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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
"The knowledge that rare high-risk events like pandemics are not just theoretically possible but likely, in an increasingly urban and interconnected world of nearly eight billion people. As a parent, you want to protect your children from unnecessary anxieties, but not when the threat in question is a real one. My son’s generation will forever take pandemics as a basic fact of life, and that assumption, painful as it is, will protect him when the next threat emerges. But maybe, if the science unleashed by this pandemic lives up to its promise, his children — or perhaps his grandchildren — could inherit a world where plagues are a thing of the past.
— Steven Johnson in The New York Times Magazine ([link removed])


** Share of Population Fully Vaccinated Against COVID-19
------------------------------------------------------------
November 22, 2021
Source: Our World in Data ([link removed])


** Table of Contents
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* If You Are in a Hurry (#hurry)
* Next Waves Underway and Expected (#next)
* New Wave of Protests Across Europe (#new)
* Getting More Vaccines to More People in Africa (#getting)
* Explaining Lower COVID Illness in Africa (#explaining)
* Effectiveness of Public Health Measures (#effective)
* Countering Disinformation (#counter)
* Could COVID Lead to Progress? (#could)
* What Will Be Impact of Treatment for COVID Be? (#what)


* Vaccine Mandates (#mandates)
* Delta and Pregnancy (#delta)
* Tracing the First Cases in Wuhan (#trace)
* Finding New Ways to Protect the Vulnerable (#find)
* Gender Gaps in Vaccinations (#gender)
* Promoting Scientific Evidence for African Traditional Medicines (#promote)
* A Nuanced Look at Ivermectin (#nuanced)
* Religious Leaders and Vaccine Programs (#religious)
* Understanding Compassion Fatigue (#under)

As the Northern hemisphere heads into winter, COVID cases are rising in many countries and there are fears that cases and deaths will continue to rise through the holiday season. As Germany faces the highest case load it has had during the pandemic, the Minister of Health warned, “Probably by the end of this winter, as is sometimes cynically said, pretty much everyone in Germany will be vaccinated, cured or dead.”

The Local ([link removed]) (Germany) reports, “Despite widespread access to free coronavirus vaccines, just 68 percent of the German population is fully vaccinated, a level experts say is too low to keep the pandemic under control.” Germany’s story is replicated across many countries across the region.


**
If You Are in a Hurry
------------------------------------------------------------
* Read about a planned door to door COVID vaccination campaign in Kenya in The Star ([link removed]) .
* Read MedPage Today ([link removed]) and AP ([link removed]) on possible explanations for lower COVID rates in Africa.
* Read a BMJ editorial ([link removed]) on the need for support for research into public health and social measures to combat COVID.
* Read MedPage Today ([link removed]) on a new American Medical Association resolution on fighting COVID disinformation.
* Read The Washington Post ([link removed]) on what COVID treatment can and can’t do for ending the pandemic.
* Read The Washington Post ([link removed]) on a Science ([link removed]) magazine look for the first case of COVID in Wuhan.
* Read a CARE ([link removed]) fact sheet on gender gaps in vaccinations.




** Next Waves Underway and Expected
------------------------------------------------------------

Times Live ([link removed]) (South Africa) reports, “SA Health Products Regulatory Authority (SAHPRA) chairperson Prof Helen Rees has warned of behavioural changes ahead of the festive season that could swing SA into a COVID-19 fourth wave more rapidly…. [Rees] said though SA has a low number of COVID-19 deaths, this could change rapidly if people drop safety measures they have become accustomed to…. Rees said the most concerning issue is not knowing whether the country will get a new variant once it enters the fourth wave.”

The Guardian ([link removed]) (UK) reports, “A steep rise in COVID-19 cases in Europe should serve as a warning that the US could also see significant increases in coronavirus cases this winter, particularly in the nation’s colder regions, scientists say.” However, there is some cause for optimism: “Evidence shows vaccine-conferred protection against hospitalization and death remains high several months after inoculation, vaccines for children older than five can reduce COVID transmission, and new antiviral medications hold the promise of making COVID-19 a treatable disease.”

