As 2021 comes to an end, vaccination targets in most African countries remain unmet. An op-ed in The East African (Kenya) argues for increased support of COVAX and more action: “In a globalised and interdependent world, there is no secret: we must come together to save lives.” [COVAX] on its own…will not eradicate the virus and we need continued joint collaborations and initiatives to tackle all the issues at hand, end stockpiles to share more doses, limit boosters, increase manufacturing through knowledge sharing as seen between AstraZeneca and Serum Institute of India and invest in national and local health systems—do this today rather than tomorrow to vaccinate the whole world.”
 
Yet vaccine supply is but one part of the equation. The Economist (UK) reports that COVAX and other initiatives are finally getting more vaccines to Africa and other low-income countries, but warns, “As doses arrive a critical question looms: how best to distribute them?” A new analysis tries to pinpoint how vaccines will best be rolled out. “This will depend on people’s willingness to get jabbed and on countries’ capacity to distribute the doses.”
 

If You Are in a Hurry

• Read a study in The Lancet that found deaths among those fully vaccinated in Scotland was extremely uncommon.
• Read Nature on what we still need to know about how new COVID pills will work in real world settings.
• Read Fast Company on a new concept for a COVID “smoke decector.”
• Read The New York Times on the impact of prolonged school closures in Uganda.
• Read Nature on the tantalizing idea that some people are able to resist COVID infections naturally.
• Read Scientific American about how people who are immunocompromised can be more protected from COVID.

 

COVID Pills No Substitute for Vaccines

 
Reuters (UK) reports, “Oral antiviral pills from Merck & Co and Pfizer Inc have been shown to significantly blunt the worst outcomes of COVID-19 if taken early enough, but doctors warn vaccine hesitant people not to confuse the benefit of the treatments with prevention afforded by vaccines…. One main reason not to rely on the new pills, the experts said, is that antiviral medications, which stop the virus from replicating in the body, must be given in a narrow window early in the disease because COVID-19 has different phases.”
 
Health World (India) reports, “WHO officials said on Friday they were hoping to convene a meeting soon to set guidelines on the use of COVID-19 antiviral pills, saying they offered "very attractive" new prospects for clinical care.”
 
Nature (UK) reports, “little is known about how well the [new Merck and Pfizer] drugs will work, and how easily they could be used in the places that need them most…. Judging from the press releases, both drugs can slash hospitalizations—and potentially also deaths—from COVID-19 when they are given soon after infection takes hold. But until full reports of the clinical trials are released, some crucial details are missing.” The drugs have been heralded as a potential solution for countries where vaccine access is low, but one “concern is testing: administering the antivirals early in the course of an infection means that countries will need an ample supply of COVID-19 tests” and those are not always easily procured.
 

Real World Vaccine Efficacy

 
A study in The Lancet (UK) looks at real world efficacy of vaccine in preventing deaths among the fully vaccinated in Scotland. “236 deaths in fully vaccinated people were recorded (0·007% of the total vaccinated)…. Within the vaccine-eligible population of Scotland aged 65–79 years, the death rate per 10,000 person-years was 64.8 for unvaccinated individuals and 4.2 for fully vaccinated individuals…. In summary, COVID-19-related deaths were extremely uncommon in those fully vaccinated…”
 

Covaxin Effective in Lancet Study

 
NDTV (India) reports, “Covaxin, the coronavirus vaccine developed by the government's medical research agency and Bharat Biotech, was found to have a 77.8 per cent efficacy rate against symptomatic COVID-19 in a long-awaited analysis published in The Lancet. The study also found it to be 65.2 per cent effective against the more dangerous Delta variant of the coronavirus in its preliminary analysis but said further investigations are necessary to confirm it.”
 
