-- International Rescue Committee President David Miliband in Health Policy Watch

Even as much of the world attempts to move on from the COVID-19 pandemic (which is not over) there is a move to look beyond the current pandemic to preparation for the next and to applying lessons learned to improving both health systems and pandemic response. Amref’s Githinji Gitahi and the Rockefeller Foundation’s William Asiko write in Daily Maverick (South Africa), “As the world raced to find a way to end the pandemic, African nations came together to formulate regionally led solutions to protect their populations from a disease that threatened to end life as we knew it, driving progress towards the kind of unity envisioned by the African Union upon its establishment in 2002; a concept that largely remained an idea that was spoken of, but never truly actualised – perhaps until now…. Call it political maturity, or recognition of the urgency of the situation we find ourselves in, the success of Africa’s collaborative response to the pandemic has saved – and will continue to save – millions of lives.”
 
Health Policy Watch (Switzerland) reports on a session on the sidelines of last week’s UN General Assembly addressing the need for leadership to “pandemic proof” the world, quoting International Rescue Committee President David Miliband, who “said the world needs ‘coherent global leadership’ because it is not doing what’s needed to prepare…. ‘Every part of society is impacted by a pandemic and we see a need for leadership at a global level, just as this leadership was needed at the national level and the regional level to step up and deal with pandemic preparedness and response effectively.’” 
 

 

 
All Africa (South Africa) reports, “A majority of Africans said they don't trust their governments to ensure that COVID-19 vaccines are safe, and this lack of confidence has a significant impact on people's willingness to accept vaccines. Many said they think prayer is more effective than vaccines in preventing the coronavirus infection.
 

 
Science (US) reports, “Nearly 3 years into the pandemic, SARS-CoV-2 faces a formidable challenge: finding new ways around the immunity humans have built up through vaccines and countless infections. Worrisome new data show it is up to the challenge. Several new and highly immune-evasive strains of the virus have caught scientists’ attention in recent weeks; one or more may well cause big, new COVID-19 waves this Northern hemisphere] fall and winter…. Despite their different origins, several of the new strains have chanced upon a similar combination of mutations to help scale the wall of immunity—a striking example of convergent evolution. They all have changes at half a dozen key points in the viral genome that influence how well neutralizing antibodies from vaccination or previous infection bind to the virus, says evolutionary biologist Jesse Bloom of the Fred Hutchinson Cancer Center.”
 
The New York Times (US) asks, “Where is Pi?” The Omicron variant has been the dominant variant for 10 months and is likely to stick around. The lack of development of a Pi variant, “does not mean SARS-CoV-2, the coronavirus that causes COVID-19, has stopped evolving. But it may have entered a new stage. Last year, more than a dozen ordinary viruses independently transformed into major new public health threats. But now, all of the virus’s most significant variations are descending from a single lineage: Omicron.” According to a recent study, “BA.2.75.2 is among the newest of Omicron’s grandchildren, identified just last month. It’s also the most evasive Omicron yet, according to Dr. Murrell. In lab experiments, he and his colleagues tested BA.2.75.2 against 13 monoclonal antibodies that are either in clinical use or in development. It evaded all but one of them, bebtelovimab, made by Eli Lilly.”
 
Medscape (US) reports, “A clear sign the COVID-19 numbers just aren't what they used to be: Groups that many have relied on as the best sources for updated data on the coronavirus pandemic have had to scale back their reporting because the lack of reliable information. Johns Hopkins University and the University of Washington's Institute for Health Metrics and Evaluation have retooled their systems for tracking COVID-19 tests, cases, and more…. Researchers can still look to the number of people hospitalized with SARS-CoV-2 infection and track COVID-19 deaths, because that data is still tracked. But those factors don't get as close to a big picture like the positive case reports from large-scale testing sites earlier in the pandemic."
 
Nature (UK) reports on a group of US researchers who are searching through wastewater looking for a highly mutated form of SARS-CoV-2…. O’Connor and his team think that they’re searching for a person carrying the variant — there’s no evidence that the lineage has spread to anyone else. The researchers are working with public-health officials, who hope that by identifying the person — who has been infected for at least eight months — they can treat the infection and reduce the chances of it ever spreading.”
 

