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.
"Now is the time to harness the collective momentum from COVID-19 for HIV. Throughout all the approaches described here, several overarching themes emerge: flexibility is critical for responding to an ever-changing pandemic; inclusion improves equity in access to vaccines, therapeutics, and services for communities most impacted by a pandemic…, enables a diversity of thought, and improves decision-making; transparency is vital to accelerate science and promote trust; and continued investment in basic research supports the search for an efficacious HIV vaccine. By learning from these important lessons, the scientific community can capitalize on the momentum of the COVID-19 experience to re-energize HIV vaccine development."
-- A Perspective in Communications Medicine ([link removed])


** Share of People Who Completed the Initial COVID-19 Vaccination Protocol
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August 31, 2022
Source: Our World in Data ([link removed])
Source: Our World in Data ([link removed])


** Table of Contents
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* If You Are in Hurry (#If You Are in Hurry)
* Start Early to Combat Vaccine Hesitancy (#Start Early to Combat Vaccine Hesitancy)
* Preparing for Future Pandemics (#Preparing for Future Pandemics)
* Combatting Misinformation (#Combatting Misinformation)
* Monkeypox Updates (#Monkeypox Updates)


* Learning Lessons for HIV Vaccines from COVID-19 (#Learning Lessons for HIV Vaccines from COVID-19)
* More on Fauci (#More on Fauci)
* Long COVID (#Long COVID)
* New China Lockdown (#New China Lockdown)
* Racial Disparities in Booster Uptake in the US (#Racial Disparities in Booster Uptake in the US)

As much as we want COVID-19 to be in our past, it is still a very present global threat. Last week WHO announced that there have been one million reported COVID-19 deaths so far in 2022. UN News ([link removed]) quotes WHO’s Tedros: “We cannot say we are learning to live with COVID-19 when one million people have died with COVID-19 this year alone, when we are two-and-a-half years into the pandemic and have all the tools necessary to prevent these deaths.” Tedros noted, “one-third of the world’s population remains unvaccinated. This includes two-thirds of health workers, and three-quarters of older persons in low-income countries. ‘All countries at all income levels must do more to vaccinate those most at risk, to ensure access to life-saving therapeutics, to continue testing and sequencing, and to set tailored, proportionate policies to limit transmission and save lives. This is the best way to drive a truly sustainable recovery,’ he said.”


** If You Are in Hurry
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* Read STAT ([link removed]) (US) on key questions about monkeypox that the world needs answered.
* Read Scientific American ([link removed]) on teaching key public health concepts as early as kindergarten to help combat vaccine hesitancy.
* Read a perspective in Communications Medicine ([link removed]) on what HIV vaccine research efforts can learn from COVID-19 vaccine development.
* Read a Fast Company ([link removed]) opinion piece on the deadly consequences of misinformation in the COVID-19 and HIV pandemics.
* Read Reuters ([link removed]) on the potential to halt monkeypox in Europe.
* Githinji Gitahi and Winnie Byanyima in The Daily Maverick ([link removed]) on the need for African leadership to combat future pandemics.




** Start Early to Combat Vaccine Hesitancy
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Scientific American ([link removed]) (US) reports, “The pandemic has set off a discussion about integrating teachings about public health in the K–12 curriculum as an accompaniment to lessons about personal hygiene. Such small steps might foster a mindset in the next generation that overcomes resistance to vaccines and other basic protections targeted at countering further waves of the COVID-causing coronavirus or entirely new pandemic pathogens. In an interview, public health communications expert Dolores Albarracín says, “For the kids, part of the curriculum could be understanding what pathogens are, different solutions such as preventive treatments and the mechanism for different vaccines. Once you have a good knowledge base, it’s harder to then inject far-fetched misconceptions. People believe in these misconceptions partly because they don’t have a mental model of how infection and immunity work. So
the goal would be to build those models early on.”


