COVID News Brief: The news you need to know

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AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.
"In the darkest days of the AIDS epidemic, Dr. Fauci never gave up. We didn’t sit with the mounting dead and our pitiful armamentarium of weak drugs and suggest we had the tools. We fought, and we argued, for sure, but we moved ahead together, never satisfied with the status quo."
-- Gregg Gonsalves on Dr. Fauci's retirement in The New York Times ([link removed])


** Share of People Who Completed the Initial COVID-19 Vaccination Protocol
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August 24, 2022
Source: Our World in Data ([link removed])


** Table of Contents
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* If You Are in a Hurry (#If You Are in a Hurry)
* Fauci’s Next Chapter (#Fauci’s Next Chapter)
* COVID-19 Deaths Rise (#COVID-19 Deaths Rise)
* Monkeypox Updates (#Monkeypox Updates)
* Call to Stop Using Ineffective Medicines (#Call to Stop Using Ineffective Medicines)
* Asymptomatic Omicron Infections (#Asymptomatic Omicron Infections)
* Long COVID Updates (#Long COVID Updates)
* Vaccine Rollout in Tanzania (#Vaccine Rollout in Tanzania)


* Into the Sewer for Science and Science Reporting (#Into the Sewer for Science and Science Reporting)
* Paxlovid Rebound (#Paxlovid Rebound)
* Original Antigenic Sin (#Original Antigenic Sin)
* Virus Origins (#Virus Origins)
* Paternalism, Power and the UK Government COVID-19 Response (#Paternalism, Power and the UK Government COVID-19 Response)
* Philippine Schools Reopen (#Philippine Schools Reopen)
* Myocarditis Risk with COVID-19 (#Myocarditis Risk with COVID-19)

The volume of news about COVID-19 is exponentially smaller now than it was when we began this newsletter. As COVID-19 news has waned somewhat in recent weeks, Monkeypox news is growing, especially in North America and Europe where the latest outbreak is centered. And now another virus is hitting front pages and top of the hour news breaks – hello again Polio. As Katelyn Jetelina writes in her blog Your Local Epidemiologist ([link removed]) (US): Well, we currently have three public health emergencies across the globe and in the United States: COVID-19, monkeypox, and polio…. Buckle up.” Apoorva Mandavilli writes in The New York Times ([link removed]) (US) that hopes for the global eradication of polio have been dashed in recent weeks. “[E]radication is an uncompromising goal. The virus must disappear from every part of the world and stay gone, regardless of wars, political
disinterest, funding gaps or conspiracy theories. New signs of the virus in a single country can derail the effort…. The COVID-19 pandemic left many other countries vulnerable to a resurgence of polio: It disrupted vaccination drives for months and diverted staff and resources away from prevention programs, resulting in the worst backslide in immunization rates in 30 years.”

Just as with monkeypox, outbreaks in wealthy countries – the UK, US and Israel – have generated substantially more media coverage than outbreaks in other countries that have continued through the COVID pandemic. WHO’s Oliver Rosenbauer tells Nature ([link removed]) (UK): “Outbreaks in wealthy countries get lots of attention… ‘But over the past 20 years, we’ve had many, many serious outbreaks around the world in developing countries.’ Rosenbauer says there are encouraging signs that the battle to eradicate polio is making progress, despite the disruption caused by COVID-19. Outbreaks in Yemen and a few countries in Africa are still active, he says, but their range is shrinking. In places where there is armed conflict, such as areas of Afghanistan and Yemen, vaccination is difficult. ‘We need the political will to implement a plan to reach all the children in challenging areas,’ he says. Otherwise, ‘the disease will come back globally’.”


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* Read NPR ([link removed]) on a new study that found most people with Omicron infections were unaware they had COVID-19.
* Read AIDS activist Gregg Gonsalves in what Tony Fauci’s retirement means in The ([link removed]) New York Times ([link removed]) and read Fauci’s advice to his successor in Axios ([link removed]) .
* Read Science Speaks ([link removed]) on vaccine rollout successes in Tanzania.
* See a New York Times ([link removed]) photo essay on the complex and sometimes gross process of testing wastewater for viruses and then read another New York Times ([link removed]) article from of the journalists about the process of getting the story.
* Take a deep dive into original antigenic sin in The Washington Post ([link removed]) and while you are there watch the embedded video that explains how Omicron broke through vaccines.
* Read Devex ([link removed]) on how Africa is being ignored in the monkeypox response.
* Read a STAT ([link removed]) opinion piece on the imperative to learn the lessons of HIV stigma in the response to monkeypox.
* Read Jon Cohen in Science ([link removed]) on the Chinese government pushback against the virus originating in China.
* Read Paternalism and Power in UK Pandemic Preparedness and Response ([link removed]) on the UK’s global response to COVID-19.