 
One Ebola outbreak ended even as another started. Al Jazeera (Qatar) reports, “The Democratic Republic of the Congo (DRC) has declared an end to its latest Ebola virus outbreak, according to officials…. The end of the 15th outbreak comes as neighbouring Uganda “races to curb” an Ebola outbreak of its own, the WHO said.” The Monitor (Uganda) reports, “Statistics from the Health Ministry indicate that the number of confirmed and suspected Ebola infections has increased to 34 while deaths attributable to the outbreak stand at 21.”
 
A WHO statement says the Uganda outbreak is caused by the “Sudan virus” and notes, “There are no licensed vaccines or therapeutics for the prevention and treatment of Sudan virus disease.” WHO also warns, “The currently affected Mubende district has no international borders. Nevertheless, the risk of international spread cannot be ruled out due to the active cross-border population movement. In addition, investigations are ongoing to establish transmission chains and the scope of the outbreak is yet to be determined.”
 

 
STAT (US) reports on an interview with CDC director Walensky: “Just as the CDC began scaling down the number of staff devoted to COVID-19 response, monkeypox emerged as a public health threat in the US And the agency is still grappling with some of the same problems that slowed the response to COVID-19, Walensky said. A major issue is infrastructure — the money states and cities have not spent on beefing up their public health departments, data systems and other essential services. ‘It has been waxing and waning, disaster to disaster,’ she said. ‘I can tell you, states do not have any money dedicated to monkeypox. Period.’ Despite the giant infusions of cash that states and local jurisdictions got to stay afloat during the pandemic, that is money that cannot be used to address monkeypox. Some estimates say the nation needs 80,000 more public health workers to meet the country’s various health needs; even if states do get money to respond to health crises, they probably don’t have adequate staffing to run things properly.”
 

 
A Washington Post (US) profile of WHO director Tedros says, “Tedros is now staking his legacy on a bold and controversial project, an effort he hopes will produce a new deal among states on how to prepare for and respond to a pandemic…. The proposed agreement, he said, would be a ‘game changer,’ ensuring scientific and political cooperation across borders both before and during an outbreak. A majority of member states support the idea and have pledged to finalize a draft text at the World Health Assembly, the legislature that governs the WHO, by 2024…. [Despite some pushback] Tedros says he believes the world can work together. The United States and the Soviet Union cooperated to eradicate smallpox at the height of the Cold War in 1979, he said.”
 

 
STAT (US) reports, “a large brunt of the [US monkeypox] response has fallen to clinics and organizations that specialize in STI and HIV/AIDS care, a network that for years has complained about a lack of resources even as they faced spiking STI rates. Clinics have rallied for their patients, overcoming red tape and fanning out to bars, clubs, and Pride events to expand access to testing, treatment, and vaccines. But even as monkeypox has been declared a public health emergency both domestically and globally, they haven’t been allocated additional funding. Providers and administrators warn they’re being stretched thin, running at a pace they won’t be able to keep up…. The limitations on resources have consequences. At times, it’s taken extra days to diagnose monkeypox, which means it’s taking longer to connect patients with treatment. It also means that normal care dedicated to STDs and HIV is being shoved aside to handle the emergency. Advocates say they see what’s happening as another manifestation of the country’s underinvestment in public health infrastructure, coming on top of the hit the field took during the COVID-19 pandemic.”
 
CNN (US) reports, “Eligible individuals who did not receive the monkeypox vaccine were around 14 times likelier to become infected with the virus than those who were vaccinated, according to federal government data described to CNN by multiple US health officials. That figure reflects the first wave of authoritative data collected by the Biden administration on the efficacy of the monkeypox vaccine that is currently being administered across the United States. The data marks an important milestone in the administration’s fight against monkeypox, particularly given the unprecedented nature of this year’s outbreak.”
 
Sudan Tribune (Sudan) reports, “Sudanese authorities confirmed on Sunday three new cases of monkeypox in a camp for Ethiopian refugees in eastern Sudan…. The Ministry of Health in Gedaref stated that it had received reports of 60 suspected cases from a humanitarian group in the camp. In addition, there are two suspected cases in Um Rakuba camp where they are over 21,000 refugees."
 
A PAHO statement calls “on countries to intensify the response actions, prioritizing detection, surveillance and community engagement to reduce new cases and put an end to the outbreak in the region…. Monkeypox cases have been reported in 31 countries and territories in the Americas. The United States still accounts for more than half of cases, but rapid increases were seen in Brazil, Peru, Colombia, Mexico and Chile….”
 

