As much of the world remains in the grip of a new wave of COVID fueled by the much more contagious Omicron variant, WHO, activists and public health experts renewed calls to urgently vaccinate the world. At the end of 2021, the WHO said, “The acute phase of the COVID-19 pandemic could end by July 2022 if every country ends up vaccinating at least 70 per cent of its population….” WHO’s Tedros said, “I want governments, industry and civil society to work with us on a campaign that targets 70 per cent vaccine coverage in every country by the start of July. I still remain optimistic this can be the year we could not only end the acute stage of the pandemic, but also chart a path to stronger health security,” according to Global News (Canada).
 
Canada’s Dr. Joanne Liu, a leading voice on medical humanitarian crises, told the Montreal Gazette (Canada), “It all depends on how much we want to protect the rest of the world to avoid the emergence of new variants. It’s as simple as that…. Thinking we live in isolation and that travel bans and a third dose is good enough to pull us through…. It’s not. We need to vaccinate the rest of the planet.”
 
Bipasha van der Zijde writes in The Guardian (UK) that supply chain and other issues have made vaccine delivery problematic in many countries and argues, “Added to common elements such as the lack of sufficient vaccines with adequate shelf life, each country has its own unique set of circumstances that lead to a low vaccination rate. So, with funding made available, each country can tailor their efforts to combat those circumstances and make sure the vaccines can reach the last mile.”
 

If You Are in a Hurry

• Read aidsmap on what we know and don’t know about HIV and SARS-CoV-2 mutations.
• Listen to an interview with Dr. Glenda Gray about the waning of Omicron in South Africa on NPR.
• Read what three South African scientists say about how HIV prepared the country to understand COVID in The Daily Maverick.
• Read a STAT interview with WHO’s Dr. Michael Ryan on COVID vaccines, public trust and where the pandemic may be going.
• Read a NEJM perspective on denialism, trust and a doctor’s role in helping people make good decisions.
• Read Christian Happi and John Nkengasong on the critical contributions of African scientists to development of vaccines and the lack of vaccine equity in Nature.
• Read about South America’s vaccination successes in Reuters.
• Read about new research that shows vaccine-induced T-cells play an important role in fighting Omicron in The Guardian.
• Read about thousands of people getting vaccines to go to soccer games in Nigeria Sun via VOA.

 

Africa Lags in Vaccination, Despite Critical Contributions to Research

 
Christian Happi and John Nkengasong write in Nature (UK), “In the early months of the COVID-19 pandemic, Africa’s rapid and coordinated response, informed by emerging data, was remarkable. Now, in 2022, as vast vaccination campaigns have enabled the global north to gain some control over the pandemic, Africa lags behind.” They conclude, “Unlike in previous disease outbreaks, during the COVID-19 pandemic, Africa has been a key player in the acquisition of scientific knowledge that has guided the global response. For two years, hundreds of geneticists across the continent have worked seven days a week, often through the night, to sequence strains of SARS-CoV-2. And companies worldwide have used these data (most of which are available in public repositories such as GISAID) to develop COVID-19 vaccines and therapeutics. For those contributing so much to the global effort to curb this pandemic, it is galling to watch Africa continue to struggle in the acquisition and roll-out of COVID-19 vaccines.”
 

New Research on Omicron

 
The New York Times (US) reports, “In studies on mice and hamsters, Omicron produced less damaging infections, often limited largely to the upper airway: the nose, throat and windpipe. The variant did much less harm to the lungs, where previous variants would often cause scarring and serious breathing difficulty…. Experiments on animals can help clear up these ambiguities, because scientists can test Omicron on identical animals living in identical conditions. More than half a dozen experiments made public in recent days all pointed to the same conclusion: Omicron is milder than Delta and other earlier versions of the virus.”
 