** Preparing for Future Pandemics

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Githinji Gitahi and Winnie Byanyima write in The Daily Maverick ([link removed]) (South Africa), “Resistance to…. Inequality [between Global North and South] led to advocates and activists coming together in a life-and-death struggle to get COVID-19 vaccines to Africa, to lift patents on these vaccines and to allow for vaccine manufacturing on the continent. We are now involved in an identical fight for vaccines against monkeypox; a vaccine that has been in existence for decades but whose stockpile was only released when the virus ‘jumped’ to European and North American shores. And through all this, the world claims to have learnt that epidemics and pandemics know no geographic boundaries; that ‘we’re all in this together’…. The African Union’s assertiveness on the need to revise the international approach to intellectual property in medicine is making it clear how to facilitate tech sharing
over tech hoarding. African courts striking down laws which discriminate against minorities are advancing the human rights and health of all. The African leaders who are committing to ramping up investments in health, education and social protection are demonstrating what political will makes possible. And most of all, the community-led groups across the continent who are taking services to the most excluded people, pioneering innovations, and holding duty-bearers to account, are the key drivers of progress.”

An opinion piece in Nature ([link removed]) (UK) asks, “When the next pandemic emerges, what will the first few weeks look like? Will there be systems to identify contacts of infected individuals and to combine information to get crucial insights about the incubation period, disease severity and effective control measures? Or will fragmented data and improvised policies again lead to large epidemics and lengthy restrictions?” Adam Kucharski of the Centre for Epidemic Preparedness and Response at the London School of Hygiene & Tropical Medicine argues, “Quantifying the characteristics of the virus, identifying people at risk of being infected and evaluating the effectiveness of early measures, as well as vaccines, all require good data. And that requires planning how future data systems can fulfil multiple roles…. Midway through a pandemic is not the time to debate how to balance data and privacy, or which control measures and trial designs are
appropriate. These are decisions that countries need to plan for now, before the next pandemic.”

A comment in The Lancet ([link removed](22)01435-0/fulltext?) (UK) lays out the coming work of The Lancet Commission on Future of Health and Economic Resiliency in Africa, noting, “There is an urgency to decolonise public health practice, reshape African health systems towards self-reliance, and develop strategies and equal partnerships. Reimagining health systems with increased domestic financing, expanded quality workforce, accelerating digitisation, and properly regulated and optimised markets, would improve the health of populations and make the health sector a key driver of economic growth. Additionally, it will be important to refocus on wellbeing and health promotion and prevention, while recognising changes in disease burdens and determinants, such as education, hygiene, nutrition, migration, gender, environment, and climate change. This agenda must also restore intergenerational equity, shift the balance of powers, and involve the
next generation of leaders.”

South Africa’s government news agency ([link removed]) reports on Health Minister, Dr Joe Phaahla’s remarks to the 72nd Session of the World Health Organisation Regional Committee for Africa: Africa continuously needs to reassess its public health approach and use lessons learnt during the COVID-19 pandemic to prepare for future resurgences. ‘It is our view that the health system needs to be properly reset so that it can properly recover from the pressure of the COVID-19 pandemic. In this regard, a holistic approach to resetting health systems is more likely to yield desired results not only for the recovery but also for building back better,’ he told delegates.”

An editorial in The Washington Post ([link removed]) (US) argues, “Pandemic preparedness — the action needed to turn the lessons from the nation’s COVID-19 response into reality — must be an urgent priority for the White House, Congress and the American people. Preparedness means having everything in place the day before it is needed, and no one knows when that will be…. It isn’t enough to tweak organization charts and polish briefing papers. Rather, what’s needed is a sustained, wide-ranging transformation in how the United States handles public health. Public health refers to “what we as a society do collectively to assure the conditions in which people can be healthy,” the Institute of Medicine wrote in a landmark 1988 report. We have the raw material: scientific knowledge, innovation and wealth. But we need better policies, programs and practices to marshal these assets.”



** Combatting Misinformation
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The New York Times ([link removed]) (US) reports, “Trying to strike a balance between free speech and public health, California’s Legislature on Monday approved a bill that would allow regulators to punish doctors for spreading false information about COVID-19 vaccinations and treatments. The legislation, if signed by Gov. Gavin Newsom, would make the state the first to try to legislate a remedy to a problem that the American Medical Association, among other medical groups and experts, says has worsened the impact of the pandemic, resulting in thousands of unnecessary hospitalizations and deaths.”

