to this deadly pandemic.
As Ed Yong writes in
The Atlantic (US), “Few experts guessed that by this point, the world would have not one vaccine but many, with 3 billion doses already delivered. At the same time, the coronavirus has evolved into super-transmissible variants that spread more easily. The clash between these variables will define the coming months and seasons…. Many nations that excelled at protecting their citizens are now facing a triple threat: They controlled COVID-19 so well that they have little natural immunity; they don’t have access to vaccines; and they’re besieged by Delta.
If You Are in a Hurry
- Read the compelling story of an emergency room doc in Philadelphia trying to get more people to accept vaccinations in the Washington Post.
- Read about a novel idea from two researchers to prevent future coronavirus pandemics by rewriting the DNA of bats in STAT.
- Read about the pandemics impact on prenatal care in Malawi in AP.
- Read Nature on how reseachers found a corelate of protection for the Oxford-AstraZeneca vaccine.
- Read about a report from First Draft News that looks at the origins of vaccine disinformation in West Africa.
- Read about COVID’s impact on HIV care in POZ.
- Read Ifeanyi Nsofor about a new kind og vaccine nationalism that is keeping vaccinated people out of Europe on the Goats and Soda blog.
- Read Nature on the lingering impact of the pandemic on clinical trials.
- Spend some time with pandemic haikus written by scientists in Science.
Africa’s Third Wave
The Economist (UK) reports, “’The latest surge threatens to be Africa’s worst yet,’ says Matshidiso Moeti, the head of the World Health Organisation (WHO) in Africa. Cases are rising especially quickly in 12 countries, she says, though ‘health systems are already pushed to breaking point’ in many more. In Namibia, Uganda and Zambia, among other places, oxygen is running out and hospital beds are full. The WHO calculates that, within weeks, the Africa-wide caseload of the third wave will surpass the peak of the second, which in turn was higher than the peak of the first…. In rich countries COVID-19 was seen as a once-in-a-lifetime event to be endured until vaccines arrived; in many African ones it is another burden among many, with no sign of relief.”
VOA (US) reports, “For the first time in more than a year, Tanzania has released figures on coronavirus, confirming 100 cases since a third wave of infections began. President Samia Hassan says Tanzania has budgeted $470 million to buy COVID-19 vaccine. The actions mark a sharp turn from Hassan’s predecessor, the late John Magufuli.”
The Star (Kenya) reports, “Experts have warned Kenya is likely to experience a fourth COVID-19 wave from mid-July fuelled by the highly infectious Delta variant. The highly transmissible variant first detected in India is now gaining dominance over the Alpha variant in the country and is said to have fuelled the third wave, especially in the Western and Nyanza regions.”
What about Delta Plus?
Several news outlets have reported on the emergence of a Delta Plus variant—further mutations of the highly transmissible Delta variant. CBS News (US) reports, “Concern that the so-called Delta Plus variant—a mutation of the
now-widespread Delta strain first detected in India—could be more infectious and cause more significant health problems than other variants prompted Indian officials this week to label it a ‘variant of concern.’ But while the variant's fast spread, and India's painful experience with the original Delta strain, have raised alarm in the vast nation, epidemiologists there and abroad say much more data is needed before broader cautions are issued around the world about Delta Plus.”
BBC News (UK) reports, “leading virologists have questioned the labelling of Delta plus as a variant of concern, saying there was no data yet to prove that the variant was more infectious or led to more severe disease compared to other variants.”
Delta and Masks and Vaccines
While the US and some other countries are relaxing mask mandates as more people are vaccinated, concern about the Delta variant has led the WHO and other health bodies (but not the US CDC) to reiterate the recommendation that even vaccinated people continue to mask. The
New York Times (US) reports, “with a new variant of the coronavirus rapidly spreading across the globe,
masks are again the focus of conflicting views, and fears, about the course of pandemic and the restrictions required to manage it…. Worried by a global surge in cases, the World Health Organization last week reiterated its longstanding recommendation that everyone—including the inoculated—wear masks to stem the spread of the virus. On Monday, health officials in Los Angeles County
followed suit, recommending that ‘everyone, regardless of vaccination status, wear masks indoors in public places as a precautionary measure.’”
