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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
"Do not assume that governments will be willing to invest in preparedness, despite the catastrophe we have endured. Countries are already resisting calls to invest in the next replenishment round for the Global Fund to Fight AIDS, Tuberculosis and Malaria. If governments are unwilling to support an initiative with one of the best track records in global health, it is questionable whether they will make speculative investments to prevent a future pandemic. The disagreeable truth is that we are living at a very dangerous moment, one in which careless self-satisfaction is the reward we have given ourselves for this illusory triumph."
— Richard Horton in The Lancet ([link removed](22)00874-1/fulltext)


** Share of People Who Completed the Initial COVID-19 Vaccination Protocol
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May 17, 2022
Source: Our World in Data ([link removed])


** Table of Contents
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* If You Are in a Hurry (#hurry)
* The Failures of Public Health (#fail)
* Preparing for the Next Pandemic (#prep)
* Stop Spillovers (#stop)
* The Pandemic’s Impact on Girls in South Africa (#SA)
* North Korea Outbreak (#NK)
* US Government Contributes to Patent Pool (#US)
* Vaccine Access in Africa (#access)
* Flu Vaccine May Cut COVID Risk (#risk)


* Better Fat Bubbles (#fat)
* The Future of RNA Vaccines (#future)
* Boosters for American Children 5-11 (#future)
* Rising COVID Rates Among Children in South Africa (#rising)
* COVID Vaccines May Stave Off Some Post-COVID Health Issues (#issues)
* A Call for Better Mortality Data (#mortality)

Are we entering a new phase of the pandemic? Understanding BA.4 and BA.5 and other Omicron subvariants may help us understand where we are and where we are going. These subvariants of Omicron are driving upticks in COVID infections in the US, South Africa and turning up in other countries around the world. The subvariants have different mutations in the spike protein than the original Omicron variant. The most concerning thing about these two and a handful of other subvariants is their increased transmissibility. EuroNews ([link removed]) (France) quotes WHO’s Maria Van Kerkhove: “What we can say is as this virus evolves, the latest variants that we have, the Omicron variants and all the sublineages are more transmissible than the last variant that is circulating, and we know that that will continue.” The Washington Post
([link removed]) (US) reports, “With each new variant, that period of protection [from prior infection] keeps getting shorter. In the past few weeks, studies out of South Africa, the US, and China have revealed that Omicron subvariants BA.2.12.1, BA.4 and BA.5 are alarmingly good at escaping immunity from a previous Omicron infection. In practical terms, this means that for the large swath of the US population that was first infected with COVID over the winter, the post-infection honeymoon may be over. Those people might wonder how safe it is to travel, attend large gatherings and have dinner with vulnerable friends and relatives.”

The New York Times ([link removed]) (US) reports, “The central problem is that the coronavirus has become more adept at reinfecting people. Already, those infected with the first Omicron variant are reporting second infections with the newer versions of the variant — BA.2 or BA2.12.1 in the United States, or BA.4 and BA.5 in South Africa. Those people may go on to have third or fourth infections, even within this year, researchers said in interviews. And some small fraction may have symptoms that persist for months or years, a condition known as long COVID."



** If You Are in a Hurry
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* Read Richard Horton’s editorial in the Lancet ([link removed](22)00874-1/fulltext) about what is really needed for pandemic response.
* Read a comment in Nature ([link removed]) on the case to fund actions to stop spillover infections from animals to humans.
* Read Science ([link removed]) on efforts to improve the little bubbles of fat, also known as lipid nanoparticles that deliver mRNA vaccines.
* Read an interview with researcher Anna Blakney with The Human Vaccine Project ([link removed]) on the promise of RNA vaccines.
* Read physician and epidemiologist Jay Varma on how public health failed Americans in The Atlantic ([link removed]) .
* Read Nigeria Health Watch ([link removed]) on what’s needed for increased vaccine access in Nigeria and Africa.
* Read The Conversation ([link removed]) on the impact of COVID and lockdowns on the lives and education of young women in South Africa. And see how some found resilience.