In a Fast Company ([link removed]) (US) opinion piece HIV researcher Cristian Apetrei writes, “there are striking parallels between the HIV/AIDS and COVID-19 pandemics that show the dire consequences disinformation can have on both patients and society as a whole….The next pandemic is not a question of if but when and where it will occur. Just as important as devising ways to detect emerging viruses is developing strategies to address the misinfodemics that will follow them. The recent monkeypox outbreak has already seen similar spread of mis- and disinformation about its source and spread…. Countering misinformation is difficult, because there are reasons other than ignorance for why someone believes in a falsehood. In those cases, presenting the facts may not be enough and may sometimes even result in someone doubling down on a false belief. But focusing on urgent scientific and medical needs to
the exclusion of rapidly addressing misinformation can derail pandemic control. Strategies that take misinformation into account can help other pandemic control measures be more successful.”


**
Monkeypox Updates
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STAT ([link removed]) (US) looks at “10 key questions about monkeypox the world needs to answer.” Including what animal is the original reservoir host, the role of asymptomatic individuals in transmission, just how effective vaccines are against symptoms and preventing infection, does previous smallpox vaccination protect against monkeypox? On the question of whether the outbreaks will remain largely among gay men and other men who have sex with men, epidemiologist Chris Beyrer is quoted: “There are some encouraging trends. If we can contain this epidemic of this outbreak in men who have sex with men, that is our best shot…. “We have this window of opportunity right now. We have encouraging data that vaccination and behavior change in combination are getting control of the outbreak in New York City. I wish the rest of the country looked like New York right now.”

Nature ([link removed]) (UK) reports on a potential monkeypox treatment. “As supplies of vaccines against monkeypox remain constrained and the number of people contracting the disease continues to mount, physicians and researchers are looking to the drug tecovirimat for relief. In animals infected with monkeypox, the antiviral has been shown to lower the amount of virus in their bodies and reduce the number of fluid-filled ‘pox’ lesions forming on their skin. Efficacy data in humans, however, are much more limited, making some researchers and regulatory agencies hesitant about authorizing tecovirimat’s widespread use. But people with monkeypox — in particular those with severe disease, which can cause extreme pain, scarring and, in rare cases, death — are pleading for access to the drug.”

Reuters ([link removed]) (UK) reports, “It is possible to eliminate the monkeypox outbreak in Europe, World Health Organization officials said on Tuesday, highlighting evidence that case counts are slowing in a handful of countries. There are encouraging signs of a sustained week-on-week decline in the onset of cases in many European countries, including France, Germany, Portugal, Spain and Britain, as well as a slowdown in some parts of the United States, despite scarce vaccine supplies…. The significant factors behind the slowdown appear to be earlier detection, which leads to patients isolating themselves sooner, and behavioural changes, Catherine Smallwood, senior emergency officer and monkeypox incident manager at WHO/Europe said in a press briefing. ‘We do have some pretty good anecdotal evidence that people - particularly men who have sex with men who are in particular risk groups - are much
more informed about the disease.’"

A NEJM ([link removed]) (US) editorial notes, “The current monkeypox outbreak provides a new set of challenges to patients as well as to the medical and biomedical research communities. At the time that the article by Thornhill et al. was published online, approximately 14,000 cases had been reported in the world; at the time this editorial was being written (approximately 2 weeks later), that number had doubled. 10 Lessons learned during the responses to AIDS and COVID-19 should help us to marshal a more efficient and effective response to monkeypox, and the response to monkeypox should, in turn, help to inform our response to the inevitable next emerging or reemerging infectious disease of pandemic potential.”

The New York Times ([link removed]) (US) reports on the need to rename monkeypox. “In the three months since the first cases of monkeypox were reported in Europe and the United States, public health experts have been urging the World Health Organization to come up with new nomenclature that might help to clear up any confusion and reduce the shame and stigmatization associated with a disease that has been spreading largely among men who have sex with men.’ Names matter, and so does scientific accuracy, especially for pathogens and epidemics that we are trying to control,’ said Tulio de Oliveira, a bioinformatician at Stellenbosch University in South Africa who has been among those pushing the WHO…. Monkeypox is more than just a misnomer. Many experts say the word evokes racist stereotypes, reinforces offensive tropes about Africa as a perilous, pestilence-filled continent and abets the kind of stigmatization that can prevent people from
seeking medical care.



