We know that COVID vaccines had a tremendous impact on the trajectory of the pandemic – in communities where they were available. Now a new modeling study estimated that impact.
 
CIDRAP (US) reports, “COVID vaccines reduced the potential global death toll during the pandemic by almost two-thirds in their first year, saving an estimated 19.8 million lives, according to a mathematical modeling study…in The Lancet Infectious Diseases.”
 
The flip side of the lives saved in rich countries, is the lives that weren’t saved in countries where vaccines were not—and often are still not—available. CIDRAP notes, “An additional 600,000 lives could have been spared if a World Health Organization (WHO) goal of vaccinating 40 percent of the population of every country by the end of 2021 had been met, the authors of the study say.”
 
The Lancet study authors stark conclusion: “COVID-19 vaccination has substantially altered the course of the pandemic, saving tens of millions of lives globally. However, inadequate access to vaccines in low-income countries has limited the impact in these settings, reinforcing the need for global vaccine equity and coverage.”
 
An IFRC press release this week notes, “A new analysis by the International Federation of Red Cross and Red Crescent Societies (IFRC) reveals that nearly 1 billion people in Asia and the Pacific are yet to receive a single dose of COVID -19 vaccine and remain at risk of serious illness and death.”
 

If You Are in a Hurry

• Read Ed Yong’s take on the “TB-ification of COVID” in The Atlantic.
• Read how tight sexual networks are impacting the spread of monkeypox in Science.
• Read Vox on the impact of the pandemic on healthcare for people in jail and prison in the US.
• Read David Harvey of the National Coalition of STD Directors in STAT about the lessons the US needs to heed from HIV, STIs and COVID in response to monkeypox.
• Read Healio on the pandemic impact on HIV testing rates in the US.
• Read a press release from Africa CDC that outlines the status and challenges of monkeypox on the continent.
• Read The Kenya News Agency on a new plan to bring COVID vaccines to communities.
• Read Healio on the risk of death from COVID for people of African ancestry with sickle cell trait.

 

The Long Pandemic Defeat?

 
Ed Yong writes in The Atlantic (US), “COVID is far from solved. The coronavirus is still mutating. Even at one of the lowest death rates of the pandemic, it still claims the lives of hundreds of Americans daily, killing more than twice as many people as die, on average, in car accidents. Its costs are still disproportionately borne by millions of long-haulers; immunocompromised people; workers who still face unsafe working conditions; and Black, Latino, and Indigenous Americans, who are still dying at higher rates than white Americans. When Kirsten Bibbins-Domingo, an epidemiologist and physician at UC San Francisco, works with low-income, Black, and Latino communities in the Bay Area, their concerns are less about returning to normal and more about ‘how to keep themselves safe,’ she told me. ‘Take it from a tuberculosis activist that you can lose political will, public attention, and scientific momentum and still have a disease that kills over a million people each year,’ Mike Frick of the Treatment Action Group told me. ‘We’re seeing the TB-ification of COVID start.’”
 
NBC News (US) reports, “as the [G7] leaders of the wealthiest democracies met again this week in the Bavarian Alps, combating the pandemic had fallen off the agenda, even as much of the developing world remains unvaccinated and health officials warn of another winter surge. There were no announcements about new efforts to fight the coronavirus or expand access to vaccines or treatments, no masks were worn in public by world leaders, and there were no vaccine or testing requirements for those traveling to the summit. President Joe Biden made no mention of the virus in any of his remarks.”
 

Reaching More with Vaccines in Kenya

 
A story from The Kenya News Agency details a new program to reach more people with COVID vaccines. “Amref Health Africa and AstraZeneca in collaboration with the Ministry of Health in Kenya have launched a fleet of Mobile Vaccination Clinics (MVCs) in an effort to protect last-mile communities from the pandemic. The ten movable clinics will bring COVID-19 vaccines and other health services to hard-to-reach communities across Kenya.”
 

Looking for Future Pandemics

 
A commentary in STAT (US) looks at “a visual analytics tool…designed…to help public health professionals understand and respond to new disease outbreaks by comparing them to historical ones…. The AIDO insights into the effect of human behavior on disease spread aligns with what has been seen during the COVID-19 pandemic, with behavioral responses to the timing and extent of lockdowns or mask-wearing recommendations having had major effects on either blocking or spreading the disease. Predicting the spread of infectious diseases, it turns out, isn't nearly as difficult as predicting human behavior.”
 

