Even as the world continues to grapple with the COVID-19 pandemic, many policymakers, researchers and public health experts are looking ahead to the next pandemic(s) and trying to understand how to respond. South Africa Today (South Africa) reports, “A new study emphasizes the need to stop pandemics before they start, stepping beyond the quest for new vaccines and treatments for zoonotic diseases to also aggressively fund interventions that prevent them from happening in the first place…. Addressing the main drivers—deforestation, the wildlife trade and burgeoning agriculture, especially in the tropics—could prevent future pandemics, save lives and catastrophic societal disruptions.” The paper, published in Science (US), argues, “Prominent policymakers have promoted plans that argue the best ways to address future pandemic catastrophes should entail, ‘detecting and containing emerging zoonotic threats.’ In other words, we should take actions only after humans get sick. We sharply disagree…. We find that these primary pandemic prevention actions cost less than 1/20th the value of lives lost each year to emerging viral zoonoses and have substantial co-benefits.”
 

If You Are in a Hurry

• Read The Guardian on what had caused such a high rate of deaths in the US.
• Read Devex on the work to replicate mRNA vaccines at a tech transfer hub in South Africa.
• Read about what could happen if China relaxes COVID zero policies in Reuters.
• Read MedPage Today on the moneymaking business of pushing antivaccine content.
• Read MedPage Today on a small study that shows parallels between the way COVID and Alzheimer’s can impact the brain.
• Read Ezra Klein on the crucial role of trust in the COVID response in The New York Times and The Atlantic on how Denmark is transitioning to “normal.”

 

Mandates and Returning to “Normal” COVID Policies Diverge

 
In much of Europe and in some US states policymakers are lifting restrictions and attempting to move to a return to pre-COVID life. In other countries, like Austria, new mandates are coming into play. Which policy is chosen relies a least in part on vaccination rates and trust in government, but “pandemic fatigue” also plays a role.
 
The Atlantic (US) reports, “On February 1, Denmark became the first country in the European Union to lift all pandemic restrictions…. Reading this news, you might assume that Denmark succeeded in eliminating COVID. But its infection rate is currently higher than every other country’s in the world—except one: the South Pacific archipelago nation of Palau…. Because of falling ICU admissions and shorter hospital stays…COVID is no longer a socially critical sickness in Denmark.” Michael Bang Petersen, a Danish political scientist says, In Denmark, people are in favor of vaccines, with more than 81 percent of adults doubly vaccinated, but also very opposed to vaccine mandates.”
 
CNN (US) reports, “Austria became the first country in Europe to introduce a national COVID-19 vaccine mandate for adults…. Austria's sweeping measures will see those without a vaccine certificate or an exemption potentially slapped with initial fines of 600 euros…”
 
Ezra Klein writes in The New York Times (US), “You know what’s better than a vaccine mandate? A society that doesn’t need one.” Klein looks at a recent Lancet paper that tried to understand why there were such differences in case rates and deaths across countries…population density, GDP per capita, and exposure to past coronaviruses—failed to predict much in the way of outcomes. But both trust in government and trust in fellow citizens proved potent.” He quotes one of the paper’s authors, Thomas Bollyky, director of the global health program at the Council on Foreign Relations: “When confronted with a novel, contagious virus the best way for governments to protect their citizens is to convince them to take the measures to protect themselves. Especially in free societies the success of that effort depends on trust—trust between citizens and their government, and trusts between citizens themselves.”
 
POLITICO (US) reports, “Emboldened by falling case counts, the Biden administration is plotting a new phase of the pandemic response aimed at containing the coronavirus and conditioning Americans to live with it…. Biden and his top health officials have already begun hinting at an impending ‘new normal,’ in a conscious messaging shift meant to get people comfortable with a scenario where the virus remains widespread yet at more manageable levels.”
 
The Guardian (UK) reports, “The US has suffered 900,000 deaths from COVID-19, the highest figure of any nation…. America also has the highest death rate of any wealthy country, with half of the deaths occurring after vaccines became available…. The US has never responded to the COVID pandemic in a sustained, proactive way as a unified nation. Instead, much of the responsibility—and blame—has fallen on individuals. In a country with vast income inequality, poor health and sharp political divides, the results have been grim…. Meanwhile, American leaders are attempting to mimic other countries’ return to normal, despite a markedly different situation with hospitalizations and deaths—which, every day, nearly reach the losses from the September 11 terrorist attacks.”
 
Activist and epidemiologist Gregg Gonsalves writes in The Nation (US), “we’re being told SARS-CoV-2 is endemic now—which of course has nothing to do with the technical term, but has become popular shorthand for ‘it’s over.’ We’re vaxxed-and-done now and we should be allowed, with no more mask requirements or other efforts to mitigate spread, to resume our pre-pandemic lives with the ‘urgency of normal.’…I’m not suggesting that we need to be on a state of high alert forever. But we need to shape COVID-19 policies according to the data, not by wishful thinking among people who should know better. To sound the all-clear now or imply that we can in the next few weeks is presumptuous at best.”
 