Medscape ([link removed]) (US) reports, “The situation is worse in Eastern Europe, where vaccine uptake has lagged and fatality rates in some countries are reaching new records. In Russia, authorities reported 1,254 COVID-19 fatalities on Friday, higher than at any other point in the pandemic. (The country's mortality data has not always been reliable.) Russia, the first country to approve a COVID-19 vaccine, thanks to an accelerated process that controversially bypassed late-stage clinical trials, also has a long history as a global purveyor of medical disinformation campaigns. Vaccination rates there hover just above one-third of the population, lower than nearly any other middle or upper-income country.”



** New Wave of Protests Across Europe
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The New York Times ([link removed]) (US) reports, “Tens of thousands of people protested official crackdowns and vaccine requirements in Austria, the Netherlands, Belgium, Denmark, Italy, Switzerland and Croatia, with scattered violence and police use of tear gas and water cannons. Some protesters were organized by far-right parties, but many were simply fed up with almost two years of intermittent state controls over their lives in the name of public health.”

NBC News ([link removed]) (US) reports, “Police opened fire on anti-lockdown protesters in the Dutch city of Rotterdam Friday ahead of demonstrations in several European cities against new COVID restrictions. Mayor Ahmed Aboutaleb told reporters about police officers ‘felt it necessary to draw their weapons to defend themselves’ more than once after protesters tore through the city's central shopping district, setting fires in their wake.”



** Getting More Vaccines to More People in Africa
------------------------------------------------------------

The Star ([link removed]) (Kenya) reports, “In its new strategy, the government plans to employ the services of at least 10,000 vaccinators who will move from door to door just as has been the case with polio and measles. The plan is to administer at least 150,000 doses daily, up from the current 60,000 to 70,000…. Kenya banks on the improved COVID-19 vaccines supply chain to achieve the set target to vaccinate 10 million people by end of December and 26 million by end of next year.”

The Washington Post ([link removed]) (US) reports on last week’s announcement from the Biden administration “that the country would invest billions of dollars to expand US manufacturing capabilities so more coronavirus vaccine doses reach poorer parts of the world…. The scale of the effort is grand: a public-private partnership aimed at producing at least 1 billion high-quality doses a year by the second half of 2022. The hope is that it could also allow a quick scale-up during future pandemics…. Though Wednesday’s announcement was generally well received by groups pushing for a fairer global supply of vaccines, many also felt that it didn’t go far enough.”



** Explaining Lower COVID Illness in Africa
------------------------------------------------------------

MedPage Today ([link removed]) (US) looks at possible explanations of lower rates of symptomatic COVID in Africa. “Both rural and urban areas of Mali experienced high seroprevalence of COVID-19, but a low burden of symptomatic disease, a researcher said.” The study in Mali found much lower rates of symptoms and hospitalizations than expected based on US rates of illness and hospitalizations. “There were only three hospitalizations throughout spring and fall 2020, which also fell far below the expected 11-30 hospitalizations, and no deaths.”

AP ([link removed]) (US) reports on much lower than expected COVID rates in Africa. “Scientists emphasize that obtaining accurate COVID-19 data, particularly in African countries with patchy surveillance, is extremely difficult, and warn that declining coronavirus trends could easily be reversed. But there is something ‘mysterious’ going on in Africa that is puzzling scientists, said Wafaa El-Sadr, chair of global health at Columbia University. ‘Africa doesn’t have the vaccines and the resources to fight COVID-19 that they have in Europe and the US, but somehow they seem to be doing better,’ she said…. On Friday, researchers working in Uganda said they found COVID-19 patients with high rates of exposure to malaria were less likely to suffer severe disease or death than people with little history of the disease.”



** Effectiveness of Public Health Measures
------------------------------------------------------------

A systemic review and meta-analysis of studies published in the BMJ ([link removed]) (UK) “suggests that several personal protective and social measures, including handwashing, mask wearing, and physical distancing are associated with reductions in the incidence COVID-19. Public health efforts to implement public health measures should consider community health and sociocultural needs, and future research is needed to better understand the effectiveness of public health measures in the context of COVID-19 vaccination.” An accompanying editorial ([link removed]) argues, “Although the pandemic has seen remarkable trials for vaccines and drug treatments, much less has been done to evaluate the effects of public health and social measures (PHSM)…. The most striking finding of Talic and colleagues’ systematic review is that only one completed randomised trial of a PHSM was identified, in contrast with the hundreds for trials completed
for drug treatments of COVID-19. Considering the central importance of PHSMs for pandemic control, the uncertainties and controversies around their effects, and the immense research effort being put into vaccine and drug development, this lack of investment in public health measures is puzzling—at just 4 percent of global research funding for COVID-19…”