** The Failures of Public Health
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Physician and epidemiologist Jay Varma writes in The Atlantic ([link removed]) (US) that in addition to the US government failing citizens in the pandemic, public also failed people. “As federal, state, and local health officials struggled in spring 2020 to obtain the basic funding, staff, lab supplies, and data systems to test, trace, and isolate cases, academics on Twitter and cable news became the face of public health—and they zeroed in on the many ways in which the US response to COVID-19 fell short of a textbook approach to pandemic control. Public-health agencies were ill-prepared for this crisis, and academics were ill-prepared to speak on their behalf.” He argues, the public face of the pandemic response was often “university-based physicians, epidemiologists, and virologists opining about what the government should do without fully understanding or communicating what is feasible, affordable, legal, and
politically acceptable for public-health agencies.”



** Preparing for the Next Pandemic
------------------------------------------------------------

Richard Horton writes in a scathing Lancet ([link removed](22)00874-1/fulltext) (UK) editorial that both Bill Gates and WHO’s proposed strategies for pandemic response fall far short of what is urgently needed. “Neither Gates nor WHO seem to understand the nature or true scale of this pandemic. First, SARS-CoV-2 thrived on inequality. There is no serious discussion about the way this virus exploited deep disparities across societies and why attacking these disparities must be part of preparedness planning. Second, COVID-19 is a disease that normalised inequity—for testing, vaccines, and now antivirals. There is no sense of urgency to advance equity. And third, COVID-19 is a zoonotic disease. There is no recognition that preventing a pandemic means redefining the relationship between humans, wildlife, and the viruses that pass among us. One final warning. Do not assume that governments will be willing to invest in preparedness, despite the
catastrophe we have endured. Countries are already resisting calls to invest in the next replenishment round for the Global Fund to Fight AIDS, Tuberculosis and Malaria. If governments are unwilling to support an initiative with one of the best track records in global health, it is questionable whether they will make speculative investments to prevent a future pandemic. The disagreeable truth is that we are living at a very dangerous moment, one in which careless self-satisfaction is the reward we have given ourselves for this illusory triumph.”



** Stop Spillovers
------------------------------------------------------------

A comment in Nature ([link removed]) (UK) argues, “an August 2021 analysis of disease outbreaks over the past four centuries indicates that the yearly probability of pandemics could increase several-fold in the coming decades, largely because of human-induced environmental changes. Fortunately, for around US$20 billion per year, the likelihood of spillover could be greatly reduced. This is the amount needed to halve global deforestation in hotspots for emerging infectious diseases; drastically curtail and regulate trade in wildlife; and greatly improve the ability to detect and control infectious diseases in farmed animals. That is a small investment compared with the millions of lives lost and trillions of dollars spent in the COVID-19 pandemic. The cost is also one-twentieth of the statistical value of the lives lost each year to viral diseases that have spilled over from animals since 1918…and less than one-tenth of the economic productivity erased
per year.”



** The Pandemic’s Impact on Girls in South Africa
------------------------------------------------------------

Zoe Duby writes in The Conversation ([link removed]) (Australia) about a study among adolescent girls and young women that looked at the impact of the COVID and lockdowns on their lives. “More than half of the young women who had been enrolled in education were not able to continue with their studies. Reasons for this included lacking cellphones or reliable internet access, and households struggling with food insecurity…. It wasn’t all doom and gloom. There were some rays of light in young women’s stories. Some participants showed educational resilience, and a determination to achieve their educational goals. Some girls spoke of how they had found ways to cope, and with resourcefulness and creativity, had remained motivated and focused. This helped them to reduce disruptions to their education.”



** North Korea Outbreak
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The New York Times ([link removed]) (US) reports, “North Korea said the number of suspected coronavirus infections in the vulnerable, isolated country was nearing 1.5 million on Tuesday, and that the virus had caused 56 deaths there since April. State media has recently been reporting hundreds of thousands of new patients a day with fevers, without saying how many of them had tested positive for the coronavirus…. Before the country’s current COVID outbreak was first reported last week, North Korea had claimed for more than two years that it had not had a single case of the coronavirus. Most of the country’s 25 million people are unvaccinated against the virus, and the country has rebuffed repeated international offers of millions of vaccine doses.”