The Wall Street Journal reports, “About half of adults infected in an outbreak of the Delta variant of COVID-19 in Israel were fully inoculated with the Pfizer Inc. vaccine, prompting the government to reimpose an indoor mask requirement and other measures to contain the highly transmissible strain.”
Malawi Women Forgoing Prenatal Care
AP (US) reports, “Officials say far fewer pregnant women in Malawi are getting the health care they need amid the pandemic, with many forgoing medical visits and relying solely on traditional birth attendants, who provide emotional support and administer traditional herbal treatments but are technically banned by the government from delivering babies because of their lack of formal training. Many families can’t afford clinic visits, or, like Maxwell, the transportation to get there; they also fear they’ll catch coronavirus in a medical facility.”
COVID Leading Cause of Death in New Moms in Mumbai
Times of India reports, “Haemorrhage, sepsis, hypertensive disorders and tuberculosis have for years been the leading causes of maternal mortality in Mumbai. In 2020-21, however, COVID-19 has raced past all to contribute to the biggest share of maternal deaths…. An analysis of 193 maternal deaths in Mumbai from April 2020 to March 2021 showed 16.5 percent were caused due to complications arising out of COVID-19….” One expert said, “The government should start vaccination of pregnant women without a day’s delay if they want to avoid deaths in young women.”
Racial Disparities in Vaccinations Persists in the US
The
Washington Post (US) reports, “The United States is awash in coronavirus vaccines, with free beer, plane tickets and million-dollar prizes dangled as inducements to persuade the reluctant to get a shot. Philadelphia is doling out $400,000 in giveaways. Despite that, a racial divide persists in the nation’s vaccination campaign, with federal figures showing counties with higher percentages of Black residents having some of the lowest vaccination rates in the country.” An audio journal recorded by an emergency room doctor in Philadelphia presents “a portrait of how environmental, economic and political factors entwine, putting Black people at higher risk of chronic conditions that leave immune systems vulnerable while fueling the misinformation, mistrust and fear that leave them unprotected.”
Call for Reinvesting in Public Health
An opinion piece in
STAT (US) notes, “Decades of chronic underfunding and a failure to invest in the public health workforce, the physical infrastructure of state and local health departments, and critical data systems have
left Americans vulnerable to calamities like COVID-19 and other pathogens that lie just around the corner.” The authors argue: “With more than
600,000 American deaths caused so far by COVID-19, the effects of chronically underfunding public health have never been clearer. Now is the time to overhaul the ways in which the US addresses public health, including creating a new set of funding initiatives that are based on long-term sustainability, equity, and flexibility for those who implement these programs on the ground.”
Confronting Long Haul COVID
A
NEJM (US) Perspective argues that in the US, “current numbers and trends indicate that ‘long-haul COVID’ (or ‘long COVID’) is our next public health disaster in the making…. If the past is any guide, [people with long COVID] will be disbelieved, marginalized, and shunned by many members of the medical community. Such a response will leave patients feeling misunderstood, aggrieved, and dissatisfied…. There is, therefore, an urgent need for coordinated national health policy action and response, which we believe should be built on five essential pillars.”
Learning from COVID Vaccine Development
Helen Branswell for
STAT (US) interviewed “experts in immunology, drug development, and government research” to find “a dozen lessons we should learn from the COVID vaccine project for next time.” These include: investing in basic science, “redundancy is critical in a vaccine quest” and “vaccine inequity is well and truly entrenched.”
Vaccine Disinformation in West Africa
A report from
First Draft News looked for the origins of vaccine disinformation in West Africa “In West Africa, vaccine hesitancy is a particularly worrisome issue. In an AfroBarometer survey of five West African countries from March 2021, 60 per cent of respondents said they were unlikely to try to get vaccinated. Mis- and disinformation make up only one component of vaccine hesitancy…. Through our monitoring and research, one finding stood out: Foreign narratives and conspiracy theories—initially developed and popularized in North America—are taking hold in West Africa, further eroding trust in institutions in the region. Sources operating outside West Africa have been driving these narratives.”
