-- Stephanie Nolan from The New York Times

Hoarding vaccines, tests and treatments. It’s a familiar story, especially from the early days of COVID-19 vaccines. And now it’s a story for monkeypox. Stephanie Nolan reports in The New York Times (US) writes, “The scramble for monkeypox vaccines and treatments has been centered in the United States and Europe, where supplies of shots have stretched thin or nearly run out. But more than 100 countries are now reporting monkeypox cases, and a vast majority of those have had no vaccine or treatments at all. Some public health groups…say the issues echo those seen with COVID-19, but without any of the mechanisms that were developed to try to right the balance during the coronavirus pandemic.” She quotes Dr. Ranu Dhillon, an infectious disease expert and instructor at Harvard Medical School: “’The original sin of this whole pandemic is that we could have tested these [drugs for treatment] in endemic countries, and then we would have the data.’ But there was little appetite or investment in monkeypox when only countries such as Cameroon and Central African Republic were affected.”
 
AP (US) quotes WHO Africa director Dr. Matshidiso Moeti: “’Africa is still not benefiting from either monkeypox vaccines or the antiviral treatments,’ [she] said, adding that only small amounts have been available for research purposes. Since 2000, Africa has reported about 1,000 to 2,000 suspected monkeypox cases every year. So far this year, the Africa Centers for Disease Control and Prevention have identified about 3,000 suspected infections, including more than 100 deaths.”
 
 

 

 
Activist and epidemiologist Gregg Gonsalves writes in a Nature (UK) commentary about political choices about HIV, COVID-19, monkeypox and other disease outbreaks: “Very often, humanity has the ability to prevent and treat infectious disease; not doing so is a political choice…. Just look to the US surrender to COVID-19, with 400–500 people still dying there each day; those in power decided that there are people who are simply expendable. Supposedly, as US President Joe Biden has said, we are tired of the pandemic. However, we are not bothered much by the human carnage. We could do more but have decided not to…. For too long, we’ve been too willing to sacrifice people to protect the status quo. Some viruses might be deadly, but they need our help to cause havoc.”
 

 
A recent media science café meeting in Kenya focused on planning for the next pandemic.
 
The Star (Kenya) reports, “A leading scientist says there is enough evidence the next pandemic is coming, but Kenya and other African countries are woefully unprepared. Microbiologist Prof Walter Jaoko said the continent must learn the painful lessons from COVID-19, which has so far killed at least 5,600 Kenyans…. He urged governments to set up national public health institutes to help prepare for the next pandemic. ‘We need to train personnel for epidemic preparedness:  Doctors, nurses, epidemiologists, public health technicians, laboratory technologists so that if a disease is newly diagnosed we quickly put preventive measures around it,’ he said.”
 
The Nation (Kenya) quotes Prof Jaoko: “’Without a healthy population, a country will record a zero development record.’ He called upon the African governments to fulfil their commitments by increasing the health sector budgets as per the Abuja Declaration signed 21 years ago.”
 

 
AP (US) reports that COVID-19 cases are falling in almost every country, but WHO cautions against complacency. “’This is very encouraging, but there is no guarantee these trends will persist,’ said WHO Director-General Tedros Adhanom Ghebreyesus at a press briefing. ‘The most dangerous thing is to assume (that) they will,’ he said. He added that even though the number of weekly reported deaths have plummeted more than 80 percent since February, one person still dies with COVID-19 every 44 seconds and that most of those deaths are avoidable…. Maria Van Kerkhove, WHO’s technical lead on COVID-19, noted that the virus has not yet settled into a seasonal pattern and that its continued evolution will require constant surveillance and possible tweaks to diagnostics, treatments and vaccines.”
 
Reuters (UK) reports WHO “expects a rise in COVID-19 in Ukraine to peak in October, possibly bringing hospitals close to their capacity threshold.” WHO also expressed concern about a rebound of polio in the war-torn country. “Ukraine has low vaccination coverage for both COVID-19 and polio.”
 
Health-e News (South Africa) reports, “Experts have warned South Africa could experience its 6th wave of COVID-19 by the end of September and are urging South Africans to continue getting vaccines and booster shots.
 

 
Bloomberg (US) reports, “The Biovac Institute, a partly state-owned vaccine producer in South Africa, has produced its first batch of COVID-19 vaccines as part of an arrangement under which it aims to fill and package as many as 100 million doses a year of Pfizer Inc. and BioNtech SE’s inoculation….. [WHO’s] mRNA technology hub, also in Cape Town…. Will develop a COVID-19 shot of its own and that know-how will then be transferred to at least 15 production facilities in low and middle income countries across the world.”
 