** US Government Contributes to Patent Pool
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Science ([link removed]) (US) reports, “The US government has agreed to put licenses for 11 medical technologies developed at the National Institutes of Health (NIH) into a so-called patent pool, a move that promises to make it easier for low- and middle-income countries to gain access to vaccines, drugs, and diagnostics for COVID-19…. ‘It’s a pretty big deal,’ says James Love, who directs Knowledge Ecology International, a nonprofit that advocates for sharing intellectual property to benefit the public.”



** Vaccine Access in Africa
------------------------------------------------------------

Mail & Guardian ([link removed]) (South Africa) reports, “Data collected by the United Nations Children’s Fund (UNICEF) shows an alarming drop-off in shipments arriving across the [African] continent since the start of 2022, yet the only factory that produces vaccine shots locally is in danger of closing down…. According to official statistics from the government, somewhere in the region of a third of the South African population has received at least one vaccine to protect against COVID-19, but the number of people turning up to be jabbed has fallen from a peak of over a million a week in August 2021 to just 40,432 in mid-April.”

(UK) reports, “African leaders have called on the organisation in charge of procurement for the COVAX vaccine sharing scheme to commit to buying at least 30 per cent of all COVID-19 jabs produced on the continent, as the future of Africa’s biggest manufacturing facility hangs in the balance. In a communique from an African Union meeting…leaders of 16 African nations called for Gavi — a vaccine alliance which runs COVAX alongside the World Health Organization and the Coalition for Epidemic Preparedness Innovations — to ‘offtake at least 30 per cent of all vaccines produced by the continent for global consumption’. The heads of state and government, most of whom have plans to build local vaccine manufacturing capacity, also called on organisations responsible for bulk buying jabs ‘to prioritise procuring vaccines meant for African countries from African producers’. In the communique, leaders ‘expressed strong concern’ that Gavi had been ‘slow to support’ local production facilities,
‘therefore hampering African-based manufacturing.’”

Nigeria Health Watch ([link removed]) (Nigeria) reports, “In 2020, the Central Bank of Nigeria introduced the ‘Healthcare Sector Research and Development Intervention Scheme’ (HSRDIS) ([link removed]) as part of its policy response to the COVID-19 pandemic. The scheme is intended to boost the domestic manufacturing of critical drugs and vaccines, ensure their sustainable domestic supply, and reduce the cost of manufacturing drugs, medical devices, and vaccines in Nigeria. As at March 2021, N253.54 million worth of grants ([link removed]) have been awarded to five researchers. Vaccine manufacturing is a multifaceted undertaking, but it is imperative that Nigeria, and Africa continue to commit to reducing
dependence on other countries for life saving vaccines and drugs. Strengthening our health systems is critical to building resilient communities.”



** Flu Vaccine May Cut COVID Risk
------------------------------------------------------------

Nature ([link removed]) (UK) reports, “A study of more than 30,000 health-care workers in Qatar found that those who got a flu jab were nearly 90 percent less likely to develop severe COVID-19 over the next few months, compared with those who hadn’t been recently vaccinated against flu. The study, which was conducted in late 2020, before the roll-out of COVID-19 vaccines, is in line with previous work suggesting that ramping up the immune system using influenza vaccines and other jabs could help the body to fend off the coronavirus SARS-CoV-2.”



** Better Fat Bubbles
------------------------------------------------------------

Science ([link removed]) (US) reports on the potential for improvement of “the little fatty balls found in two of the world’s most widely used COVID-19 vaccines. Known as lipid nanoparticles (LNPs), these tiny bubbles of fat encase messenger RNA (mRNA) that encodes a viral protein, helping ferry it into cells and shield it from destructive enzymes. The technology was key to the success of COVID-19 shots from Moderna and the Pfizer-BioNTech collaboration. But as beneficial as these fats are, there is plenty of room for improvement…. A new generation of LNPs with greater potency, fewer side effects, increased stability, and more precise tissue-targeting properties is now under development at big pharma and biotech startups. Big money is at stake: These improved nanoparticles could lead to better mRNA vaccines for COVID-19 and other diseases. They might also help mRNA deliver on its promise as a therapeutic tool to
treat disease.”