Schengen Visa News reports, “soon after the World Health Organization (WHO) disclosed that Covaxin had been officially approved for use, 12 EU countries automatically accepted the vaccine as valid proof of immunity for travel…”
 

T-cell Skin Patch Vaccine to be Tested

 
The Guardian (UK) reports, “An Oxfordshire-based company will soon start clinical trials of a second-generation vaccine against COVID-19, an easy-to-administer skin patch that uses T-cells to kill infected cells and could offer longer-lasting immunity than current vaccines…The vaccines prime T-cells to remove infected cells from the body quickly after infection, thus preventing viral replication and disease. While the antibodies produced by the current COVID vaccines stick to the virus and stop it infecting cells, T-cells find and destroy infected cells.” A Phase I trial will enroll 26 people.
 

Moderna’s Patents and Access

 
The New York Times (US) reports, “Moderna and the National Institutes of Health are in a bitter dispute over who deserves credit for inventing the central component of the company’s powerful coronavirus vaccine, a conflict that has broad implications for the vaccine’s long-term distribution and billions of dollars in future profits…. The dispute is about much more than scientific accolades or ego. If the three agency scientists are named on the patent along with the Moderna employees, the federal government could have more of a say in which companies manufacture the vaccine, which in turn could influence which countries get access. It would also secure a nearly unfettered right to license the technology, which could bring millions into the federal treasury.”
 

US Transitioning to Living with COVID

 
Axios (US) reports, “The US and COVID-19 are settling into a long, but hopefully manageable future together…. Experts have been saying for a long time that there’s almost no chance COVID-19 would disappear. Rather, they’ve been expecting it to become endemic—meaning it will stick around, possibly forever, but at more predictable, manageable levels.
That transition appears to be happening right now.”
 

The Trump Administration’s Efforts to Thwart the CDC

 
POLITICO (US) reports, “New emails and documents released by a congressional committee investigating the Trump administration’s handling of the pandemic show the extent to which top White House officials interfered in the Centers for Disease Control and Prevention’s efforts to warn Americans about COVID-19…. On Friday, the committee released emails and transcripts with former senior CDC officials about the White House’s attempts to sideline the agency at critical moments at the beginning of the US outbreak.”
 

Inequities and Disparities

 
A study in JAMA (US) reports, “In this systematic review and meta-analysis of 4.3 million patients from 68 studies, African American, Hispanic, and Asian American individuals had a higher risk of COVID-19 positivity and ICU admission but lower mortality rates than White individuals. Socioeconomic disparity and clinical care quality were associated with COVID-19 mortality and incidence in racial and ethnic minority groups.”
 
In an opinion in STAT (US) Ugandan researchers write about how US colleagues working in the country were evacuated as the COVID pandemic began to hit and the devastating effect on programs there. “Although collaborations between scientists from high-income and low-income settings have yielded tremendous public health achievements, partnership priorities are too often dictated by the perspectives of those who control project funding, not necessarily by the individuals living in the communities where these programs take place. Sometimes, as was the case for COVID-19 staff withdrawals, choices affecting both parties are made without the collaborating local scientists and clinicians being asked for their opinions at all.”
 

“Smoke Detector” for COVID

 
Fast Company (US) reports on COVID air detectors that could help manage the pandemic. “Poppy is designed more like an everyday smoke detector, but built to spot COVID-19 instead of smoke. It consists of nothing more than a router-size white box installed at various intervals around a space…. If the last two years have taught us anything, it’s that we understand very little about how viruses are actually transmitted in the real world. Poppy offers a way of visualizing these invisible pathogens in our spaces, and a manner to fact-check our own best practices of prevention.”
 

Keeping People Who are Immunocompromised Safe

 
Scientific American (US) reports, “Throughout the pandemic, most people have had to adjust to the restrictions of life under COVID. But for those who belong to a broad category known as ‘immunocompromised,’ even ordinary activities come with extraordinary risks…. Studies have shown that immunocompromised people are more vulnerable to being hospitalized or dying from COVID and less likely to develop strong protection from vaccination. But there are also some hopeful signs: additional doses of some COVID vaccines, strategic timing of immunosuppressive treatments and prophylactic COVID treatments may boost protection among some immunocompromised individuals—and restore at least some of the freedoms they have lost.”
 