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The announcement that NIAID director Anthony Fauci would be leaving his role in December prompted several media outlets and individuals to look back on a storied career. In a New York Times ([link removed]) guest essay activist Gregg Gonsalves writes, “In the darkest days of the AIDS epidemic, Dr. Fauci never gave up. We didn’t sit with the mounting dead and our pitiful armamentarium of weak drugs and suggest we had the tools. We fought, and we argued, for sure, but we moved ahead together, never satisfied with the status quo. If he weren’t retiring in December, I’d imagine him working to his very last breath until there was a cure for AIDS. We should all have his resolve and commitment, even if Dr. Fauci lives in a world of dire constraints, of the men and women of politics, who dream small and think about the next election always, rather than the nature and qualities of their legacies, of which Dr. Fauci’s is assuredly great.”

In an interview with Axios ([link removed]) (US) Fauci says, “It isn't like I or my colleagues say, ‘I'm going to be polarizing today.’ You stick to the facts, and if people push back against the science and the evidence and create unreality, that's the reason for the polarization.’ One piece of advice for his successor: ‘Stick with the science, and try as best as you can to completely stay out of the political stuff. The political stuff will spill over into what you do....That's unfortunate. But the scientists themselves must stay out of the politics.’"



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Global News ([link removed]) (Canada) reports, “Reported COVID-19 deaths around the globe have increased by 35 per cent over the past four weeks, the World Health Organization said Wednesday, warning that risk factors are set to increase as cold weather approaches. In the last week alone, 15,000 people died from COVID-19 globally, according to WHO Director-General Tedros Adhanom Ghebreyesus.” Tedros is quoted: “There is a lot of talk about learning to live with this virus, but we cannot live with 15,000 deaths a week. We cannot live with mounting hospitalizations and deaths.”

Kyodo News ([link removed]) (Japan) reports, “Japan saw a record 343 daily COVID-19 deaths on Tuesday amid the ongoing seventh wave of coronavirus infections, exceeding the previous high of 327 logged during the previous wave in late February, according to a tally of new cases across the country. The death toll is also quickly mounting as monthly virus-related deaths exceeded 5,000 for the first time on Tuesday with more than a week left to go in August.



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The New York Times ([link removed]) (US) reports on racial disparities in the Monkeypox response in New York that mirror those seen in the COVID-19 response. “White New Yorkers represent about 45 percent of people at heightened risk of monkeypox infection, and received 46 percent of vaccine doses. Black New Yorkers, who make up 31 percent of the at-risk population, received only 12 percent of doses administered so far, according to data from the city’s Health Department. Hispanic residents were overrepresented among vaccine recipients. They made up 16 percent of the at-risk population, but received 23 percent of shots. Hispanic men so far represent the largest share of monkeypox patients…. Racial and ethnic imbalances in vaccine distribution are also happening elsewhere, as a highly limited supply of monkeypox vaccine has often gone first to those with better access to the health care system and more time to figure out when
doses will be released.”

Devex ([link removed]) (US) reports, “African countries have recorded seven of the 12 deaths in the monkeypox outbreak so far, but have watched as high-income nations divide up the available supplies of vaccines and treatments. It echoes the disparities in the initial distribution of COVID-19 vaccines, experts say, but also a decades long disregard of monkeypox in Africa. ‘We’re a bit disappointed that it took the occurrence of cases outside of the continent for people to pay attention and then to sit up and declare an emergency, when no such effort was done for countries that have had monkeypox in the background for years,’ said Ifedayo Adetifa, the director general of the Nigeria Centre for Disease
Control…. Infectious disease expert [Boghuma] Titanji is looking for WHO or another international body to introduce a structured system to facilitate sharing of vaccines and treatments and to ensure some level of accountability. ‘It’s been a month since the [public health emergency of international concern] was declared,’ she said. ‘I’d like to see something beyond just statements and calls for solidarity.’”

In an opinion piece in STAT ([link removed]) (US) infectious disease doctor Ofole Mgbako writes, “Had this outbreak been among young children in classrooms and summer camps across the country, the public health response would almost certainly have been swift to protect them. But it happened among a community whose lives are undervalued and whose rights are under attack, and has escalated into a mass trauma event for the LGBTQ+ community. There’s a palpable sense of frustration among my infectious disease colleagues since it feels like we haven’t learned at all from the past. But lessons from the history of HIV/AIDS might show a path forward in policy and approach to prevent stigma from influencing the spread of monkeypox and the treatment of people with it.”