** The Future of RNA Vaccines
------------------------------------------------------------

The Human Vaccine Project ([link removed]) looks at the future of RNA vaccines: “The rapid development and massive global deployment of mRNA-based COVID-19 vaccines was one of the greatest scientific success stories of the pandemic. But that doesn’t mean these vaccines are perfect. There are, in fact, several ways they can be optimized or improved.” In an interview, researcher Anna Blakney says, “self-amplifying RNA (saRNA) is just a type of messenger RNA (mRNA) that has all the same structural components, but it encodes four extra proteins that make up a replicase enzyme. This enzyme is able to make copies of the RNA once it gets into a cell. With mRNA, the amount of RNA you deliver in the vaccine is all you’re going to have. As soon as it gets into a cell it starts making protein, but it also starts getting degraded. With saRNA, once it gets into a cell it starts making protein, but it also makes copies of itself so then
you get many thousands more copies of RNA than you get with the mRNA. It’s also getting degraded, but since its replicating, you’re able to have a longer duration of protein expression.”



** Boosters for American Children 5-11
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The US FDA announced ([link removed]) , “Today, the US Food and Drug Administration amended the emergency use authorization (EUA) for the Pfizer-BioNTech COVID-19 Vaccine, authorizing the use of a single booster dose for administration to individuals 5 through 11 years of age at least five months after completion of a primary series with the Pfizer-BioNTech COVID-19 Vaccine. ‘While it has largely been the case that COVID-19 tends to be less severe in children than adults, the omicron wave has seen more kids getting sick with the disease and being hospitalized, and children may also experience longer term effects, even following initially mild disease,’ said FDA Commissioner Robert M. Califf, M.D.”



** Rising COVID Rates Among Children in South Africa
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Health-e News ([link removed]) (South Africa) reports, “Low vaccination rates and the highly transmissible Omicron sub-variant are behind the recent jump in COVID-19 infections amongst children between 10 and 14-years-old. In week 17 this age group represented 34.2 percent of all infections in South Africa…. Dr. Waasila Jassat is quoted: ‘The surge is being seen in all age groups and is due to a highly transmissible Omicron sub-variant that has shown some immune escape. However, younger people have a lower vaccination coverage, and are likely having lower immunity and are susceptible to infection.’”



** COVID Vaccines May Stave Off Some Post-COVID Health Issues
------------------------------------------------------------

MedPage Today ([link removed]) (US) reports, “Risks of long COVID symptoms and the incidence of new onset hypertension, diabetes, and heart disease were lower among vaccinated patients with breakthrough infection versus those with COVID who were unvaccinated, a large analysis of medical records in the US suggested…. The authors noted that in addition to the usual post-COVID symptoms, such as headaches, fatigue, body aches, and respiratory and gastrointestinal symptoms, they found that vaccination was associated with a lower risk of new-onset diseases such as hypertension, diabetes, heart disease, and mental disorders. They ‘very carefully captured new outcomes’ occurring after COVID, not merely pre-existing medical conditions, the group maintained.”



** A Call for Better Mortality Data
------------------------------------------------------------

In the PloS blog Speaking of Medicine and Health (US) biostatistician Bhramar Mukherjee lays out the need for more robust mortality data for COVID and beyond, noting the difficulty in determining the true number of COVID deaths and excess deaths during the pandemic. “With different countries having different levels of testing, varying protocols for classifying COVID-19 deaths, data paucity, data opacity (often driven by political dictum), incomplete death registration systems plagued by backlogs, such studies are extremely critical. Excess death estimates help us to assess the true toll of the pandemic and ensure a fairer comparison across countries. However, imperfect, and incomplete death registration often makes these calculations a tricky “missing data” problem…[when] not in a crisis. The pandemic has drawn public attention to the relevance of these measures, and the public has a right to accurate information. The cry for accurate mortality data is not just about paying respect to the
dead but these measures have serious implications for the lives of the living. To prioritize future healthcare resources, to rank and compare performance and needs of different countries and to appreciate the magnitude of this pandemic on human life, we need to know more about the true excess mortality rate during the pandemic.”

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