** Countering Disinformation
------------------------------------------------------------

MedPage Today ([link removed]) (US) reports on a new resolution from members of the American Medical Association (AMA). “The new resolutions called for the AMA to: first, take aim at disinformation in all types of media; and second, focus inward and tackle disinformation promoted by members of the medical community. ‘[W]hen physicians...and other medical professionals join in this disinformation, the effects can seriously undermine the public health efforts of the whole medical community,’ [said Kavita Arora, MD who proposed the policy.]"

Sermo, a private social media network for physicians reports in a press release ([link removed]) on data from a survey of 3,050 physicians across 26 countries. The survey “showed that while more physicians are hearing fewer concerns from patients about the side effects of the vaccine now (59 percent) compared to six months ago (72 percent), more physicians are reporting patients are coming to them with vaccine misinformation vs. six months ago.”



** Could COVID Lead to Progress?
------------------------------------------------------------

Steven Johnson in a think piece in The New York Times Magazine ([link removed]) (US) looks at what the legacy of COVID could be. “There are many examples of mass tragedies that inspired meaningful reforms or scientific breakthroughs—steps forward in human progress that, in the end, most likely saved more lives than the original tragedy claimed…. My son’s generation will forever take pandemics as a basic fact of life, and that assumption, painful as it is, will protect him when the next threat emerges. But maybe, if the science unleashed by this pandemic lives up to its promise, his children—or perhaps his grandchildren—could inherit a world where plagues are a thing of the past.”



** What Will Be Impact of Treatment for COVID Be?
------------------------------------------------------------

The Washington Post ([link removed]) (US) reports, “The notion that a fearsome infection could soon be treatable with a handful of pills is an exhilarating idea nearly two years into a pandemic that has killed more than 5 million people…. But experts—who are thrilled about the prospect of two powerful new medicines—worry that enthusiasm for the idea of treatments may distract from their limitations and the necessity of preventing illness in the first place…. But these treatments alone aren’t likely to close the book on the coronavirus. Instead, they will be a valuable addition to an armamentarium that the world is going to have to keep building and maintaining long term: vaccines, booster shots, more antiviral pills, virus-fighting antibodies engineered to stick around in people’s bodies and fast turnaround testing linked to treatment options.”



** Vaccine Mandates
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The Guardian ([link removed]) (UK) reports the Austrian chancellor announced “that Austria would…be the first in Europe to bring in compulsory vaccination beginning on 1 February 2022…. A vaccine mandate—once an unthinkable option—has been broached…. But while a majority of citizens may actually support a mandate, Austrian society is deeply divided between those who have accepted vaccination measures thus far, and a hardened, unvaccinated residuum caught up in conspiracy theories and false information, and attracted to far-right politics.”

Okay Africa ([link removed]) (US) reports, “Kenya's Health Secretary Mutahi Kagwe announced Sunday that those not vaccinated—or able to show proof of vaccination—by December 21 will not be given access to various public and government settings. The list of banned in-person services includes hospitals, prisons, education agencies, bars, restaurants, and hotels. Kagwe and her department are also limiting access to game parks, and businesses that attend to 50 people or more a day.”

STAT ([link removed]) (US) reports in the US, “Right-wing politicians’ resistance to vaccine mandates is extending far beyond COVID-19 immunizations, a startling new development that carries vast implications for the future of public health…. In many cases, right-wing legislators’ resistance to vaccine mandates has been cloaked in rhetoric specific to COVID-19 immunizations. Upon closer reading, however, many of the proposals they have floated—some of which have already been signed into law—apply to all vaccines, not just the three currently authorized in the US to prevent COVID.”



** Delta and Pregnancy
------------------------------------------------------------

The Washington Post ([link removed]) (US) reports, “Once the delta variant took hold in the United States, pregnant individuals and their fetuses or babies faced increased risks from coronavirus infections, according to two new reports” from the US CDC. “One report found that 15 pregnant patients died of COVID-related causes between March 2020 and early October, including nine who died after delta became the most prominent strain. All but one of the women who died had underlying health conditions, and none had been fully vaccinated. The second report found that the risk of stillbirth increased about fourfold for women with COVID-19 as delta surged.”



