On Thursday, November 4^th, 10-11am ET, award-winning journalist Stephanie Nolen will join AVAC to discuss the findings and backstory of her recent New York Times investigation, "Here’s Why Developing Countries Can Make mRNA COVID Vaccines.” During the webinar, Stephanie, AVAC and partners will explore where we are in the fight to bring COVID mRNA vaccine manufacturing to the places where doses are needed most, in countries where vaccine access has been grievously stalled. We’ll talk through her report and the parallels with HIV. Register for Reality check about “global” COVID-19 vaccine production to join the conversation.

The world reached another grim milestone this week, as the total reported deaths crossed five million. According to DW (Germany), “More than half the COVID deaths reported were in the United States, Russia, Brazil, Mexico and India combined.” As cases and deaths continue to mount worldwide, “On one hand, some Western countries are facing an increase in vaccine hesitancy. On the other, developing countries lack doses to offer even one shot to their eligible population. Several rich nations have offered booster shots even as more than half of the world is yet to receive at least one dose of a COVID vaccine.” AP (US) reports, “many communities around the globe [are] dedicating memorials to commemorate lives lost…. [Bergamo], the Italian city that suffered the brunt of COVID-19’s first deadly wave is dedicating a vivid memorial to the pandemic dead: A grove of trees, creating oxygen in a park opposite the hospital where so many died, unable to breathe.”
 
Even as the number of cases and deaths continue to rise and memorials to the dead are built, the WHO’s International Health Regulations Emergency Committee “unanimously agreed that the COVID-19 pandemic still constitutes an extraordinary event that continues to adversely affect the health of populations around the world, poses a risk of international spread and interference with international traffic, and requires a coordinated international response. As such, the Committee concurred that the COVID-19 pandemic remains a public health emergency of international concern….”
 

If You Are in a Hurry

• Read an in-depth description of gain-of-function research and the controversies around it in Nature.
• Read an issue brief from Friends of the Global Fight that explores the intersections of HIV, COVID and pandemic responses.
• Read The Star on how a syringe shortage could affect vaccine access in Kenya.
• Read Science News on whether viruses are alive and their role in the world.
• Read a commentary in The Lancet that argues the UK’s vaccine and quarantine rules are based on suspicion not evidence.
• Read a comment in Nature Communications that shows the potentially log-lasting effects of COVID on research.
• Read a commentary in All Africa by Dr. Jonathan Awori, who argues that vaccinations for young people are critical for getting their lives back on track.
• Read Scientific American on a small preprint study that shows some Americans’ expanded their personal space zone of comfort.
• Read Nature on results of a clinical trial of Fluvoxaine, a cheap and widely available drug that could help treat COVID.

 

Vaccine Access

 
Power 98.7 (South Africa) reports the African Union is set to buy 110 million doses of the Moderna vaccine. WHO’s Dr Matshidiso Moeti is quoted, “With just 5.7 percent of the continent’s population being fully vaccinated, COVID-19 still poses a very real risk to populations in Africa, and globally. Vaccine shipments are ongoing, with COVAX deploying more than 40 million doses to African countries so far in October. We welcome African Union’s announcement that it will buy up to 110 million Moderna doses with 15 million due to arrive before end of 2021.”
 
The Star (Kenya) reports, “The World Health Organization has said scarcity of syringes for COVID-19 vaccination could paralyze progress in Kenya, Rwanda and South Africa. Dr Matshidiso Moeti, WHO regional director for Africa, said the looming threat of a vaccine commodities crisis hangs over the continent. ‘Early next year, COVID-19 vaccines will start pouring into Africa, but a scarcity of syringes could paralyse progress. Drastic measures must be taken to boost syringe production, fast. Countless African lives depend on it,’ said Moeti…”

Devex (US) reports, “Only five African nations are on track to fully inoculate 40 percent of their populations against COVID-19 by the end of the year—a global goal set by the World Health Assembly in May—as the continent faces a shortfall of 275 million vaccine doses…. But overall, just 77 million people—less than 6 percent of the continent’s population—are fully vaccinated.”