Manufacturing Vaccines in South Africa
News24 (South Africa) reports, “The World Bank and a trio of western government agencies announced a financing package for production of the Johnson & Johnson coronavirus vaccine in South Africa, part of an effort to scale global production and meet demand for billions of doses. The $712 million (~R10.2 billion) deal, announced Wednesday, will support Aspen Pharmacare Holdings Ltd. in producing 500 million doses of the shots through 2022. Of that amount, 30 million will be produced for use in South Africa in 2021, out of a total of 250 million due by the end of the year.”
Adèle Sulcas and Mia Malan for
Bhekisisa look at what it will take for South Africa to manufacture mRNA vaccines. “Merely giving South Africa the instructions to make a shot would be a little like giving a recipe for a molecular-cuisine dish to someone who has only ever made toast—and then expecting them to cook it to a Michelin three-star standard. Where intellectual property is the theory of how to make something, technology transfer is the practice of that theory. It requires a company to share its expertise, experience, tips and insights on making a product.”
A Correlate of Protection Identified
Nature (UK) reports, “Researchers developing the Oxford–AstraZeneca COVID-19 vaccine have identified biomarkers that can help to predict whether someone will be protected by the jab they receive. The team at the University of Oxford, UK, identified a ‘correlate of protection’ from the immune responses of trial participants—the first found by any COVID-19 vaccine developer. Identifying such blood markers, scientists say, will improve existing vaccines and speed the development of new ones by reducing the need for costly large-scale efficacy trials.”
Vaccines and People Who Are Immunocompromised
USA Today (US) reports on vaccine efficacy among people with compromised immune systems. “Although COVID-19 vaccines work incredibly well for the vast majority of people, roughly 10 million Americans whose immune systems are compromised because of medication or disease may not be well protected…. For people who are immunocompromised, there's no good way to tell if they're protected. Antibody tests, which look for some types of protective antibodies, may not tell the whole story and are only a snapshot in time….”
Mix and Match Vaccines
Nature (UK) reports, “Mixing COVID-19 vaccines is emerging as a good way to get people the protection they need when faced with safety concerns and unpredictable supplies. Most vaccines against SARS-CoV-2 must be given in two doses, but multiple studies now back up the idea that mixing the Oxford–AstraZeneca jab and the Pfizer–BioNTech vaccine triggers an immune response similar to—or even stronger than—two doses of either vaccine. Results
announced on Monday by a UK group suggest that the combination sometimes outperforms two shots of the same vaccine, and a similar picture is emerging from German studies…. But at least 16 vaccines have been approved for use in one or more countries, and mix-and-match studies so far have been small, so more extensive trials and long-term monitoring for side effects are sorely needed.”
Vaccine Passport Inequity
The
Washington Post (US) reports, “The European Union’s much anticipated coronavirus digital certificate, which is intended to facilitate unrestricted movement across the continent for vaccinated travelers, will begin Thursday…. But many vaccinated would-be travelers—particularly those from poorer countries—do not meet the program’s criteria because they received AstraZeneca shots produced by India’s Serum Institute, which has not been approved by EU regulators…. As of Wednesday, only four Western-produced vaccines qualify under the EU certificate’s criteria….”
In an opinion piece on NPR’s
Goats and Soda blog, Ifeanyi Nsofor focuses on a different kind of vaccine nationalism: “I'm fully vaccinated. I want to travel to Europe. And fully vaccinated visitors are welcome. But I can't get in.” Nsofor got the Oxford-AstraZeneca vaccine manufactured in India “branded as Covishield, [and it] is not on the list of vaccines approved by the European Medicines Agency. And that's the vaccine I got—along with hundreds of millions of other people, mostly in lower- and middle-income countries…. COVID-19 vaccine nationalism has taken different dimensions, all to the detriment of people from poorer countries. COVAX, the vaccine distribution program co-led by the World Health Organization, has distributed more than 89 million doses of the Oxford-AstraZeneca vaccine to countries across Africa, Asia and Latin America. More than 90 percent of which are manufactured in India, so none of these individuals will be able to travel to Europe any time soon either. Why would a vaccine using the same recipe from the same pharmaceutical firm not be accorded similar respect simply because it is manufactured in India rather than in a rich European country?”