The Washington Post (US) reports, “As the coronavirus pandemic creeps into its third year, and the death toll in the United States reaches 900,000, the 1918 influenza pandemic can offer some insight into how this chapter of history might draw to a close. But an 'ending,' when it comes to viruses such as these, is a misleading word. Eventually, experts say, the novel coronavirus is likely to transition from a deadly and disruptive pathogen to a milder, more seasonal nuisance. In the meantime, though, the country’s experience a century ago suggests that we could be in for a lot more pain—especially if we let our guard down.”
 

Vaccine Access

 
CNBC (US) reports, “Burundi, the Democratic Republic of Congo and Haiti are the least vaccinated countries in the world against COVID-19, data has shown…. In low-income countries, just 5.5 percent of people have been fully vaccinated against the coronavirus, according to Our World in Data. In high-income countries, 72 percent of the population has been fully vaccinated with at least two doses. Countries in which civil unrest and conflict are ongoing are also among the world’s least vaccinated, with violent combat making it difficult for vaccines to reach their general populations.”
 
Devex (US) reports, “Approval of a messenger RNA COVID-19 vaccine produced at a technology transfer hub in South Africa could take up to three years if companies do not share the technology around the vaccines they’ve produced [according to a WHO official]…. If an mRNA vaccine producer agrees to cooperate, the process would only take about 12 to 18 months…. South Africa's Afrigen Biologics and Vaccines, a partner in the hub, announced it was successful in replicating Moderna’s vaccine by using publicly available information…”
 
Biz Community (South Africa) reports, “South Africa's health regulator said on Monday it had approved a COVID-19 vaccine from China's Sinopharm, although a senior health official said the government was not planning to procure doses for now. The government delayed some vaccine deliveries late last year because of oversupply as hesitancy slowed the uptake.”
 
News Breakers (Nigeria) reports, “The Nigerian government has received two million doses of the Johnson & Johnson COVID-19 vaccine donated by the European Union…. The donation is coming at the time government has begun another phase of mass vaccination in its determination to control the coronavirus pandemic.”
 

Vaccine Uptake

 
USA Today (US) reports, “Gay and lesbian adults report higher vaccination rates overall against COVID-19 than heterosexual adults, the Centers for Disease and Control and Prevention announced in a new study. Data collected from the National Immunization Survey Adult COVID Module showed 85.4 percent of gay and lesbian adults over 18 had received at least one dose of a COVID-19 vaccine compared with 76.3 percent for heterosexual adults…. Across all sexual orientation categories, vaccination coverage was the lowest among non-Hispanic Black LGBTQ adults. Gay, lesbian, and bisexual women also had lower rates of vaccination coverage compared with men.”
 

Changes in Vaccine Schedule

 
As more data becomes available from the billions of vaccines administered, public health officials have evidence to help make decisions about changes in timing of vaccine doses to optimize immune responses or to avoid side effects.
 
Reuters (UK) reports, “US health officials on Friday said they are considering lengthening the recommended interval between the first two doses of the most widely used COVID-19 vaccines to eight weeks to lower the risk of heart inflammation and improve their effectiveness…. [CDC’s Dr. Sara] Oliver said an extended interval appears to reduce the risk of already rare cases of myocarditis, and that the lowest rates of heart inflammation following vaccination occur if the vaccines are given eight weeks apart.”
 
CNN (US) reports, “The US Centers for Disease Control and Prevention is clarifying the COVID-19 vaccination schedule for people who are moderately to severely immunocompromised, it said Friday, to address some of the challenges they may be having in getting an additional dose. The CDC has been recommending that immunocompromised people who got an mRNA vaccine get an additional booster, a fourth shot, at least five months after their third shot. It's going to revise these guidelines to encourage a booster at three months instead.… The CDC is also adding language to its guidance that will allow doctors who care for people who are moderately or severely immunocompromised to give them another dose of mRNA vaccine outside these recommendations ‘based on clinical judgment when the benefits of vaccination with a different schedule or dosage are deemed to outweigh the potential and unknown risks.’"
 

Challenge Trial Determined to Be Safe

 
Reuters (UK) reports, “The world's first ‘human challenge’ trial in which volunteers were deliberately exposed to COVID-19 to advance research into the disease was found to be safe in healthy young adults, leaders of the study said…The data supports the safety of this model and lays the groundwork for future studies to test new vaccines and medicines against COVID-19 using this kind of trial by the end of this year, the team added.”
 

Growing Understanding of Long COVID

 
Mercury News (US) reports on a perspective from Science which looks at how COVID affects the brain: “The virus doesn’t cause extensive infection in the brain. Instead, the neurological effects seem to be caused by ‘friendly fire’—an exaggerated or misguided immune response, as well as damage to the brain’s blood vessels…. ‘Immune activation and inflammation within the central nervous system is the primary driver of neurologic disease in acute COVID-19,’” the perspective authors say.
 