Africa Confidential (UK) reports, “Germany's BioNTech said that it would start building its first African factory producing COVID vaccines early next year. The facility, initially producing 50 million vaccine doses a year, will be in Rwanda. BioNTech has also signed a memorandum of understanding with the Institut Pasteur de Dakar for a factory in Senegal. The two factories will produce the vaccine doses, then take on all the final production steps and bottling, known as 'fill and finish'. Their output would meet about 2 percent of Africa's needs.” Reuters (UK) reports, “The project marks a longer-term attempt to avoid a repeat of healthcare inequalities brought to the fore by the coronavirus pandemic. ‘Today's agreements are key steps toward producing vaccines end-to-end in Africa,’ Rwandan Health Minister Daniel Ngamije said during the signing ceremony in the capital Kigali, adding that the goal was to include the continent in the ‘networks of science, innovation and production.’”
 
Reuters reports, “Novavax Inc and partner Serum Institute of India said on Monday they received emergency use authorization for their COVID-19 vaccine in Indonesia, making it the first approval anywhere in the world for Novavax…. Novavax has so far applied for EUA in various countries, including the UK, Australia, India and the Philippines.”
 
NDTV (India) reports the in the Rome Declaration released from the G20 meeting, “G20 leaders…vowed to take steps to boost its supply in developing nations and remove relevant supply as well as financing constraints for advancing toward the global goal of vaccinating at least 40 per cent of the population in all countries by the end of 2021 and 70 per cent by mid-2022…. The G20 leaders thanked healthcare and frontline workers, international organisations and scientists for their relentless efforts to cope with the deadly COVID-19 pandemic.” In a press statement Oxfam condemned the lack of action at the G20: “While the G20 intend to help get at least 40 percent of the population in all countries vaccinated by the end of 2021 and 70 percent by mid-2022, they did not take the concrete action to put us on the path to deliver on that goal, such as a plan to boost the supply of vaccines in developing countries and remove relevant supply and financing constraints. According to the World Health Organization, 82 countries are at risk of missing that target. It is clear that we will not get there if we perpetuate the current profit-driven approach of insufficient donations of doses, voluntary licenses, generic support for technology transfer which has crashed and failed miserably.”
 
The Guardian (UK) reports, “More people have received a COVID booster vaccination in the UK per head of population than are reported to have had their first shot in Africa, according to the latest available data. By 26 October, 9.4 percent of the UK’s population had received a booster dose, compared with 8.5 percent of Africa’s population who had received their first dose, according to Our World in Data, with 5.6 percent fully vaccinated across the continent as of the same date. The data reveals the state of vaccine inequality between high and low-income countries, particularly in Africa, with the UK among those accused of hoarding vaccines at the expense of more vulnerable populations.”
 

Oral COVID Vaccine Trial Approved in South Africa

 
I24 News (South Africa) reports, “An Israeli biomedical company announced Friday that it was granted clearance by South Africa's top health regulator to begin enlisting volunteers for a Phase I clinical trial of its oral coronavirus vaccine, the first of its kind.” The Jerusalem Post (Israel) quotes the company’s CEO: “An oral COVID-19 vaccine would eliminate several barriers to rapid, wide-scale distribution, potentially enabling people to administer the vaccine themselves at home.”
 

When Suspicion Replaces Evidence

 
A commentary in The Lancet (UK) by “a group of scholars from the medical humanities and social sciences” takes on the UK’s policy of not recognizing people as vaccinated if they received their vaccine  “in most of Latin America, Africa, and south Asia…. The policy recalls an earlier moment in global public health. At the height of the British Empire, quarantine effectively served to prevent citizens from low-income and middle-income countries entering high-income countries on the basis of the assumption that people from these countries were vectors of contagion. Both then, with quarantine islands, and now, with quarantine hotels, these policies rely on and exacerbate the role of suspicion in policing public health, especially regarding vaccines that are manufactured in countries other than the UK…. This UK policy is irrational because many of these low-income and middle-income countries administered the same vaccines that the UK Government distributed to its own population. In some instances, the UK Government donated these vaccines.”
 

