As the map above shows, COVID vaccination rates are still very low in much of the world and access to proven treatments and diagnostics remains scarce in most low- and many middle-income countries. Yet POLITICO (US) reports the “program for the fast-tracking and distribution of COVID-19 vaccines, diagnostics and therapeutics is likely to close in its current form in the [northern hemisphere] fall The program, known as the ACT-Accelerator, is a collaboration among the WHO, governments and global health organizations that works to ensure equitable access to COVID tools. It faced significant obstacles to get vaccines to low- and middle-income countries, but it eventually succeeded in shipping over one billion shots. As COVID cases have declined from the height of the pandemic, ACT-A has struggled to secure funding with only Germany, Norway, Sweden and Canada promising the requested financing this year…. The questions about ACT-A’s fate come at a time when funding for the global COVID fight is winding down and as governments and major global health organizations turn their attention to other health issues, including pandemic preparedness.”
 

If You Are in a Hurry

• Read an editorial in Science arguing the need for science and politics to work together for health.
• Read STAT on efforts to develop an animal model to study long COVID.
• Read FT on the impact of immune imprinting on planning for future vaccines.
• Read Heidi Larson and colleagues in NEJM on understanding and overcoming vaccine hesitancy.
• Read a Washington Post profile of Tony Fauci.
• Read The New York Times on efforts to combat viral misinformation on TikTok.
• Check out “Monkeypox Vaccine 101” in Your Local Epidemiologist.
• Nature reports on the first documented case of COVID transmission from a cat to a human.

 

Science and Politics

 
An editorial in Science (US) argues, “The reality is that both science and politics are essential for public health to work well. Scientists inform public understanding of the patterns of health and illness in populations, especially when epidemics and pandemics strike. And politics—the way decisions are made in a democratic society—is vital for acting on the information and insights that the scientific community provides for the benefit of everyone…. The challenges of communicating messages about science, health, and truth are among the often-mentioned reasons for the fatigue and discouragement that public health and medical leaders face today. And that same frustration is transferred to those who seek to engage the wider public with these messages. Overcoming these challenges will surely be difficult, but with concerted effort it can be done, as it has before—for example, in efforts to promote widespread childhood immunizations. And this requires a never-ending commitment, as we are learning every day.
 
A NEJM (US) perspective looks at the decision making around policies for COVID interventions (vaccines and more). “For all interventions, there is some degree of uncertainty about long-term effects, given the relatively short course of the COVID-19 pandemic and the inherent difficulty involved in projecting likely outcomes with or without intervention…. For all interventions, there is some degree of uncertainty about long-term effects, given the relatively short course of the COVID-19 pandemic and the inherent difficulty involved in projecting likely outcomes with or without intervention.”
 

COVID Cases on the Rise Globally

 
AP (US) reports, “The number of new coronavirus cases rose by 18 percent in the last week, with more than 4.1 million cases reported globally, according to the World Health Organization. The UN health agency said in its latest weekly report on the pandemic that the worldwide number of deaths remained relatively similar to the week before, at about 8,500. COVID-related deaths increased in three regions: The Middle East, Southeast Asia and the Americas…. ‘This pandemic is changing, but it's not over,’ Tedros said this week during a press briefing. He said the ability to track COVID-19's genetic evolution was ‘under threat’ as countries relaxed surveillance and genetic sequencing efforts, warning that would make it more difficult to catch emerging and potentially dangerous new variants.”
 

Looking for a Pan-corona Vaccine

 
Forbes (US) reports on a study published in Science (US) that showed promising results in an animal study of an “’all-in-one’ vaccine currently in development could protect people from future COVID-19 variants, as well as SARS, MERS and new strains of other coronaviruses from other animals.” A Cal Tech statement quotes author Alexander Cohen: Animals vaccinated with the mosaic-8 nanoparticles elicited antibodies that recognized virtually every SARS-like betacoronavirus strain we evaluated. Some of these viruses could be related to the strain that causes the next SARS-like betacoronavirus outbreak, so what we really want would be something that targets this entre group of viruses. We believe we have that."
 
Reuters (UK) reports that BioNTech and Pfizer announced they would “start tests on humans of next-generation shots that protect against a wide variety of coronaviruses in the second half of the year. Their experimental work on shots that go beyond the current approach include T-cell-enhancing shots, designed to primarily protect against severe disease if the virus becomes more dangerous, and pan-coronavirus shots that protect against the broader family of viruses and its mutations.”
 