Bloomberg (US) reports, “A string of new studies has confirmed the silver lining of the omicron variant: Even as case numbers soar to records, the numbers of severe cases and hospitalizations have not. The data, some scientists say, signal a new, less worrying chapter of the pandemic…. One study out of South Africa found that patients admitted to the hospital there during the omicron-dominated fourth wave of the virus were 73 percent less likely to have severe disease than patients admitted during the delta-dominated third wave.”
 
The Guardian (UK) reports, “Omicron has a higher number of mutations than other variants, which means it can sometimes slip past the antibodies produced by vaccination or infection. But if it does enter the body, the T-cells – white blood cells that originate in the marrow – will attack.” This comes from research published in the peer-reviewed journal Viruses. Researcher Matthew McKay is quoted: “Even if Omicron, or some other variant for that matter, can potentially escape antibodies, a robust T-cell response can still be expected to offer protection and help to prevent significant illness…. Based on our data, we anticipate that T-cell responses elicited by vaccines and boosters, for example, will continue to help protect against Omicron, as observed for other variants. We believe this presents some positive news in the global fight against Omicron.”
 
NPR (US) interviews Dr. Glenda Gray, head of the South African Medical Research Council about Omicron. Gray says, “We are happy that we've passed our peak of our fourth wave and that we also are seeing much less hospitalizations and a lot less deaths than we've seen in the past…. I think we can be cautiously optimistic. We have to keep on watching to see what emerges. We wish and are hopeful that this may be the first move towards the SARS-CoV-2 becoming an endemic virus like the flu and hope omicron is the beginning of the evolution of the virus that enables us to coexist in a way that's not devastating to our health and to our economies.”
 

There’s a lot Riding on the Novavax Vaccine

 
Politico (US) reports, “As the US, Europe and parts of Asia consume more booster doses than expected, global health advocates hope the emerging vaccine produced by Maryland-based Novavax will fill the supply gap in low- and middle-income countries in 2022… [but] crucial questions remain about both its ability to obtain Food and Drug Administration approval and to produce enough doses in manufacturing sites other than the Serum Institute…. The supply problem could still be alleviated, the Biden officials said, if new vaccines become available after the turn of the year. Officials working with COVAX are gearing up to begin filling the gap with Novavax, whose protein-based shot has long been considered key to vaccinating the world.”
 

Fourth Doses

 
Reuters (UK) reports Israel “is now administering fourth doses to people over 60, health workers and immunocompromised patients.” This comes as preliminary data from a study there show, “a fourth dose of COVID-19 vaccine boosts antibodies five-fold a week after the shot is administered.” Reuters notes, “The World Health Organization has said more people worldwide should be vaccinated with first doses before others receive boosters.”
 
The New York Times (US) reports in the US, “People with compromised immune systems are getting unapproved fourth or fifth COVID-19 shots, despite uncertainty about their safety or effectiveness.” The Times profiles one woman who has so far received five COVID vaccines. “Ms. Ricks is one of many people with compromised immune systems in the United States who have sidestepped government guidelines and received unauthorized fourth or fifth shots…. Higher levels of antibodies seem to correlate with better protection against the virus, but researchers are not sure exactly what level of protection different numbers of antibodies provide, and the FDA does not recommend that people use antibody tests to gauge immunity.”
 

Long COVID

 
Infection Control Today (US) reports, “Sometimes lost among the evidence that the Omicron variant of COVID-19 might be a way to, ironically, end the pandemic–mild symptoms and high infectivity might get us to herd immunity—is this question: What about long COVID? ... Some health care professionals warn that the system should brace itself for an onslaught of long COVID cases in February, after the current Omicron surge subsides, as many experts predict.”
 
“Flurona”
 
Several media outlets are reporting breathlessly on what many have dubbed a “new disease: flurona,” with some calling it a “fresh hell” or a “nightmare.” Few cases have been reported. The Times of Israel (Israel) reports, “Israel confirmed its first case of an individual infected with both the seasonal flu and COVID-19 at the same time, authorities said on Thursday. The two infections were found in an unvaccinated pregnant woman who had mild symptoms….” WPLG (US) reports, “A dual diagnosis of the flu and COVID-19, sometimes called Flurona, is now being seen in South Florida,” especially among children. CNN (US) reports, the Israeli Health Minister, “Davidovitch is concerned about the potential strain the flu and coronavirus could put on health care systems—especially during the winter months. ‘During the winter because...it's cold and people are closed inside, you have a higher risk of being infected in upper respiratory infections in general. And when you have high infectivity of both influenza and COVID, together this can create an overburdened system,’ Davidovitch said.”
 

