-- Paul Kagame, Emmanuel Macron, Cyril Ramaphosa, Macky Sall, Olaf Scholz, and Tedros Adhanom Ghebreyesus in Le Monde

 

COVID-19 has exposed many of the weaknesses in global, national and local public health responses. One big question is how the lessons of the COVID-19 response will be used to reform public health agencies across the globe. From the beginning of the COVID-19 crisis the US CDC has been criticized for often slow and inadequate responses and confusing guidance. Much of the early issues are closely tied to an overall US government response led by a President who all to often practiced denial and disinformation. Under a new more science friendly administration CDC is moving to make changes. The Washington Post (US) reports, “A consistent criticism has been the agency’s failure to be agile, especially with the analysis and release of real-time data..” The article quotes CDC Director Rochelle Walensky: “For 75 years, CDC and public health have been preparing for COVID-19, and in our big moment, our performance did not reliably meet expectations. My goal is a new, public health action-oriented culture at CDC that emphasizes accountability, collaboration, communication, and timeliness.” Time will tell if these changes will lead to better responses to the ongoing pandemics and outbreaks and better plans for future ones.
 
CNN (US) reports, “The pandemic laid bare the gaps and disparities in the US public health system, and often resulted in blowback against local officials trying to slow the coronavirus's spread. But one positive outcome, in part fueled by a boost in federal dollars, is that health workers have started adapting lessons they learned from their COVID-19 response to other aspects of their work….[For example] in Houston, health officials announced this month they'll begin monitoring the city's wastewater for monkeypox, a tactic broadly used to gauge how far and fast COVID-19 spread. And in Chicago, government agencies have tweaked covid collaborations to tag-team a rise in gun violence.”
 

 

 
The Guardian (UK) reports the UK is the first country to approve a COVID-19 vaccine booster shot that targets the Omicron variant as well the original virus. “Manufactured by the US firm Moderna, the vaccine targets not only the original coronavirus – as is the case for vaccines currently in use – but is designed specifically to target the Omicron variant BA.1, which fuelled a wave of COVID-19 in the UK last winter…. The MHRA said an exploratory analysis of the bivalent vaccine had shown it generated a good immune response against the Omicron subvariants BA.4 and BA.5. According to Moderna, trial participants who were given the booster had antibody levels against these subvariants that were 1.69 times higher than those given the original booster.”
 
The New York Times (US) reports on results of clinical trials to test the impact of the century old BCG vaccine for TB on COVID-19 and other diseases. The Times reports, “the results of clinical trials conducted during the pandemic are coming in, and the findings, while mixed, are encouraging…. ‘We have seen clear immunological effects of BCG, and it’s tempting to ask if we could use it — or other vaccines that induce training effects on immunity — against a new pathogen that emerges in the future, that is unknown and that we don’t have a vaccine for,’ said Dr. Mihai Netea…co-principal author [of one of the studies]… ‘Nobody argues that there are off-target effects, but how profound is that, and does it translate to a clinical effect? And is it confined to neonates, whose immune systems are more susceptible? These are very different questions,’ Dr. [Nigel] Curtis, [not involved with any of the studies] said.”
 
The Guardian (UK) outlines some of the research into new COVID-19 vaccine strategies, including nasal vaccines, vaccine pills and pan-corona virus vaccines. “Scientists hope nasal vaccines, similar to those used for seasonal flu, could overcome this shortcoming and help weaken the chain of transmission and reduce the continued impact of Covid. There are at least 12 nasal vaccines in clinical development, with four in phase 3 trials, and many view an effective nasal vaccine as the next major prize for vaccine research…. A phase 2 trial [of a vaccine in tablet form] with 900 participants is under way and expected to report next year….[Research into pan-corona vaccines “is some way off and is perhaps best viewed as pandemic preparedness research rather than something likely to yield a new COVID-19 vaccine that could be widely deployed in the next year.”
 
Reuters (UK) reports, Novavax “filed for US authorization for use of its COVID-19 vaccine as a booster dose in people who had either received its shots or a different vaccine. The application to the US Food and Drug Administration comes in the face of a slow rollout in the United States, where the Novavax vaccine was authorized in July, despite expectations that it would convince vaccine skeptics to get inoculated.” In a Twitter thread Monica Gandhi writes she, “think this is great use of this particular vaccine as "mixing and matching" (specifically mixing) seems to boost responses…”
 
Africa News (Congo) reports that in Le Monde a group of European and African leaders, including Emmanuel Macron, Paul Kagame, Cyril Ramaphosa, Olaf Scholz, WHO’s Tedros, and others “called for ‘technology sharing’ and ‘innovation support’ to produce more vaccines locally in the world to combat pandemics, writing, "’It is high time to intensify collaboration, promote local production and build confidence in locally produced products, in order to be better prepared for the next crisis…. They call for more training of personnel, more regulation, in Africa and elsewhere in the world, and more investment ‘in pandemic preparedness’. mRNA technology can also be ‘adapted to fight other diseases, such as HIV infection, tuberculosis, malaria and leishmaniasis’, they note.”
 

 
POLITICO (US) reports, “Governments worldwide quickly mobilized to slow early COVID-19 infections, but patients stuck with long-term, debilitating symptoms from the virus — sometimes left unable to work or perform basic daily tasks — feel national and international responses have ignored one of the pandemic’s most significant effects, nearly a dozen activists in 10 countries told POLITICO. ‘We are just left to rot,’ said Chantal Britt, founder and president of Long COVID Switzerland. ‘That’s why all those organizations are popping up: There is no official help.’… Some studies suggest long COVID could affect as much as 30 percent of people who are infected — a fact that is not often publicly discussed when governments talk about which preventive measures are appropriate at this stage of the pandemic. The long-term effects of the virus could disable enough people to even have global economic impacts researchers worry.”
 