The Pandemic’s Knock-on Effects

 
Healio (US) reports, “In 2020, more than 22 million infants globally did not receive a first dose of measles vaccine—the largest number in 2 decades, according to a report published Wednesday in MMWR…. According to a joint statement by the CDC and WHO, 24 measles vaccination campaigns in 23 countries were postponed last year because of the COVID-19 pandemic.”
 
The New York Times (US) reports that Uganda has kept schools mostly or partially closed during the pandemic. “Eighteen months into the pandemic, officials in the country have kept more than 10 million primary and secondary school students at home, with no plans to reopen their classrooms soon. And while Uganda’s leaders say that the policy is the safest option, on the ground, the effects of the closures are stark…. Young women, abandoning hopes of going to school, are getting married and starting families instead. School buildings are being converted into businesses or health clinics. Teachers are quitting, and disillusioned students are taking menial jobs like selling fruit or mining for gold.”
 

Boosters

 
The Washington Post (US) reports, “The rate at which fully vaccinated residents are getting the shots is highest in the states that also have high rates of new coronavirus cases…. In swaths of the country where health officials will not impose mask and vaccine mandates to curb the virus’s spread, or have had their powers stripped away by Republican state lawmakers or governors, boosters are one of the few shields left for those worried about contracting and spreading the virus.”
 
Reuters (UK) reports the US FDA “is unlikely to ask its outside vaccine advisers to weigh in on whether the agency should authorize Pfizer COVID-19 boosters for all adults…. Pfizer and BioNTech on Tuesday requested the FDA to authorize booster doses of their COVID-19 vaccine in all adults, presenting data showing the shot would help prevent disease across ages.”
 
Sunday Times (South Africa) reports, “Healthcare workers lined up slowly this week for a booster shot of the J&J COVID-19 vaccine, with about 6,000 getting a second dose of the vaccine after it became available…. MRC head Glenda Gray is quoted, “We started slowly on Wednesday (with boosters) and had a good number to test our systems. We hope to go to scale by mid-December and be finished by the end of the year.”
 

Europe Becomes the Epicenter Once Again

 
Reuters (UK) reports, “Europe has become the epicentre of the pandemic again, prompting some governments to consider re-imposing unpopular lockdowns in the run-up to Christmas and stirring debate over whether vaccines alone are enough to tame COVID-19…. Countries including the Netherlands, Germany, Austria and the Czech Republic are taking or planning measures to curb the spread.”
 
The Guardian (UK) reports, “Austria is to introduce a lockdown for unvaccinated people in two of Europe’s worst-hit coronavirus regions from Monday and could extend it across the country…. Millions of people not fully vaccinated against COVID…will be allowed to leave their homes only for reasons considered essential to life, such as going to work, grocery shopping or visiting the doctor…. Measures believed to be unprecedented in Europe. The restrictions are in line with recommendations from medical experts and will be monitored through random checks that the health minister, Wolfgang Mückstein, compared to traffic controls.”
 
An op-ed by three Danish researchers in The New York Times (US) looks at how Danish trust in government has affected vaccine uptake and other COVID considerations and argues, “Trust remains critical to ending pandemics. Achieving it requires transparency, openness and willingness to embrace uncertainty. This may be the most critical challenge for post-COVID-19 societies, including in Denmark. Let’s hope we can trust one another enough to approach this challenge openly and honestly.”
 

Ivermectin

 
Bhekisisa (South Africa) reports on the use of ivermectin by people who mistakenly believe it can treat or prevent COVID and the state of research on whether or not it works. “In agricultural circles, ivermectin isn’t hard to come by; it’s an over-the-counter medication widely used to treat parasites such as worms or lice in cattle.” In early 2021, “millions of people around the world had started to use the drug to prevent and treat COVID—caused by a virus (as opposed to a parasite). Back then, there was no conclusive research or evidence that ivermectin worked against COVID. Nearly a year on, considerably more ivermectin studies have been done, but whether the medicine works or not remains blurry…."
 