India’s Vaccine Gender Gap
The Guardian (UK) reports, “Deep-rooted structural inequalities and patriarchal values are to blame for India’s worrying COVID vaccine gender gap, campaigners and academics have warned. As of 25 June, of the 309m COVID vaccine doses delivered since January 2021, 143m were administered to women compared with nearly 167m to men….” One expert says, “There is hesitancy because of rumours about side-effects, and how the vaccine affects fertility and menstruation. But there are other factors such as women not being able to access the technology needed to register for it, not having information on where the centres are or not being able to go to the centres alone.”
An Ancient Coronavirus’s Impact on People Today
Carl Zimmer writes in the
New York Times (US), “Researchers have found evidence that a coronavirus epidemic swept East Asia some 20,000 years ago and was devastating enough to leave an evolutionary imprint on the DNA of people alive today…. The new
study suggests that an ancient coronavirus plagued the region for many years, researchers say. The finding could have dire implications for the COVID-19 pandemic if it’s not brought under control soon through vaccination.”
COVID’s Disruption of HIV Care
Liz Highleyman writes in
POZ (US), “Whether or not HIV itself worsens COVID-19 outcomes, it’s increasingly clear that the pandemic has had a detrimental impact on people living with HIV in other ways. COVID-19 has disrupted HIV services nationwide and around the world, threatening to set back recent progress in the fight against HIV/AIDS…. A model based on gay and bisexual men in Baltimore estimated that disruptions in condom use, HIV testing, PrEP use, antiretroviral treatment initiation and viral suppression could lead to an 11 percent increase in new HIV infections over a year if sexual activity remains unchanged. Even more sobering, the model predicted that COVID-19–related declines in treatment and viral suppression could substantially increase HIV-related deaths.”
How Safe is Public Transit?
GroundUp (South Africa) conducted a “journalistic” study of public transit to try to determine how risky it is to take transit during the pandemic. Using carbon dioxide meters as an imperfect proxy for spread of the virus in vehicles, they found “it’s clear that so much depends on the weather. The trips that recorded high levels of carbon dioxide concentrations were all when there was rain. Understandably, very few people will tolerate being rained on for a 54-minute-long bus ride. When people open windows, carbon dioxide concentrations drop rapidly, usually to acceptable bounds. ‘Open windows, all the time’ needs to be our golden rule on public transport, no matter what the weather.”
Are We Ready for the Next Pandemic? Short Answer: No
The Atlantic (US) asked experts if the US is ready for the inevitable next pandemic. “After an inept coronavirus response, will the United States do better when the next pandemic strikes? Experts generally agree that America learned from the past year, and that the next public-health crisis won’t be quite as bewildering. But America’s pandemic preparedness still has major gaps, some of which are too big for any one administration to fix…. [Experts asked, ‘Are we ready for another one?’ The short answer is ‘Not quite.’ The long answer is that being truly ‘ready’ will be harder than anyone realizes.”
The Pandemic’s Continued Impact on Clinical Trials
Nature (UK) reports, “Medical researchers are beginning to shift their focus away from COVID-19—but the pandemic could continue to affect studies focused on other diseases…. Some research centres say that the urgency of the pandemic forced them to accelerate their procedures in ways that will carry over to future trials, regardless of whether changes to official guidelines stay in place. Katherine Tuttle, a nephrologist and executive director for research at Providence Health Care in Spokane, Washington, points out that her centre can now get clinical trials running in a matter of days, rather than having to wait six weeks or more, as was typical before the pandemic. ‘A lot of things that we knew we were doing before, that should change, finally changed because we were in a state of emergency,’ she says. ‘We’re not going back to doing it the old way.’”
Editing Bat Genomes to Prevent Pandemics
STAT (US) reports, “two researchers are proposing a drastic way to stop future pandemics: using a technology called a gene drive to rewrite the DNA of bats to prevent them from becoming infected with coronaviruses. The scientists aim to block spillover events, in which viruses jump from infected bats to humans—one suspected source of the coronavirus that causes COVID. Spillover events are thought to have sparked other coronavirus outbreaks as well, including SARS-1 in the early 2000s and Middle East respiratory syndrome (MERS).”
Pandemic Haikus
Science (US) published several haikus written by scientists to reflect pandemic experiences. Many focused on zoom and some tackled the public’s growing familiarity with the language of science. Here’s one:
Infectious disease modeling
No one knew my field
Now all say “R naught”; I hope
They can forget soon
By Akira Endo, UK