South America’s Vaccination Successes

 
Reuters (UK) reports, “South America is now the most vaccinated region in the world, with 63.3 percent of the population fully inoculated, according to the Our World in Data project…. Infection and death rates have plummeted compared to the middle of the year when Latin America and the Caribbean accounted for almost half of global deaths and infections…. Epidemiologists point to several factors to explain the speedy vaccination drive. But the most important, they say, has been decades of successful inoculation campaigns that have created the infrastructure needed to deliver jabs en masse, while instilling trust among the population.”
 

Soccer Fans Line Up for Vaccines

 
Nigeria Sun via VOA (US) reports, “Authorities in Cameroon say thousands of people have gotten the COVID-19 vaccine so they can attend the continent's top soccer tournament, the Africa Football Cup of Nations, or AFCON, which begins January 9. Organizers are putting out the word that even if they have been vaccinated, fans will also need to present a negative test to enter stadiums.”
 

What is the COVID Endgame?

 
AP (US) reports, “Pandemics do eventually end, even if omicron is complicating the question of when this one will. But it won’t be like flipping a light switch: The world will have to learn to coexist with a virus that’s not going away.” Experts say there is no clear line that would mark the virus becoming endemic. “Exactly how much continuing COVID-19 illness and death the world will put up with is largely a social question, not a scientific one. ‘We’re not going to get to a point where it’s 2019 again,’ said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security. ‘We’ve got to get people to think about risk tolerance.’”
 
STAT (US) interviews WHO’s Dr. Michael Ryan on COVID vaccines and what to expect next: “’What’s shocked me most in this pandemic has been that absence or loss of trust,’ he said of people’s unwillingness to follow the advice of public health leaders and the containment policies set out by governments…. ‘We need a social solution for future pandemics, much more than we need a technological solution. Because we’re dealing with a fractured world, fractured communities. We’re dealing with a breach and prolonged breakdown in trust.’”
 

Vaccines for Teens

 
STAT (US) reports the US FDA, “extended the emergency use authorization for the Pfizer and BioNTech COVID-19 booster shot to include teens aged 12 to 15, paving the way for them to be eligible for the jabs later this week…. The Biden administration is pushing to get booster shots into as many Americans as possible as the highly transmissible Omicron variant sweeps across the country.”
 
Khaleej Times (India) reports, “Indian health authorities Monday began vaccinating teens in the age group of 15 to 18, as more states started to enforce tighter restrictions to arrest a new surge stoked by the infectious Omicron variant…. India has so far partially vaccinated almost 90 percent of its eligible population and nearly 64 percent have received both doses. The government is yet to decide on offering booster shots for adults.”
 

COVID and HIV

 
Medscape (US) reports, “Around the world, people with HIV show variations in COVID-19 vaccination rates similar to those seen in the general population, raising concerns because of their increased risk for morbidity and mortality from COVID-19 infection…. The findings reflect data on nearly 7,000 people with HIV participating in the REPRIEVE clinical trial. As of July, COVID-19 vaccination rates ranged from a high of 71 percent in higher income regions to just 18 percent in sub-Saharan Africa and bottomed out at 0 percent in Haiti…. ‘This disparity in COVID-19 vaccination rates among people with HIV across income regions may increase morbidity from COVID-19 in the most vulnerable HIV populations,’ the authors note.”
 