Viral Escape from Paxlovid

 
Science (US) reports, “a bevy of new lab studies shows the coronavirus can mutate in ways that make it less susceptible to [paxlovid], by far the most widely used of the two oral antiviral drugs authorized to treat COVID-19 in the United States. Researchers have found some of those mutations in variants already circulating in infected people, raising fresh concerns that physicians could soon lose one of their best therapies for fighting COVID-19. Taken together, the studies show that ‘when you put pressure on the virus it escapes,’ says David Ho, a virologist at Columbia University who was among the first to document drug resistance mutations in HIV some 3 decades ago. Ho was not involved with the new studies but is conducting similar work on SARS-CoV-2. Although the newly identified mutations have yet to become widespread, Ho and many other scientists think it’s only a matter of time. ‘Given the amount of infections out there, it’s going to come,’ Ho says.”
 

Responding to Health Crises on Multiple Fronts

 
In an interview with POLITICO (US) Atul Gawande, the head of the US Agency for International Development’s global health office outlines many of the challenges in global health and the US response to them. POLITICO notes, “The virus has killed millions across the globe—and shut economies, ravaged health systems and slashed the health care workforce. Low-income countries remain highly unvaccinated and the war in Ukraine is leading to food shortages, worsening the conditions for people living through droughts in parts of Africa. Now, monkeypox infections are causing some countries to scramble for vaccines. Combined, global officials confront health emergencies that are increasingly dire—and deadly—as nations wrestle with putting up money to curb their growth.” Gawande says, “COVID is not over. It is a continuing recurrent illness that we will be living with, at least for the next few years to come. And being prepared for a health system, whether it’s in the United States or abroad, that is going to have more hospital visits, more needs hitting primary health care offices…. We need to make sure that the health systems at home and around the world have the basic tools to respond.”
 
A Devex (US) opinion piece argues for development of a new fund that “would give USAID the flexibility to support high-impact global health innovations wherever there is a great opportunity or an urgent need…. Entering the third year of a global pandemic, everyone in the world is aware of the disruptive power of infectious diseases. Fortunately, we have in USAID an agency with a proven ability to fast-track health innovations suitable for deployment in very challenging conditions. We encourage others to join us in supporting the creation of the SIGHT Fund so we can take full advantage of these unique and valuable attributes.”
 

Repeat Infections

 
AP (US) reports, “medical experts warn that repeat infections are getting more likely as the pandemic drags on and the virus evolves – and some people are bound to get hit more than twice. Emerging research suggests that could put them at higher risk for health problems…. The risk of reinfection has been about seven times higher with omicron variants compared with when delta was most common, research out of the United Kingdom shows. Scientists believe the omicron mutants now causing the vast majority of US cases are particularly adept at getting around immunity from vaccination or past infection, especially infection during the original omicron wave. US health officials are mulling whether to modify boosters to better match recent changes in the coronavirus.”
 

Animal Model for Long COVID

 
STAT (US) reports on a study published “in Science Translational Medicine, showing [that] hamsters mimic some symptoms and molecular changes observed in humans [with long COVID] and pointing to several plausible explanations for the disease. If further research bears out the results, these hamsters and several other groups of animals at other labs could allow scientists to probe the basic biology of the mysterious disease, performing the kinds of analyses that you could never do in humans. They may even allow academics and companies to screen therapies before testing them on humans, a crucial step in building up what remains a barren therapeutic armamentarium.”
 

Immune Imprinting and Vaccines

 
FT (UK) reports, “Research into immune imprinting, whereby exposure to the virus via either infection or vaccination determines an individual’s level of protection, is now driving the debate over the make-up of COVID-19 vaccines. Immunologists say that, more than two years into the coronavirus pandemic, people have acquired very different types of immunity to the Sars-Cov-2 virus, depending on which strain or combination of strains they have been exposed to — leading to big differences in COVID-19 outcomes between individuals and countries.”
 

COVID from a Cat

 
Nature (UK) reports, “A team in Thailand reports the first solid evidence of a pet cat infecting a person with SARS-CoV-2 — adding felines to the list of animals that can transmit the virus to people…. Researchers say that such cases of cat-to-human transmission are probably rare. Experimental studies have shown that infected cats don’t shed much virus, and shed for only a few days, says Leo Poon, a virologist at the University of Hong Kong. Still, Chusri says it is worth taking extra precautions when handling cats suspected of being infected. People ‘should not abandon their cats, but take more care of them’, he says.”
 

COVID 3^rd Leading Cause of Death in US

 
A US NIH statement says, “COVID-19 was the third leading cause of death in the United States between March 2020 and October 2021, according to an analysis of national death certificate data by researchers at the National Cancer Institute, part of the National Institutes of Health. The study appears July 5 in JAMA Internal Medicine. During the 20-month period studied, COVID-19 accounted for 1 in 8 deaths (or 350,000 deaths) in the United States…. The pandemic has also had an indirect effect on other causes of death in the United States. Past data have shown that deaths from other causes, including heart disease, accidents, stroke, Alzheimer’s disease, and diabetes increased from 2019 to 2020, possibly because people were reluctant to seek medical care for fear of catching COVID-19.”
 