China’s mRNA Vaccine Hope

 
Nature (UK) reports, “China is getting closer to approving its first mRNA vaccine to protect people against COVID-19. In a small clinical trial, the Chinese vaccine candidate triggered a stronger antibody response in vaccinated adults when given as a booster shot than did a jab containing inactivated SARS-CoV-2, the vaccine platform that the country has mostly relied on so far. The experimental jab, called ArCoV, is a strong candidate to become China’s first approved mRNA vaccine. But what it would mean for the government’s handling of the pandemic is hard to know, say researchers. A highly effective mRNA vaccine would reduce the chances of widespread serious infections that could overwhelm hospitals. However, it is unlikely to bring an end to the country’s strict ‘zero COVID’ strategy, which uses mass testing and lockdowns to quash all infections.”
 

Refugees and COVID

 
The East African (Kenya) reports, “The recent explosion of violence in eastern DR Congo has triggered a new wave of refugees crossing into Uganda, presenting a potential health crisis as the region grapples with a new COVID-19 wave…. According to the Uganda Red Cross, the majority of the refugees are not vaccinated against COVID-19.”
 

Omicron Vaccines

 
Reuters (UK) reports, “COVID-19 vaccines this fall are likely to be based on the Omicron variant of the coronavirus rather than the original strain, although some experts suggest they may only offer significant benefits for older and immunocompromised people. Moderna, Pfizer and Novavax have been testing vaccines based on the first Omicron variant that became dominant last winter, BA.1, driving a massive surge in infections. On Wednesday, Moderna said its updated vaccine worked well against more recent Omicron sublineages, and that it was moving forward with plans to ask regulators for approval.”
 
Nature UK) reports as a US FDA advisory panel is scheduled to meet about whether vaccine should be updated, “Many—although by no means all—scientists agree that COVID-19 vaccines are overdue for change. But constantly emerging variants and hard-to-predict immune responses mean that it’s far from clear what the new jabs ought to look like.” John Moore is quoted: “The question the FDA advisers have to decide on is whether this modest increase is enough to justify the expense and complexity of a composition switch. I’ve seen nothing in the Pfizer and Moderna data to obviously justify a composition switch to Omicron."
 

This Week in Long COVID

 
Reuters (UK) reports on a small preprint study: “Some cases of long COVID may be the immune system's response to a SARS-CoV-2 infection lurking somewhere in the body, new findings from a small study suggest…. In the majority of those with long COVID, the spike protein from the surface of the virus was detectable for up to 12 months, whereas it was not present in plasma samples from recovered patients without lasting symptoms. Spike protein circulating in the blood could mean ‘a reservoir of active virus persists in the body,’ the researchers said…”
 

COVID and HIV Testing

 
Healio (US) reports, “New data showed a sharp decrease in CDC-funded HIV tests administered in health care and non-health care settings from 2019 to 2020—primarily among groups disproportionately affected by HIV…. Overall, they found that the number of HIV diagnoses reported to the CDC decreased by 17 percent in 2020 compared with 2019, whereas the number of CDC-funded HIV tests administered in health care and non-health care settings declined 43 percent and 50 percent, respectively.”
 

Mask Mandates Lifted in South Africa

 
VOA (US) reports, “South Africa has repealed COVID-19 rules that made masks mandatory in indoor public spaces, limited the size of gatherings and imposed entry requirements at its borders, the health minister said on Thursday. Around half of the country's 40 million adults have received at least one vaccine dose, with 46 percent fully vaccinated.”
 
SABC (South Africa) reports, “The Solidarity Doctors Network says South Africa’s decision to drop the compulsory wearing of masks was sudden and premature. The group consisting of over 6000 healthcare professionals says it is seeing the highest number of patients with upper respiratory tract infections in comparison to the last two years.”
 

The Pandemic and Prison Healthcare

 
Vox (US) reports, “America’s 1.7 million incarcerated people have a constitutional right to medical treatment. During the pandemic, many of them say they didn’t get it in time…. The pandemic erected even more barriers between incarcerated people and medical access. Our reporting found that jail and prison officials frequently denied outside appointments and prohibited outside providers from entering, while in-house doctors and nurses prioritized COVID-19 over other concerns. Medical workers were in critically short supply as people called in sick—or quit and were not replaced.”
 

COVID and Increased Risk of Neurological Diseases

 
The Star (Kenya) reports, “A new study from Denmark has found an increased risk of neurological problems such as Alzheimer's disease, Parkinson’s disease and stroke among patients with COVID-19…. [The study] analysed the health records of over half of the Danish population, found that those who had tested positive for COVID-19 were at an increased risk.”
 