** Tracing the First Cases in Wuhan
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A new report in Science ([link removed]) (US) looks at early cases in Wuhan in an attempt to understand the beginnings of the pandemic. The Washington Post ([link removed]) (US) reports, “The new analysis suggests that the first known patient sickened with the coronavirus was a vendor in a large Wuhan animal market, not an accountant who lived many miles from it…. The scientist, Michael Worobey, a leading expert in tracing the evolution of viruses at the University of Arizona, came upon timeline discrepancies by combing through what had already been made public in medical journals, as well as video interviews in a Chinese news outlet with people believed to have the first two documented infections.”



** Finding New Ways to Protect the Vulnerable
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Writing in Frontiers in Public Health ([link removed]) (US) two Canadian researchers argue, “based on Emergency Management principles, the age-dependent risk from SARS-CoV-2, the minimal (at best) efficacy of lockdowns, and the terrible cost-benefit trade-offs of lockdowns, we need to reset the pandemic response. We can manage risk and save more lives from both COVID-19 and lockdowns, thus achieving far better outcomes in both the short- and long-term.”



** Gender Gaps in Vaccinations
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An Analysis from the NGO CARE ([link removed]) found “In 22 of 24 countries where CARE has data, women are less likely to be vaccinated, and less likely to feel vaccines are safe…. In many low- and middle-income countries, women are less likely to get COVID-19 vaccines than men are. This compounds gender inequality women are already facing in health and decision-making…. In initial vaccine rollout where countries prioritize essential health workers, women should be more than half of people who receive vaccines. This is rarely the case…”



** Promoting Scientific Evidence for African Traditional Medicines
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A commentary in Scientific African ([link removed]) argues, “In contemporary times, it has become necessary to modernize [Africa’s] traditional medical care system via scientific studies…. Validation of the efficacy of health-enhancement products and drugs from plants and other bio-resources is predicated on diligent and intensive research accompanied by rigorous and conclusive clinical trials.” The authors conclude success in integrating traditional medicine and conventional western medicine “can be achieved only if the traditional herbal and other bio-resources are subjected to rigorous scientific studies, accompanied with rigorous and conclusive clinical trials that could stand the test of international scrutiny.”



** A Nuanced Look at Ivermectin
------------------------------------------------------------

The Economist ([link removed]) (US) looks at a more nuanced look at who ivermectin may help. “Ivermectin probably does help one subset of COVID-19 patients: those who are also infected by the worms it was designed to fight…. Dr. Bitterman noticed that the studies that looked best for ivermectin tended to cluster in regions with high rates of infections by strongyloides, a parasitic worm…. In trials conducted in countries where the parasites are common, many people could have both COVID-19 and strongyloides infections…. In the groups who received ivermectin during trials, the drug would keep strongyloides in check. But patients in control groups would be left at the worms’ mercy. This would make it look as if ivermectin were preventing deaths caused solely by COVID-19, when in fact it was preventing those caused by the parasites or by a combination of the two infections.”



** Religious Leaders and Vaccine Programs
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The Nation ([link removed]) (Kenya) reports on a call from religious leaders to be more involved in vaccine campaigns. "According to [Cardinal Elias Odhiambo Komenya], religious leaders have been sidelined in the nationwide COVID-19 campaign…. ‘The fight against HIV/AIDS largely succeeded because faith leaders and organisations were involved. We have not fully participated in the campaign against the global coronavirus pandemic,’ he said. ‘It is very difficult for a religious leader to go round villages telling people to take a vaccine that he or she knows little about.’”



** Understanding Compassion Fatigue
------------------------------------------------------------

MedPage Today’s Track the Vax ([link removed]) podcast (US) looks at dealing with “compassion fatigue” among healthcare workers. A psychiatrist says, “I think we're seeing more compassion fatigue right now. I think what I've been seeing in patients went from people kind of saying this career is hard, but I signed up for it and I'm ready to help, to it doesn't have to be this way, to I just don't want to do this and I don't want to be here doing this job. And that kind of expression is a really different expression than I've heard in patients. I think people don't feel as comfortable being around patients who don't necessarily have to be in the hospital because they could have done one thing to keep themselves out of the hospital…”

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