 
The Telegraph (UK) reports on concern about the resurgence of polio in New York. Epidimiologist Dr Emily Lutterloh is quoted: “’One case of polio essentially is an outbreak – because one case of paralytic polio means you almost certainly have hundreds of other people who are infected.’…. On Wednesday, the Pan American Health Organization also warned that Brazil, the Dominican Republic, Haiti and Peru are at very high risk for the reintroduction of polio, as dwindling vaccination rates during the coronavirus pandemic has led to historic lows in protection against the illness."
 

 
An opinion piece in STAT (US) argues, “More than two years into the pandemic, COVID-19 misinformation still runs rampant. Some comes from doctors spreading lies about unproven — and actually harmful — “treatments” for COVID-19 and promoting anti-vaccine conspiracy theories. Physicians account for three of the 12 individuals thought to be responsible for up to 73 percent of anti-vaccine content on Facebook. These physicians have been highly influential in their claims that, for example, masks suppress the immune system and that, after getting the vaccine, “becoming sterile [is] almost a certainty.” These lies have real and potentially deadly consequences…. As the US takes further steps towards accountability, the core principles of health care ethics — autonomy (affirming that patients have the right to make their own decisions), beneficence (acting for the benefit of others), nonmaleficence (doing no harm), and justice — must all be in effect. Rooting out misinformation and fighting back against anti-science laws that embolden misinformation remain vital first steps toward ensuring physicians are held accountable to their professional ethics as well as to the patients and the communities they serve.”
 

 
A press release from Washington University School of Medicine outlines finding from a study published in Nature Medicine (UK): Those who have been infected with [COVID-19] are at increased risk of developing a range of neurological conditions in the first year after the infection, new research shows. Such complications include strokes, cognitive and memory problems, depression, anxiety and migraine headaches, according to a comprehensive analysis of federal health data…”
 
A McMaster University statement says a new study “has found that the majority of people infected with the SARS-CoV-2 virus recover within 12 months, irrespective of its severity. However, although 75 per cent are recovered at the 12-month mark after becoming ill with the virus, 25 per cent of patients still had at least one of the three most common symptoms of coughing, fatigue and breathlessness. Researchers also found that patients with persistent symptoms also had antibodies associated with autoimmune illnesses, as well as raised levels of cytokines, which cause inflammation.” Read the study in European Respiratory Journal.
 
Ed Yong reports in The Atlantic (US) on myalgic encephalomyelitis, or chronic fatigue syndrome (ME/CFS): “Many cases of long COVID are effectively ME/CFS by another name…. The US has so few doctors who truly understand the disease and know how to treat it that when they convened in 2018 to create a formal coalition, there were only about a dozen, and the youngest was 60."
 

 
A press release from Case Western Reserve University outlines new data published in JAMA Network Open (US) about the risk of type 1 diabetes (T1D) among children who have had COVID-19. “children and adolescents who contracted COVID-19 were more prone to developing T1D in the six months following their COVID-19 diagnosis…. The findings showed a 72 percent increase in new diagnoses of T1D in COVID-19 patients 18 years old and younger—although the research emphasized that it is unclear whether COVID-19 triggers new onset of T1D….”
 

 
A study in Frontiers in Public Health (US) finds, “During the pandemic, women workers had to further deal with the socioeconomic vulnerability of their employment, dual domestic and working responsibilities and those infected with COVID-19, with the clinical sequelae of the disease. The government implemented several policies to assist workers and reduce the risk faced by vulnerable workers, including women. Despite these initiatives, long-term policies aimed at socioeconomic protection and employment creation that focus on women workers are required to address the negative impact of the COVD-19 pandemic as experienced by women workers in South Africa."
 
The Washington Post  ( US) reports, “A study of nearly 20,000 people around the world shows that getting vaccinated against COVID-19 can change the timing of the menstrual cycle. Vaccinated people experienced, on average, about a one-day delay in getting their periods, compared with those who hadn’t been vaccinated…. Alison Edelman, a professor of obstetrics and gynecology at Oregon Health & Science University, who led the study, said that for most people the effects were temporary, lasting for one cycle before returning to normal. She said there were no indications that the period side effects had any impact on fertility.” Read the study in BMJ (UK).
 

 
Radio Free Asia (US) reports, “At least 22 people died of starvation or lack of medical attention on a single day last week under China’s COVID-19 lockdown policies in the northern Xinjiang city of Ghulja…. Appeals for help from Uyghurs trapped in quarantine under Beijing’s zero-COVID measures are popping up on Chinese social media platforms.”