COVID and the Brain

 
Scientific American (US) reports on “COVID’s brain-related symptoms [that] go beyond mere mental fuzziness. They range across a spectrum that encompasses headaches, anxiety, depression, hallucinations and vivid dreams, not to mention well-known smell and taste anomalies. Strokes and seizures are also on the list. One study showed that more than 80 percent of COVID patients encountered neurological complications.”
 

Misinformation

 
KFF’s Vaccine Monitor (US) reports, “We find in the latest Vaccine Monitor that belief in pandemic-related misinformation is widespread, with 78 percent of adults saying they have heard at least one of eight different false statements about COVID-19 and that they believe it to be true or are unsure if it is true or false…. With the public’s trust in news media declining over many years, we find that no news media source garners the trust of a majority of the public when it comes to COVID-19 information…. The share who hold at least four misconceptions is small (between 11-16 percent) among those who say they trust COVID-19 information from network news, local TV news, CNN, MSNBC, and NPR. This share rises to nearly four in ten among those who trust COVID-19 information from One America News (37 percent) and Fox News (36 percent), and to nearly half (46 percent) among those who trust information from Newsmax.”
 
The New York Times (US) reports on a bishop in Romania who spread false information about COVID and vaccines. “The bishop is now under criminal investigation by the police for spreading dangerous disinformation, but his anti-vaccine clarion call, echoed by prominent politicians, influential voices on the internet and many others, helps explain why Romania has in recent weeks reported the world’s highest per capita death rate from COVID-19.”
 
NIH Record (US) reports on a presentation from Timothy Caulfield, a Canadian health law and policy expert: “Over time, harmless-sounding terms like ‘immune-boosting’ have normalized misinformation, he said. Such language is often associated with healthy behaviors, such as exercise, sleep and a balanced diet, creating a ‘health halo’ effect. Those pushing immune-boosting misinformation use scientific jargon to give credibility to bunk, a practice Caulfield calls ‘scienceploitation.’”
 
The New York Times (US) reports on rampant misinformation on radio and podcasts. “As the global death toll related to COVID-19 exceeds five million…iHeart, Spotify, Apple and many smaller audio companies have done little to rein in what radio hosts and podcasters say about the virus and vaccination efforts…. The reach of radio shows and podcasts is great, especially among young people: A recent survey from the National Research Group, a consulting firm, found that 60 percent of listeners under 40 get their news primarily through audio, a type of media they say they trust more than print or video.”
 

Scenario Planning

 
Reuters (UK) reports, “Israeli Prime Minister Naftali Bennett and senior aides holed up in a nuclear command bunker on Thursday to simulate an outbreak of a vaccine-resistant COVID-19 variant to which children are vulnerable, describing such an eventuality as ‘the next war’….”
 

Some People Seem to Resist COVID Infections

 
Nature (UK) reports, “Data from dozens of UK health-care workers suggest a tantalizing possibility: that some people can clear a nascent SARS-CoV-2 infection from their bodies so quickly that they never test positive for the virus nor even produce antibodies against it. The data also suggest that such resistance is conferred by immune players called memory T cells—possibly those produced after exposure to coronaviruses that cause the common cold.”
 

COVID and Diabetes

 
VOA (US) reports, “Dr. Benido Impouma, director of the communicable and noncommunicable diseases cluster at the WHO regional office for Africa, said with just 6 percent of the continent’s population fully vaccinated, COVID-19 still poses a very real threat to populations in Africa, especially people with diabetes. He said WHO’s preliminary analysis shows that death rates from COVID-19 are significantly higher in patients who also have diabetes.”