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In a NEJM ([link removed]) (US) editorial Slim Abdool Karim and Nikita Devnarain write that early rushed and sometimes badly conducted clinical trials seemed to provide evidence for some treatments that have become widely used. “Ivermectin and fluvoxamine, in particular, are still widely prescribed, even though evidence has been steadily accumulating to indicate that both treatments at acceptable doses are not effective for COVID-19…. Prescribing nonefficacious treatments is not a neutral or harmless option. In addition to denying patients the appropriate treatment, such prescribing can lead to side effects without any therapeutic benefit and to drug shortages for patients who need the medications for other conditions…. In keeping with evidence-based medical practice, patients with COVID-19 must be treated with efficacious medications; they deserve nothing less.”

The editorial refers to results of a trial testing Metformin, Ivermectin, and Fluvoxamine for COVID-19 published in NEJM ([link removed]) (US) as well. Th study authors concluded, “None of the three medications that were evaluated prevented the occurrence of hypoxemia, an emergency department visit, hospitalization, or death associated with COVID-19.”



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NPR ([link removed]) (US) reports, “The majority of people likely infected with the omicron variant that causes COVID-19 were not aware they contracted the virus, which likely played a role in the rapid spread of omicron, according to a study published this week… Of the 210 people [of 2,479 blood samples] who likely contracted the omicron variant — based on antibodies in their blood — 56 percent did not know they had the virus, the researchers found… They also found that only 10 percent of those who were unaware reported having any symptoms relating to a common cold or other type of infection…A lack of awareness could be a major factor in the rapid transmission of the virus between individuals, according to the study.” Read the JAMA ([link removed]) study.



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Science ([link removed]) (US) reports, on a preprint study: “An ambitious study of people with Long COVID, the mysterious, disabling symptoms that can trail a SARS-CoV-2 infection, has turned up a host of abnormalities in their blood. The clues add to a body of evidence hinting at drivers of the condition and potential treatments worth testing. They also suggest that, as many scientists and patients have suspected, Long COVID shares certain features with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), another condition thought to follow an infection…The Long COVID patients, most of them struggling with intense fatigue, brain fog, and other symptoms, had low levels of cortisol, a stress hormone that helps the body control inflammation, glucose, sleep cycles, and more. Features of their T cells
indicated their immune system was battling unidentified invaders, perhaps a reservoir of SARS-CoV-2 or a reactivated pathogen such as Epstein-Barr virus.” Read the study here. ([link removed])

POLITICO ([link removed]) (US) reports, “Patients recovering from coronavirus infection suffer from increased rates of neurological and psychological problems, according to a wide-ranging observational study published Thursday. Researchers from Oxford University combed through more than a million patient files and discovered that, two years after infection, patients who had recovered from COVID-19 were at a higher risk of psychosis, dementia and ‘brain fog’ when compared with patients who recovered from other respiratory diseases.” Read the study in The Lancet Psychiatry ([link removed](22)00260-7/fulltext) (UK).



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A post from Tanzanian immunization officials in Science Speaks ([link removed]) (US) documents successes in COVID-19 vaccine rollout in the country: “Many of the successes in the vaccination campaign, which initially targeted high-priority groups, have resulted from local community engagement and mobilization efforts. Examples include the following…Students from the University of Dodoma were involved in supporting vaccination activities on weekends in the Chamwino District. Vaccination rates usually drop during weekends, but the participation of students helped bring daily vaccinations from 20 to more than 500 people per day. The integration of COVID-19 vaccination in routine HIV/AIDS care and treatment clinics in the Dar es Salaam region allowed increased vaccinations among attendees at those clinics.”



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The New York Times ([link removed]) (US) photo essay documents the work of “scientists, public health experts and plumbers” in looking for viruses in wastewater…Six months ago, NYC Health + Hospitals, a large, local health care system, began piloting its own wastewater surveillance system to track the coronavirus and the flu. Monkeypox and polio monitoring will start as soon as next week…. Dr. Dennehy, Dr. Trujillo and their colleagues have found that the amount of coronavirus and influenza in the hospital’s wastewater often began rising 10 to 14 days before the hospital saw an increase in COVID and flu patients. ‘When you are testing everything and everybody, the wastewater doesn't give you such a big lead,’ Dr. Trujillo said. But once coronavirus testing in the city dropped off, the wastewater data became especially valuable. ‘It’s really something that we are hoping that will be incorporated as another tool for public
health,’ she said.

In a separate New York Times ([link removed]) article, Aliza Aufrichtig details her experiences as a journalist accompanying researchers to document the process: “I left the basement and the labs determined to not only convey in our article the intensive process of wastewater surveillance, but also the playful and collaborative spirit of the diverse group of people coming together to solve a major public health challenge.”