COVID Treatments

 
NPR (US) reports, “US-based pharmaceutical giant Merck & Co. said it will license drugmakers worldwide to produce its potentially lifesaving antiviral pill for treatment of COVID-19 in adults. The drug, known as molnupiravir, has shown promise in treating the disease, and the agreement to license its production could help millions of people in the developing world gain access to it.
 
Nature (UK) reports, “A cheap, widely available drug used to treat mental illness cuts both the risk of death from COVID-19 and the need for people with the disease to receive intensive medical care, according to clinical-trial results.” Fluvoxaine, a drug used for treating depression and other conditions, “is also known to dampen immune responses and temper tissue damage, and researchers credit these properties for its success in the recent trial. Among study participants who took the drug as directed and did so in the early stages of the disease, COVID-19-related deaths fell by roughly 90 percent and the need for intensive COVID-19-related medical care fell by roughly 65 percent.... Fluvoxamine’s low cost could make it accessible worldwide, says study co-author Edward Mills, a health researcher at McMaster University in Hamilton, Canada. A ten-day course costs only about US$4, and the drug’s patents have expired, meaning that any company can produce it.”
 
A commentary in The Lancet Global Health (UK) argue, “From a clinical practice perspective, the results represent an important step in understanding the role of fluvoxamine for outpatients with COVID-19. In this sense, the study strongly suggests that fluvoxamine constitutes an effective, safe, inexpensive, and relatively well tolerated option for the management of ambulatory patients with COVID-19, which is particularly useful for (but not limited to) low-resource settings.”
 

Delta and Delta Plus

 
A new variant, AY.4.2, also known as Delta Plus has emerged in the UK. STAT (US) reports, “AY.4.2 has caused some alarm because its prevalence is building up in the United Kingdom, where it’s even gained ground on the remarkably transmissible Delta variant. It now accounts for about 10 percent of sequenced virus samples in England.” It’s too early to tell of the variant will become more dominant in the UK or jump to other areas. It’s also impossible to know if there are other Delta sublineages in other poopulations. “It’s perhaps not a surprise that the UK noticed AY.4.2 so quickly. The country has an incredible sequencing system in place to monitor genetic changes in the virus, and researchers there have been among the global leaders in characterizing different mutations and forms of the virus. It’s possible that other Delta sublineages have similar growth rates to AY.4.2, but they’re in parts of the world where it will take longer for scientists to detect.”
 
Reuters (UK) reports, “The Delta coronavirus variant can transmit easily from vaccinated people to their household contacts, a British study found on Thursday, although contacts were less likely to get infected if they were vaccinated themselves. The Imperial College London study illustrates how the highly transmissible Delta variant can spread even in a vaccinated population.” The researchers are quoted: “Our findings provide important insights into...why the Delta variant is continuing to cause high COVID-19 case numbers around the world, even in countries with high vaccination rates."
 

Boosters

 
Bhekisisa (South Africa) reports, “Half a million healthcare workers in South Africa were vaccinated with one shot of Johnson & Johnson (J&J) in the country’s Sisonke implementation trial, can get a second shot of the same vaccine from 8 November as part of a new leg of the study.”
 

COVID and Children

 
STAT (US) reports, “The Food and Drug Administration granted emergency use authorization to the COVID-19 vaccine developed by Pfizer and its partner BioNTech Friday for children ages 5 to 11, a significant step toward making the vaccine available to millions of school-age children.” The US CDC is expected to meet this week to sign off on the FDA approval, paving the way for making the vaccine available for children. However, NPR (US), reports, “New research suggests parents may take a more cautious approach when it comes to deciding if they'll get their younger children vaccinated against COVID-19, compared with their decision to get themselves vaccinated…. A survey published by Kaiser Family Foundation this week suggests there's a group of parents eager to get the shot for their younger kids: 3 in 10 of parents surveyed said that they are ready to get a COVID-19 vaccine for them as soon as one is authorized…. But one-third of parents want to wait and see how the vaccine is working for other people before they get their child vaccinated. And about 3 in 10 say they don't plan to get their child the vaccine.”
 