 
The New York Times (US) looks at why China is continuing its zero COVID policy: “Beyond the political importance of zero COVID-19 to China’s leadership, practical considerations have made it difficult to pull back on coronavirus controls. China has held off importing vaccines, including the mRNA vaccines made abroad that have been most effective, while it develops its own. Residents do not have natural immunity, as the virus has spread far less than in other countries…. Chinese officials signaled earlier this year that they wanted to ease the heavy-handed approach to fighting the virus, particularly as the economic impacts have become clearer and the Omicron variant has proved less deadly than previous variants. But suggestions of a new approach ended with the Shanghai outbreak in the spring. Now lockdowns appear to be increasingly common.”
 

 
Nature (UK) reports, “Two needle-free COVID-19 vaccines that are delivered through the nose or mouth have been approved for use in China and India…. These mucosal vaccines target thin mucous membranes that line the nose, mouth and lungs. By prompting immune responses where SARS-CoV-2 first enters the body, mucosal vaccines could, in theory, prevent even mild cases of illness and block transmission to other people — something COVID-19 shots have been unable to do. Vaccines that produce sterilizing immunity would be game changing for the pandemic.”
 

 
DW (Germany) reports, “The World Health Organization's (WHO) European offices said on Tuesday that some 17 million people in Europe experienced COVID-19 symptoms long after having recovered from the disease….. The Europe study found that the probability of contracting long COVID is twice as high in women as in men, the WHO said. The research also found that the chances of developing long COVID are very high for those who suffer a severe coronavirus infection requiring hospitalization for treatment. But gender also made a difference. One in three affected women and one in five affected men developed long COVID symptoms after suffering a severe COVID-19 infection.”
 
Reuters (UK) reports on the potential for suicide to be a “hidden crisis” from long COVID. “There is no authoritative data on the frequency of suicides among sufferers. Several scientists from organizations including the U.S. National Institutes of Health and Britain's data-collection agency are beginning to study a potential link following evidence of increased cases of depression and suicidal thoughts among people with long COVID, as well as a growing number of known deaths. ‘I'm sure long COVID is associated with suicidal thoughts, with suicide attempts, with suicide plans and the risk of suicide death. We just don't have epidemiological data,’ said Leo Sher, a psychiatrist…. Among key questions now being examined by researchers: does the risk of suicide potentially increase among patients because the virus is changing brain biology? Or does the loss of their ability to function as they once did push people to the brink, as can happen with other long-term health conditions?”
 
Reuters (UK) reports, “Top scientists from leading academic centers are banding together to answer a key question about the root cause of long COVID - whether fragments of the coronavirus persist in the tissues of some individuals. The effort, known as the Long COVID Research Initiative, aims to streamline research and quickly pivot to clinical trials of potential treatments. By sharing diverse skill sets and resources, the group hopes to uncover the scientific underpinnings of the disease and use that to design evidence-based trials.”
 

 
A Washington Post (US) opinion piece points out the dangers of using war metaphors to describe the COVID-19 pandemic and response, citing the damage done with such metaphors after the 9/11 attacks in the US. “The way we speak about the pandemic comes straight from the conceptual mold of 9/11 — the last crisis we can remember fondly for the way it brought us all together, if only for a while. Such rhetoric was stunningly effective at convincing the vast majority of Americans at the time that military actions were not only justified but a necessary response to the attacks. That focus, however, left us blind to the extent of the internal damage, including the suffering of those such as sick first responders and civilians. While similar martial metaphors have failed to unite us as successfully throughout the pandemic, they may still serve to obscure pain and loss…. The coronavirus pandemic in the United States is a self-inflicted national tragedy whose uneven effects on people make it hard to classify. The fact that it has occurred in an age of intense political polarization and was exacerbated by the incompetence of the nation’s leaders has only made matters worse. Like the story of 9/11, the story of the pandemic is about the struggles of civilians to be taken seriously in the aftermath of government negligence. They are both stories of the failure of institutions and imagination and, frankly, our failure to recognize them as such is tied to our inability to conceive of these events as chronic rather than acute disasters.”
 