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Reuters ([link removed]) (UK) reports, “The US Food and Drug Administration (FDA) has asked Pfizer Inc to test the effects of an additional course of its antiviral Paxlovid among people who experience a rebound in COVID-19 after treatment, the regulator said on Friday. The drugmaker must produce the initial results of a randomized controlled trial of a second course of the antiviral by Sep. 30 next year, the FDA told Pfizer…The directive follows reports of recurrent viral infection or symptoms, or both, after the first course, including in President Joe Biden and National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci.”



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The Washington Post ([link removed]) (US) unpacks the concept of “original antigenic sin” and what it means for booster and vaccination plans. “Scientists are watching in real time as original antigenic sin ([link removed]) plays out against the coronavirus — and debating how it will influence future vaccine strategy. Contrary to its biblical thunderclap of a name, the phenomenon is nuanced — more often beneficial or neutral than harmful. It helps explain why vaccines based on the original virus continue to keep people out of the hospital, despite challenging new variants. But it may also mean that revamped fall boosters have limited benefits, because people’s immune memories are dominated by their first experience with the virus.” Barney Graham is quoted: “’We may have gotten about as much advantage out of the vaccine, at this point, as we can get.’ Graham emphasizes that the
vaccines are doing exactly what they were designed to do: keep people out of the hospital. Retuning them will have benefits, albeit limited. ‘We can tweak it and maybe evolve it to match circulating strains a little better,’ Graham said. “’It will have a very small, incremental effect.’”



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Jon Cohen reports in Science ([link removed]) about “a growing political reality in China. From the start of the pandemic, the Chinese government—like many foreign researchers—has vigorously rejected the idea that SARS-CoV-2 somehow originated in the Wuhan Institute of Virology (WIV) and escaped. But over the past 2 years, it has also started to push back against what many regard as the only plausible alternative scenario: The pandemic started in China with a virus that naturally jumped from bats to an ‘intermediate’ species and then to humans—most likely at the Huanan Seafood Market in Wuhan.”



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Devex ([link removed]) (US) reports, “A coalition of health and development NGOs are calling to expand an official inquiry ([link removed]) into the UK government’s domestic response to COVID-19 to also consider what role the country played in increasing global inequality during the pandemic… Officially launched in July, the UK COVID-19 Inquiry is tasked with conducting a broad independent investigation of the British government’s pandemic response, including an initial focus on the imposition of lockdowns and handling of scientific advice, with a specific eye on how communities were impacted differently. It will expand over time to address, among other issues, questions around vaccines and therapeutics. It is not, however, tasked with considering the role that the United Kingdom played in the international response.

In a letter ([link removed]) to the head of the commission several NGOs say, “In order to effectively examine the UK’s response to the pandemic and identify lessons to be learned to inform preparations for future pandemics, as stipulated in the Terms of Reference, the inquiry must also investigate the UK’s role in the global response and the domestic implications of this.”

They reference a report Paternalism and Power in UK Pandemic Preparedness and Response ([link removed]) by RESULTS UK which “explores how the UK pre-ordered excessive quantities of COVID-19 vaccines to the detriment of access in low- and middle-income countries, and continues to impede a temporary waiver on intellectual property rights to upscale manufacture of COVID-19 tools. It is argued that these, and many other detrimental decisions, were influenced by paternalism, outdated stereotypes and racism, and decision-making lacked genuine consultation with affected communities and civil society. Future pandemic preparedness planning should learn lessons from the COVID-19 pandemic response and centre on equity and global solidarity. The report concludes with a number of key recommendations for the UK Government, including the recommendation that the terms of reference of the COVID-19 inquiry be broadened to
include evaluating the UK's role in the international response.”



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Al Jazeera ([link removed]) (Qatar) reports, “Millions of children in the Philippines have returned to primary and secondary schools for their first in-person classes since the COVID-19 pandemic hit two years ago…. The country was among the worst hit by the pandemic in Southeast Asia, and then-President Rodrigo Duterte enforced one of the world’s longest coronavirus lockdowns and school closures. Duterte, whose six-year term ended on June 30, had turned down calls for reopening in-person classes due to fears it might ignite new outbreaks.”



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Healio ([link removed]) (US) reports, “Data from a large cohort in England suggest that risk for myocarditis ([link removed]) , while small overall, is significantly higher after SARS-CoV-2 infection in unvaccinated individuals vs. after COVID-19 vaccination, researchers reported. In an analysis of more than 42 million vaccinated children and adults, researchers also found that although the risk for myocarditis with SARS-CoV-2 infection remained after vaccination, it was “substantially reduced,” suggesting vaccination provides some protection from the CV consequences of SARS-CoV-2.”
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