** Learning Lessons for HIV Vaccines from COVID-19
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A group of mostly US government based researchers write in Communications Medicine ([link removed]) (UK), “The rapid development of COVID-19 vaccines and their deployment in less than a year is an unprecedented scientific, medical, and public health achievement. This rapid development leveraged knowledge from decades of HIV/AIDS research and advances. However, the search for an HIV vaccine that would contribute to a durable end to the HIV pandemic remains elusive. Here, we draw from the US government experience and highlight lessons learned from COVID-19 vaccine development, which include the importance of public-private partnerships, equitable inclusion of populations impacted by the infectious pathogen, and continued investment in basic research. We summarize key considerations for an accelerated and re-energized framework for developing a safe and efficacious HIV vaccine.”


** More on Fauci

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Tony Fauci’s announcement of his plan to leave government service in December continued to garner media coverage and conversation across social media, including from critics and conspiracy theorists who we will not quote here. Writing in in Science ([link removed]) (US) Jon Cohen fact checked, “Tucker Carlson, a political commentator on Fox News, [who] has long assailed Anthony Fauci for his role in the US government’s response to the COVID-19 pandemic during both former President Donald Trump’s and President Joe Biden’s administrations…. The analysis shows Carlson took facts out of context and cited long-debunked studies or reports to attack Fauci. He also repeatedly blamed Fauci and other scientists for changing their minds based on new evidence—the bedrock of scientific progress. In Carlson’s calculus, such reversals equal lying.” The article includes an annotated transcript of
Carlson’s show.

STAT ([link removed]) (US) reports, “Fauci said that his chief objective after he steps down is addressing the splintering national sentiment towards vaccination and the federal response. ‘Science has to stay strong and not get intimidated by the anti-science trend that we’re seeing,’ he said. ‘The underlying theme that I would say is: Please don’t accept the normalization of untruths…. The basis of science is evidence, and data leading to the truth. When you have a society that’s leaning towards a disrespect to science, a distortion of the truth, and then just out-and-out lying, that’s really not only a threat to my field, which is the scientific enterprise, I think it’s a threat to our democracy.’”


** Long COVID
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Nature ([link removed]) (UK) reports, “Researchers are baffled by long COVID ([link removed]) : hundreds of studies have tried to unpick its mechanism, without much success. Now some scientists, and an increasing number of people with the condition, have been lining up behind the as-yet-unproven hypothesis that tiny, persistent clots might be constricting blood flow to vital organs, resulting in the bizarre constellation of symptoms that people experience…. When it comes to long COVID, ‘we’ve now got little scattered of bits of evidence’, says Danny Altmann, an immunologist at Imperial College London. ‘We’re all scuttling to try and put it together in some kind of consensus. We’re so far away from that. It’s very unsatisfying.’”


** New China Lockdown
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AP ([link removed]) (US) reports, “China has placed millions of its citizens under renewed lockdown following fresh outbreaks of COVID-19, authorities reported Tuesday, as the government persists in its hard-line policy on containing the virus…. China has largely kept its borders closed to foreign visitors, while requiring those who do come to submit to more than a week of quarantine in hotels where sanitary conditions are often poor. Masking and regular testing are also standard and anyone found to have been in close contact with a person confirmed to have the virus is forcibly transported to field hospitals…. The World Health Organization has called China's policy unsustainable and on Monday, a Chinese think tank issued a rare public disagreement with the ruling Communist Party, saying the curbs that have shut down cities and disrupted trade, travel and industry must change to prevent an ‘economic stall.’”


** Racial Disparities in Booster Uptake in the US
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The Conversation ([link removed]) (Australia) reports, “More than 450 people are dying of COVID-19 in the US each day as of late August 2022.” Initial efforts to reach Black, Hispanic, American Indian and Alaska Native populations with vaccine information and vaccines led to high uptake of initial shots among many in these populations. “But boosters are a different story. Comparable booster vaccine promotion efforts have been lacking. Confusion in the public health messaging surrounding boosters and limited federal funding for rolling out vaccination campaigns have resulted in slow booster uptake across the country. As a result, divides have once again emerged. A recent study of COVID-19 booster rates found that 45 percent of white adults and 52 percent of Asian American adults had received boosters by January 2022. But only 29 percent of Black adults and 31
percent of adults who reported another racial or ethnic identity, such as American Indian, Alaska Native, Native Hawaiian, Pacific Islander or multiracial, were boosted.”
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