The New York Times (US) reports the US FDA, “is reviewing reports suggesting the coronavirus vaccine made by Moderna can cause heart problems in some adolescents, the company said on Sunday. Moderna requested authorization from the FDA for use of its vaccine in children ages 12 to 17 years in June. The adolescents would receive 100 micrograms of the vaccine—the same dose given to adults 18 and above. But the agency has not yet made a ruling on the application, prompting speculation about reasons for the delay.
 
The New York Times (US) reports, “Britain is once again at the peak of a coronavirus surge, just over three months after all coronavirus restrictions were lifted…. Cases have stayed at high levels since then, with more than 20,000 new cases recorded each day. There are almost 9,000 Britons hospitalized with COVID-19—the highest level since March, when the United Kingdom was in the midst of a long national lockdown…. The current surge is being primarily driven by high levels of infection in school-age children, with more than a third of all recent cases being reported in those under 15 years old.
 
In a commentary in All Africa (US) Dr. Jonathan Awori writes, “Early data indicated that while young people were as susceptible to the disease as anyone else, they were much less likely to be hospitalized or die from it. Yet there were other costs. Hidden costs…. COVID-19 has cost young people their education, their mental health, their wellbeing, and their hopes. It has dimmed their prospects for economic prosperity. Today, widespread vaccination is the best tool we have for saving lives in Africa. Vaccination is the only way [young people] can resume life, learning, and social interactions. It’s the only way economies can fully and permanently reopen and begin recovering to restore and create opportunities for young people.”
 

COVID and Gender Equality

 
The Washington Post (US) reports, “The coronavirus pandemic has caused ‘big losses’ for gender equality in Europe, with few gains, according to an index published Thursday by the European Institute for Gender Equality… The Gender Equality Index assigned the European Union 68 points out of 100, according to its scoring system…This means an improvement of 0.6 points compared with 2020…. The scores are mostly based on data from 2019 and therefore don’t fully capture the impact of the coronavirus crisis on gender equality, although the report does include evidence on the pandemic’s negative impact on women in key areas.”
 

COVID and Migration

 
AFP (France) reports, “The flow of immigrants to developed countries fell at its fastest pace ever at the height of the COVID-19 pandemic last year, the OECD club of leading economies said in a report Thursday. Some 3.7 million people immigrated last year to the 38 leading developed and emerging economies that make up the Organization for Economic Cooperation and Development, the lowest level since 2003…. The number of new asylum claims fell by 31 percent, the biggest drop since the Balkan wars of the early 1990s.”
 

Pandemic Response

 
An issue brief from Friends of the Global Fight (US) argues, “National HIV programs made substantial contributions to early COVID-19 control, including through community systems, laboratory, testing, health care worker mobilization, and surveillance capacity. HIV programs often demonstrated adaptability, innovation and community focus…. The HIV response offers a critical pathway towards robust, resilient, rights-based and people-centered health systems. It provides opportunities for pursuing ambitious disease-specific targets while advancing progress on broader health goals.”
 

Vaccine Mandates

 
CNBC (US) reports, “Five percent of unvaccinated adults say they have left a job due to a vaccine mandate, according to a survey released Thursday by the Kaiser Family Foundation. This early read on whether workers will actually quit their jobs over mandates comes as more employers are requiring shots. One-quarter of workers surveyed by KFF in October said their employer has required them to get vaccinated, up from 9 percent in June and 19 percent last month.”
 

Kenya’s Curfew Lifted, Will It Prompt More Vaccinations?