CIDRAP (US) reports, “A pair of studies published today detail long COVID, with US researchers finding that more than one in four pediatric patients hospitalized for COVID-19 or multisystem inflammatory syndrome in children (MIS-C) [a rare but serious post-infectious complication of COVID-19] had persistent symptoms or impaired activity 2 to 4 months later, and a Norwegian study revealing that nearly half of patients with mild COVID-19 still had symptoms after 1 year."
 

 
Nature (UK) reports, “As global monkeypox cases continue to soar, researchers are learning more about how the disease is spreading. Early predictions that the virus transmits primarily through repeated skin-to-skin contact between people have largely borne out, according to a tranche of new studies… Several studies…show that few people contract the disease from an infected household member with whom they didn’t have sexual contact. This finding, paired with the data about viral load, suggests that respiratory droplets and airborne particles probably aren’t the primary transmission route, [infectious-disease physician Boghuma] Titanji says. If corroborated by further research, it could call into question whether people should isolate for the entire duration of infection, which might be difficult because the illness seems to take up to a month to resolve…”
 
Ben Ryan reports in NBC News (US) reports, “an expanding cadre of experts has come to believe that sex between men itself — both anal as well as oral intercourse — is likely the main driver of global monkeypox transmission. The skin contact that comes with sex, these experts say, is probably much less of a risk factor. In recent weeks, a growing body of scientific evidence — including a trio of studies published in peer-reviewed journals, as well as reports from national, regional and global health authorities — has suggested that experts may have framed monkeypox’s typical transmission route precisely backward. Reconceiving the primary risk factors for transmission is crucial because of how it may affect guidance on reducing the risk of infection, including the question of whether demanding that people with the virus self-isolate has any substantial impact on transmission."
 
Axios (US) reports, “The CDC updated its monkeypox guidance on pets after a new study reported that a dog tested positive for the virus in France. Monkeypox infection among domesticated animals, such as dogs and cats, had never previously been reported, note researchers from Sorbonne University in the study, published in The Lancet medical journal… ‘Infected animals can spread Monkeypox virus to people, and it is possible that people who are infected can spread Monkeypox virus to animals through close contact’ the Centers for Disease Control and Prevention states in its guidance. ‘While we do not know all the symptoms infected animals may have, watch the animal for potential signs of illness including lethargy, lack of appetite, coughing, nasal secretions or crust, bloating, fever, and/or pimple- or blister-like skin rash.’”
 
POLITICO (US) reports, “It may be too late to stop monkeypox from circulating in the US permanently… Epidemiologists, public health officials and doctors now fear the government cannot eliminate the disease in [the MSM] community, and they’re warning that they are running out of time to stop the virus from spreading in the US population more broadly. ‘We now have so many infections in so many corners of the Earth that it will be very difficult to chase this down with vaccination campaigns,’ said Sara Sawyer, a professor at the University of Colorado in Boulder who studies the spread of animal viruses to humans. ‘Not only do we not have enough vaccines, but if even some people go undetected or don’t have symptoms, they’re going to continue to spread it.’”
 
The Hill (US) reports, “The World Health Organization (WHO) announced Saturday that it renamed variants of the virus monkeypox as it looks to counter concerns about the original naming conventions. The Congo Basin and West African variants were reclassified as Clade I and Clade II, the latter of which has two subclades. The new names go into effect immediately. A global expert group decided on the new naming convention ‘as part of ongoing efforts to align the names of the monkeypox disease, virus, and variants—or clades—with current best practices.’”
 

 
COVID-19 has given new life and attention to preprints. A Nature Podcast (UK) looks at preprints and their impact on science. “Amongst other things, we ask whether preprints could help democratize science or contribute to a loss of trust in scientists. We pick apart the relationship between preprints and peer-reviewed journals and tackle some common misconceptions. We ask how preprints have been used by different fields and how the pandemic has changed the game. And as we look to the future, we ask how preprints fit into the discussion around open access and even if they could do away with journals all together.”
 

 
Reuters reports, “A measles outbreak has killed 80 children in Zimbabwe since April, the ministry of health has said, blaming church sect gatherings for the surge. In a statement seen by Reuters on Sunday, the ministry said the outbreak had now spread nationwide, with a case fatality rate of 6.9 percent.” An official is quoted: “Most reported cases are among children aged between six months and 15 from religious sects who are not vaccinated against measles due to religious beliefs.”
 
CNBC (US) reports, “Polio has been circulating locally in the New York City metropolitan area for months after an individual introduced the virus from abroad, according to the Centers for Disease Control and Prevention… Polio has also been detected in New York City sewage samples, state health officials confirmed on Friday… No additional cases of paralytic polio have been confirmed, though CDC officials warned that detection of the virus in wastewater samples collected over the course of more than two months in Rockland and Orange indicates community transmission of the virus that puts unvaccinated people at the risk of paralysis.”
 
CBC (Canada) reports, “When scientists published a letter in early August announcing a little-understood virus was infecting dozens of people in China, it echoed headlines from more than two-and-a-half years earlier. A novel pathogen. People falling ill with fever, cough, fatigue. Both humans and animals getting infected. In this case, the letter was about the arrival of the Langya henipavirus… The vast majority of cases were farmers, who faced a range of symptoms, including fever, fatigue, cough, nausea, headaches, and vomiting. But there are no reports of human-to-human transmission — at least not yet… The most likely scenario for Langya…is that the case count remains small, human transmission fizzles out, and it doesn't spark a COVID-level pandemic… Researchers expect more animal-to-human virus transmission in the years ahead, thanks to factors such as globalization, widespread development, and ongoing encroachment on animal habitats.”