 
CIDRAP (US) reports, “Two US monkeypox patients developed encephalomyelitis—inflammation of the brain and spinal cord—in the week after symptom onset, one in Colorado and one in Washington, DC, suggesting neurologic complications are a potential outcome of monkeypox infections. The cases are described today in Morbidity and Mortality Weekly Report.”
 
Nature (UK) looks at what is known about monkeypox fatality rates, noting a lower-than-expected recorded death rate in the global outbreak. “In reality, the true death rate is almost certainly higher than current estimates: countries in some parts of the world, including Africa, might not be capturing all deaths during this outbreak because they have limited resources for testing and surveillance. And it could still rise, especially if the virus spreads more extensively among people at high risk of severe disease, such as children, older people and those with severely compromised immune systems, says Andrea McCollum, an epidemiologist who heads the poxvirus team at the US [CDC].”
 

 
A review of papers on COVID vaccine acceptance and uptake published in Nature Communications Medicine (UK) found, “519 articles with 7,990,117 participants are eligible for meta-analysis. The global acceptance and uptake rate of COVID-19 vaccination are 67.8 percent (95 percent CI: 67.1–68.6) and 42.3 percent (95 percent CI: 38.2–46.5), respectively. Among all population groups, pregnant/breastfeeding women have the lowest acceptance (54.0 percent, 46.3–61.7) and uptake rates (7.3 percent, 1.7–12.8). The acceptance rate varies across countries, ranging from 35.9 percent (34.3–37.5) to 86.9 percent (81.4–92.5) for adults, and the lowest acceptance is found in Russia, Ghana, Jordan, Lebanon, and Syria (below 50 percent)….. There are large gaps (around 20 percent) between acceptance and uptake rates for populations with low education or income…. COVID-19 vaccine acceptance needs to be improved globally. Continuous vaccine acceptance monitoring is necessary to inform public health decision making.”
 

 
Reuters (UK) reports, “Efforts to tackle AIDS, tuberculosis and malaria began to recover last year after being hit hard by the COVID-19 pandemic in 2020, but the world is still not on track to defeat these killer diseases, according to a report. In its 2022 report, released on Monday, the Global Fund to Fight AIDS, Tuberculosis and Malaria said the numbers of people reached with treatment and prevention efforts rebounded last year after declining for the first time in almost 20 years in 2020. However, all the ground lost has not been regained, said Peter Sands, head of the Fund…” Read the report.
 

 
EWN (South Africa) reports, “The South African Health Products Regulatory Authority (Sahpra) has reported a second death following vaccination with the Johnson & Johnson COVID-19 vaccine. According to Sahpra, Guillain-Barré syndrome (GBS) is a rare but potentially severe neurological adverse event that is associated with the administration of various vaccines and other medicines. In a press statement SAHPRA said, “COVID-19 vaccines have consistently been shown to prevent severe forms of disease, hospitalisation and death. Based on the currently available evidence, SAHPRA has determined that the benefits of COVID- 19 vaccination far outweigh the very low risk of severe adverse events, including GBS. The public are strongly advised not to delay COVID-19 vaccination if eligible in terms of the national vaccination programme.”
 

 
NPR’S Goats and Soda Blog (US) looks at the possibility that some people may have some innate something that protects them from COVID-19 infection. “…just as with HIV, some people have been exposed multiple times but never had symptoms and never tested positive…. After two years of hunting, a team at the University of California, San Francisco has come pretty close to answering the question. ‘These findings are like hot off the presses,’ says immunogeneticist Jill Hollenbach, who led this research. ‘We haven't published them yet…’ Hollenbach and her team have found a genetic mutation doesn't prevent the virus from infecting cells – that's what Landau was searching for– but still does something remarkable: It prevents a person from having COVID-19 symptoms…. After analyzing DNA from more than 1,400 people, they identified a mutation that helps a person clear out a SARS-CoV-2 so fast that their body doesn't have a chance to develop symptoms.”
 

 
Nature (UK) reports, “Most scientists agree that lockdowns did curb COVID-19 deaths and that governments had little option but to restrict people’s social contacts in early 2020, to stem SARS-CoV-2’s spread and avert the collapse of health-care systems…. At the same time, it’s clear that lockdowns had huge costs, and there is debate about the utility of any subsequent lockdown measures…. Lockdowns hold another clear lesson: they exacerbate inequalities that already exist in society. Those already living in poverty and insecurity are hit hardest. Guarding against these unequal impacts requires improved health access and financial safeguards when times are good.”