Sickle Cell and COVID

 
Healio (US) reports, “Among patients with African ancestry, those with sickle cell trait are at a higher risk for COVID-19–related death, according to data published in JAMA Internal Medicine…. ‘Our findings suggest that SCT can further contribute to worse outcomes in individuals of African ancestry, and there is a need for new treatment strategies to improve clinical outcomes of COVID-19 in individuals with SCT,’ Verma and colleagues wrote.”
 

COVID and Traditional Medicines

 
A tweet from WHO Afro says, “70 traditional medicine experts from countries across #Africa held a virtual meeting with @WHO on the role of traditional medicine in the #COVID19 response. They unanimously agreed that clinical trials must be conducted for all medicines in the Region, without exception.”
 

Monkeypox Mutations

 
CIDRAP (US) reports, “The strain of the virus in the current monkeypox outbreak in nonendemic countries likely diverged from the monkeypox virus that caused a 2018-19 Nigerian outbreak and has far more mutations than would be expected, several that increase transmission, according to a study…in Nature Medicine…. Researchers found the current strain diverges from the original strain by 50 single nucleotide polymorphisms (SNPs), and several mutations made the virus more transmissible…. The authors said the outbreak was likely not caused by undetected silent spread, or from an animal-to-human crossover event. Instead, ‘Current data points for a scenario of more than one introduction from a single origin, with superspreader event(s) (e.g., saunas used for sexual encounters) and travel abroad likely triggering the rapid worldwide dissemination.’"
 

What Is the Status of Monkeypox?

 
David Harvey of the National Coalition of STD Directors writes in STAT (US), “While monkeypox has not technically been categorized as a sexually transmitted infection (STI), it looks and acts like common STIs and shares the same barriers to detection and treatment, including stigma and access to knowledgeable providers. For people like me who are working inside the broad national response to monkeypox, there are loud echoes of the earliest days of COVID-19 and, longer ago, of AIDS. But understanding the country’s capacity to contain monkeypox requires an examination of the STI epidemic that the nation has ignored for years, which is why these diseases continue to be out of control…. If HIV and COVID-19 were wake-up calls for the government to prioritize public health, monkeypox shows the consequences of hitting the snooze button too many times. HIV showed the importance of creating an infrastructure of health care workers who can provide approachable, competent care for stigmatized infections. COVID-19 revealed the make-or-break nature of coordinated logistics and communications.”
 
AP (US) reports, “The World Health Organization said the escalating monkeypox outbreak in more than 50 countries should be closely monitored but does not warrant being declared a global health emergency. In a statement Saturday, a WHO emergency committee said many aspects of the outbreak were ‘unusual’ and acknowledged that monkeypox—which is endemic in some African countries—has been neglected for years.”
 
In a press release Africa CDC says, “Africa CDC has continued to monitor the situation of monkeypox on the continent and globally, while supporting AU MS in their efforts to strengthen surveillance systems in-country and across borders. The tools required to contain this expanding outbreak include diagnostics, vaccines, and therapeutics, all of which are currently not easily accessible to AU MS. The technical and financial resources required to effectively respond to monkeypox in Africa are not yet optimally mobilised. Monkeypox remains a public health emergency in affected African countries, and is a high-risk pathogen for other neighbouring countries.”
 
NPR (US) reports, “On the surface, the monkeypox outbreak in the US doesn't look that bad, especially compared with other countries. Since the international epidemic began in May, the US has recorded 201 cases of monkeypox. In contrast, the UK has nearly 800 cases. Spain and Germany both have more than 500. But in the US, the official case count is misleading, Makofane and other scientists tell NPR. The outbreak is bigger—perhaps much bigger—than the case count suggests. For many of the confirmed cases, health officials don't know how the person caught the virus. Those infected haven't traveled or come into contact with another infected person. That means the virus is spreading in some communities and cities, cryptically.”
 

Monkeypox and Sexual Networks

 
Science (US) reports, “Ever since monkeypox started to sicken thousands of people worldwide this spring, two big questions have loomed: Why is a virus that has never managed to spread beyond a few cases outside Africa suddenly causing such a big, global outbreak? And why are the overwhelming majority of those affected men who have sex with men (MSM)? A long history of work on sexually transmitted infections (STIs) and early studies of the current outbreak suggest the answers may be linked: The virus may have made its way into highly interconnected sexual networks within the MSM community, where it can spread in ways that it cannot in the general population…”