Aidsmap (UK) reports on stigmatizing headlines that link people with HIV and SARS-CoV-2 mutations. “To be clear, people with HIV are not COVID mutation factories, but there is a plausible evolutionary path for variants that involves a small number of people with compromised immune systems.” Aidsmap spoke with “Dr Alex Sigal of the African Health Research Institute, an HIV virologist studying SARS-CoV-2 mutations…. ‘If we look at Omicron, right, we don't know how it evolved,’ Sigal said. There’s no evidence that it originated in an immunocompromised individual and there may never be. But if this is how some variants evolve, then he says it provides a good argument to do more to help people living with HIV gain access to antiretroviral therapies that they need anyway. That’s especially true in countries like South Africa, where many people who live with HIV face structural barriers to treatment. Most importantly, Sigal says that people with HIV should not be stigmatised based on his and others’ research findings. ‘This is the last thing that we're aiming for here. What we're aiming for is understanding where variants come from.’”
 
The Daily Maverick (South Africa) looks at how HIV prepared South African scientists for COVID. “When COVID-19 hit South Africa, it found a dedicated scientific front line of scientists who already knew how to find a virus and its variants, and figure out what its next move might be.” Three key South African scientists are interviewed. Dr. Michelle Groome, head of the Division of Public Health Surveillance and Response of the National Institute for Communicable Diseases says, “Experiencing a pandemic unfolding first-hand is definitely interesting from a scientific, clinical and epidemiological point of view. But each and every person has felt the impact of this pandemic on a personal level… It is great to be able to use science to answer pertinent questions about COVID-19 and use trusted public health interventions like vaccination to limit the impact of the virus….”
 

New Variant Identified in France

 
Africa Times (South Africa) reports, “Yet another strain of the COVID-19 virus has emerged in France, after the case was discovered in a person returning from travel in the West African nation of Cameroon…. The case was detected during mid-November after the unidentified person was in Cameroon for three days. The new variant shows a number of genetic changes, some but not all of them consistent with previously known strains of the virus. It’s been named the ‘IHU’ after the institution where the scientists are affiliated.” The researchers who identified the strain have published their findings in a preprint article. Bloomberg (US) reports, “The World Health Organization said a coronavirus variant found in France hasn’t become much of a threat since it was first identified in November…. The WHO monitors multiple variants, and when it finds one may pose a significant risk, it declares it a ‘variant of concern.’ This one is only under investigation.”
 

Good News for a J&J Booster

 
The New York Times (US) reports, “A Johnson & Johnson booster shot provided strong protection against the Omicron variant, greatly reducing the risk of hospitalization, according to a clinical trial in South Africa. The study, which compared more than 69,000 boosted health care workers with a corresponding group of unvaccinated South Africans, found that two shots of the vaccine reduced the risk of hospitalization from Omicron by about 85 percent. In comparison, another study in South Africa found that two shots of the Pfizer-BioNTech vaccine reduced the risk of hospitalization by about 70 percent.” The study has not yet been peer reviewed.
 

Uganda’s Museveni Gets a Booster

 
The Monitor (Uganda) reports, “President Museveni on Tuesday received his COVID-19 vaccination booster shot amid surging cases of the virus in the country.” Museveni, who had received two doses of AstraZeneca, was given a dose of Pfizer. “They said mixing vaccines is not only alright but even better. So, this is just to alert all of you that you should get fully vaccinated.” The Monitor reports, “The president reiterated that he will fully reopen the economy when 22 million Ugandans aged 18 years and above are fully vaccinated.”
 

Trust

 
A NEJM (US) perspective by HIV clinician Dr. Elvin H. Geng looks at denialism and trust and doctors’ roles in helping people make wise decisions. “COVID denialism, like AIDS denialism, reveals that many of doctors’ assumptions are incorrect. We overestimate the value of reasoning and facts. We believe in our clinical authority. We expect patients to behave rationally. But we all develop our beliefs through interactions with other people—what you believe depends on whom you trust…. No disembodied message (even if crafted by marketing experts) can compete with someone you know who will pull up a chair. Even though the pandemic has pushed those in our profession to our emotional and professional limits, one of our oldest tools may turn out to be one of our best: talking with patients.”