 
The Standard (Kenya) reports, “Kenya’s economy is gradually pulling out of the COVID-19 morass, with last week’s lifting of the 18-month night-time curfew tipped to offer tailwinds for continued recovery across sectors…. President Uhuru Kenyatta’s move to lift the nationwide curfew on the back of falling coronavirus infections and a heightened vaccination drive is expected to extend recovery to other businesses, including hotels, bars and restaurants. The lifting of the curfew offers the promise that long-distance transporters and tourist-focused hotels will also quicken their recovery.”
 
BBC (UK) reports some in the hospitality industry “fear that if Kenyans do not take vaccination seriously, then the dreaded curfew or other measures, including lockdowns, could be reinstated after Christmas. That is why they are asking the government to set up vaccination centres in popular meeting places, such as bars and restaurants, to encourage people to get jabbed. In fact, some of them are ready to sponsor free meals and drinks for those who choose to get vaccinated at their venue.”
 

Facebook and Vaccine Disinformation

 
Time (US) reports on the way Facebook’s delays in handling vaccine disinformation on the platform allowed it to spread for months. A trove of documents from a whistleblower, “shows that in the midst of the COVID-19 pandemic, Facebook carefully investigated how its platforms spread misinformation about life-saving vaccines. They also reveal rank-and-file employees regularly suggested solutions for countering anti-vaccine content on the site, to no avail."
 

Gain-of-Function Research

 
Nature (UK) looks at the history and current controversies around gain-of-function research. With all the challenges inherent in GOF studies, why do them? Because, some virologists say, the viruses are constantly mutating on their own, effectively doing GOF experiments at a rate that scientists could never match. ‘We can either wait for something to arise, and then fight it, or we can anticipate that certain things will arise, and instead we can preemptively build our arsenals,’ says [Virologist Juliet] Morrison. ‘That’s where gain-of-function research can come in handy.’”
 

COVID’s Impact on Research

 
An editorial in Nature (UK) argues, “Researchers and clinicians are upset and frustrated that decades of work in diagnosing, treating and researching tuberculosis (TB) have massively stalled. The slowdown means the world is losing ground against a disease that kills 1.5 million people every year…. Researchers are again urging decision-makers to revive diagnosis, treatment and research programmes for TB and other infectious diseases, such as malaria. And they are saying that much can be learnt from how the creation of COVID-19 vaccines was fast-tracked.”
 
A comment in Nature Communications (UK) says, “Two surveys of principal investigators conducted between April 2020 and January 2021 reveal that while the COVID-19 pandemic’s initial impacts on scientists’ research time seem alleviated, there has been a decline in the rate of initiating new projects. This dimension of impact disproportionately affects female scientists and those with young children and appears to be homogeneous across fields. These findings may have implications for understanding the long-term effects of the pandemic on scientific research.”
 

Give Me Space

 
Scientific American (US) reports on a small preprint study that “found personal boundaries had expanded by 50 percent or more by one measure. This marked the broadening of a safety zone—a natural, instinctual one that differs from the six-foot distancing guideline from public-health officials…. The study is small, but it is part of a growing body of social science work trying to gauge long-term mental health effects of the pandemic. Researchers are curious about whether changes to our comfort zone of personal space will persist…there was a 40 to 50 percent increase or more in the size of personal space….” One measure saw personal space preferences increase from around 3 feet to just over 4 feet.
 

Is It Alive?

 
Science News (US) says, “Villain. Killer. Menace. Since 2020, scientists and public officials have used these words to describe SARS-CoV-2, the virus that causes COVID-19. News articles, research papers and tweets repeatedly personify the virus as a bad guy intent on killing us. Simultaneously, we’re intent on killing it, with handwashing, antiseptic wipes, hand sanitizer, bleach, even robots zapping hospital rooms with ultraviolet light. Yet, according to most scientists, we’ve been working hard to kill something that isn’t alive.” The article delves into the definitions of life and whether viruses meet them and looks at the role of viruses in the world.