Understanding Vaccine Hesitancy

 
Heidi Larson and colleagues write in NEJM (US) “Given the dynamic and changing nature of vaccine hesitancy—particularly obvious in the context of COVID-19—keeping vaccine conversations open and ongoing will be important in order to identify and address emerging concerns early….Physicians and other health care providers are still among the most trusted persons when it comes to health care advice. The Wellcome Global Monitor surveyed people in 140 countries and found that 73 percent of the respondents said that they would trust a doctor or a nurse more than others; the percentage was 90 percent in the higher-income countries. Vaccine acceptance can increase, but health care providers need to offer support and encouragement and listen to what matters from the patient’s perspective. Equipping physicians with information on the nature and scope of circulating concerns in their communities may help them address such concerns in the clinic, while also informing appropriate interventions at the community level.”
 
A study in Nature Communications (UK) looks at vaccine hesitancy in 23 countries in 2021. “Here, we show that more than three-fourths (75.2 percent) of the 23,000 respondents report vaccine acceptance, up from 71.5 percent one year earlier. Across all countries, vaccine hesitancy is associated with a lack of trust in COVID-19 vaccine safety and science, and skepticism about its efficacy. Vaccine hesitant respondents are also highly resistant to required proof of vaccination; 31.7 percent, 20 percent, 15 percent, and 14.8 percent approve requiring it for access to international travel, indoor activities, employment, and public schools, respectively. For ongoing COVID-19 vaccination campaigns to succeed in improving coverage going forward, substantial challenges remain to be overcome. These include increasing vaccination among those reporting lower vaccine confidence in addition to expanding vaccine access in low- and middle-income countries.”
 

Profiling Fauci

 
In a Washington Post (US) profile of Tony Fauci, he predicts the future of COVID: “He has said COVID will be his last pandemic and that he expects deaths will drop to 100 a day, with a mortality graph featuring bunny-slope waves rather than black diamond peaks. (As of press time, the daily death count was 239.) Fauci thinks we’re in the second-to-last spike; the next one will come in the fall, perhaps, but will hopefully be accompanied by a variant-specific booster. He believes we will eventually only need yearly shots.”
 

Vaccines and Long COVID

 
CIDRAP (US) reports, “An observational study of Italian healthcare workers infected with SARS-CoV-2 who didn't require hospitalization suggests a link between two or three doses of vaccine and a lower prevalence of long COVID.”
 

Combatting Misinformation on TikTok

 
The New York Times (US) reports, “Misinformation is widespread on all of the major social media platforms, but TikTok’s audio capabilities can give false claims particular longevity. Bits of misinformation clipped and saved as what TikTok calls sounds ‘operate like viral chain messages,’…” Several people are working to respond and debunk misinformation on the platform, including COVID experts. “The lack of science literacy online was partly what inspired Katrine Wallace, an epidemiologist and a professor at the University of Illinois at Chicago, to start debunking inaccurate content on TikTok. At the start of the pandemic, she noticed that users were debating whether COVID was even real, and she has since debunked videos stating that COVID vaccines cause death within six months, for example, and that microscopic worms or parasites are found in surgical face masks. That topic recirculates every six months, she said in an interview, adding, ‘People are obsessed.’”
 

Monkeypox Updates

 
A statement from the WHO regional director for Europe notes cases of monkeypox have tripled in the region in the last week. “Today, I am intensifying my call for governments and civil society to scale up efforts in the coming weeks and months to prevent monkeypox from establishing itself across a growing geographical area. Urgent and coordinated action is imperative if we are to turn a corner in the race to reverse the ongoing spread of this disease…. There is simply no room for complacency – especially right here in the European Region with its fast-moving outbreak that with every hour, day and week is extending its reach into previously unaffected areas.”
 
News24 (South Africa) reports, “History could repeat itself with African countries left behind in the fight against monkeypox just like at the onset of the COVID-19 vaccine rollout. [WHO] regional director for Africa, Dr Matshidiso Moeti, has pleaded for this trend to be stopped. ‘What happened in the early days of the COVID-19 vaccine rollout when Africa watched on the side-lines as other countries snapped up limited supplies must not be allowed to recur. There are some signs that this is already happening,’ said Moeti. ‘With new cases confirmed in non-endemic countries, namely South Africa, Morocco, and Ghana, it is more important than ever to eradicate the disease in Africa.’”
                                                        
Epidemiologist Katelyn Jetelina has published a “Monkeypox Vaccine 101” in her substack Your Local Epidemiologist (US). “We have two vaccine options in the US, with one more favorable than the other. Jynneos is safe and effective. If you’re eligible, go get a vaccine. Vaccines will help control this epidemic, but we need to do the ground work: educate, answer questions, reduce stigma, and improve access. We absolutely need to take this virus seriously so it doesn’t become endemic in more places around the world.”