CIDRAP (US) reports, “A cohort study of Americans tested for SARS-CoV-2 infection shows that new-onset shortness of breath, heart rhythm abnormalities, and type 2 diabetes were more common 31 to 150 days after testing positive for COVID-19 than among those with negative results.
 
MedPage Today (US) reports, “Brains of COVID-19 patients had some of the same pathological changes seen in Alzheimer's disease, which may explain the memory problems people with long COVID experience, a small study suggested. The study, based on autopsies of 10 people who died with COVID-19, linked the inflammatory response found in SARS-CoV-2 infection with pathways causing tau hyperphosphorylation typically associated with Alzheimer's disease…”
 

About Those Omicron Booster Vaccines

 
Helen Branswell reports in STAT (US) reports, “new study conducted in primates suggests there may not be a benefit from updating COVID-19 vaccines to target the Omicron variant at this time. The work, by scientists at the National Institutes of Allergy and Infectious Diseases’s Vaccine Research Center, shows that animals boosted with the original vaccine had similar levels of protection against disease in the lungs as did primates that received an updated booster based on the Omicron strain. The work was done with Moderna’s licensed vaccine and a booster shot based on the Omicron variant.”
 

COVID and Children

 
Nature (UK) looks at whether Omicron is hitting children harder than previous waves. “Estimates show that the individual risk of a child with Omicron being hospitalized is, in fact, lower—by one-third to one-half—than it was when the Delta variant was dominant. And hospitalized children are not presenting with any more severe illness than they were with other variants…. Even if children generally recover from an acute infection with Omicron, clinicians still worry that they might develop long COVID, in which symptoms persist for months, or a rare but serious condition called multisystem inflammatory system in children (MIS-C).”
 
MedPage Today (US) reports, “Members [of the FDA's Vaccines and Related Biological Products Advisory Committee] are being asked to consider whether a three-dose COVID-19 vaccine series should be authorized when there are only data available on two doses, and so far, all that's known about those data is that noninferiority was not met in a prespecified immunogenicity analysis for kids ages 2 to under 5.” One expert says, “that authorities are likely trying to balance the ‘ongoing surge of Omicron, and the potential for new variants to break out, coupled with the increased hospitalizations among children that we've seen in this surge.’"
 

COVID and Pets

 
In a video on MedPage Today researcher Benjamin tenOever discusses the possibilities of COVID jumping from pets to humans. The issue has been in the news after Hong Kong killed thousands of hamster following an outbreak traced to a pet store. tenOever says, “An answer to that question of whether or not the emergence of Omicron in China was a direct result of hamster imports is an impossible question to ever answer. But it is true that it is in the realm of possibility…. The chances that you could give a virus to your pet or the pet could give a virus to you, of course, is much higher the closer you interact with these animals. Whereas like a deer in the wild, you know, if a virus is evolving there it's not necessarily a foregone conclusion that it will come back into humans.”
 
Nature (UK) reports, “Pet hamsters probably carried the Delta variant of SARS-CoV-2 into Hong Kong and sparked a human COVID-19 outbreak, according to a genomic analysis of viral samples from the rodents. The research confirms earlier fears that a pet shop was the source of the outbreak, which has so far infected about 50 people and led to the culling of some 2,000 hamsters across the city…. Hamsters are highly susceptible to SARS-CoV-2 and so are a popular model for studying the virus. But the Hong Kong study—posted online as a preprint1 and yet to be peer reviewed—is the first to show that hamsters can become infected outside the laboratory, and that they can pass the virus on to both other hamsters and humans.”
 

What Could Happen if China Relaxes COVID Zero Policies?

 
Reuters (UK) reports, “Restoring normal population mobility to 'COVID-zero regions' like China will cause some 2 million deaths in a year and the key to controlling the virus is developing vaccines that are better at preventing infection, Chinese researchers said…. Chinese scientists and public health specialists have reiterated the need for maintaining the stringent controls, saying the risks of transmission were too high and that mass infection would put intolerable pressure on the health system.’ Chinese researchers said in a study published in the Chinese CDC Bulletin, “The key to controlling COVID-19 lies in the development and widespread use of vaccines that are more effective at preventing infection.”
 

The Business of Pushing Anti-vax Info

 
MedPage Today (US) reports on the moneymaking for antivaxxers on the email platform Substack: “Popular email platform Substack generates some $2.5 million each year from anti-vaccine newsletters, according to a new report from the Center for Countering Digital Hate (CCDH). The controversial physician, Joseph Mercola, DO, runs one of the platform's most popular newsletters. Newsletters from Mercola and former New York Times reporter Alex Berenson account for more than $2.2 million of that revenue, according to the report…. Substack's content guidelines prohibit authors from conducting "harmful" activities, but the company doesn't outright prohibit users from spreading misinformation. In a post published last week, Substack co-founders Chris Best, Hamish McKenzie, and Jairaj Sethi, wrote a post entitled, ‘Society has a trust problem. More censorship will only make it worse.’"