-- Esther Nakkazi in Wired

We will likely never know the many ways the COVID-19 pandemic and the response to it impacted health and well-being over the last three years and will continue into the future. A new UN report “shows that women’s and children’s health has suffered globally, as the impacts of conflict, the COVID-19 pandemic and climate change converge with devastating effects on prospects for children, young people and women.” The report notes that “An estimated 25 million children were un- or under-vaccinated in 2021 – 6 million more than in 2019 - increasing their risk of contracting deadly and debilitating diseases. Millions of children missed out on school during the pandemic, many for more than a year, while approximately 80 percent of children in 104 countries and territories experienced learning-loss because of school closures. Since the start of the global pandemic, 10.5 million children lost a parent or caregiver to COVID-19.” WHO’s Tedros says: “Almost three years on from the onset of COVID-19, the pandemic’s long-term impact on the health and well-being of women, children and adolescents is becoming evident: their chances for healthy and productive lives have declined sharply. As the world emerges from the pandemic, protecting and promoting the health of women, children and young people is essential for supporting and sustaining the global recovery.”

 

 

 
Reuters (UK) reports Moderna and GAVI have an agreement to provide the new bivalent vaccines through COVAX. GAVI and Moderna “will cancel their existing supply deal for vaccines based on the original coronavirus strain. Instead, Moderna will supply up to 100 million doses of its new, variant-adapted vaccines at its lowest available price from 2023…. GAVI chief executive Seth Berkley said the new agreement was a ‘critical step for equitable access’ to allow lower income countries to use the modified vaccines as they see fit.”
 

 
BBC (UK) reports, “Life expectancy has been slow to rise again after the shock of the pandemic, according to new research. Data on registered deaths from 31 countries shows few recovering in 2021, and many seeing further declines. Countries that rolled out vaccines quickly, to all age groups, have generally bounced back faster…. Researchers compiled data on registered deaths from 31 countries - 29 in Europe, plus Chile and the US. They found that in only four - Belgium, France, Sweden and Switzerland - has life expectancy returned to the level it was in 2019.”
 
USA Today (US) reports, “the US reported the third-largest decline in life expectancy, following closely behind Bulgaria and Slovakia. The study is the latest example of how issues relating to the US health care system, policies and public behavior, which affected life expectancy before COVID-19, were exacerbated by the pandemic, experts say.”
 

 
Fortune (US) reports that as COVID-19 cases rise in many northern hemisphere countries, “for the first time in the pandemic’s history, the variants that make up the mounting wave look drastically different, depending on where you are in the world. In England, Omicron spawn BA.5.2 is the most prevalent variant, with a long list of competitors vying for dominance. In the US, once globally dominant BA.5 is still leading the way. But it’s steadily decreasing as BA.4.6—dubbed “Aeterna” by some on the Twitterverse—rises, with BQ.1 and BQ.1.1 on its heels. And in Singapore, cases of XBB, or “Gryphon”—a combination of two Omicron variants that can evade immunity and antibody treatments—are surging…. The competing variants all feature concerning traits like improved immune evasion, increased transmissibility, or both.”
 

 
Toronto Star (Canada) reports on a new study from CMAJ (Canadian Medical Association Journal): The study of more than 500,000 Ontarians found health-care use — including hospital stays, the need for home care and trips to a clinic or the emergency department — is more frequent among those who had COVID-19. Researchers analyzed how people used the health-care system starting at eight weeks after a COVID-19 infection and compared that to similar groups of people who tested negative. Researchers say their findings show the burden of long COVID is ‘substantial’ and should prompt policymakers to plan — and provide further resources — for the condition.”
 

 
The Guardian (UK) interviews five women on the impact of long COVID. “Despite the condition gaining official recognition by the World Health Organization last October, many are still reporting wide-ranging skepticism and the minimization of their symptoms. This disregard, according to the epidemiologists Dr. Stephen Phillips and Harvard’s Prof Michelle Williams, is partially attributable to the fact that it has disproportionately affected women. ‘Our medical system has a long history of minimizing women’s symptoms and dismissing or misdiagnosing their conditions as psychological,’ they wrote in the New England Journal of Medicine last year. ‘Women of color with long COVID, in particular, have been disbelieved and denied tests that their white counterparts have received.’”
 
A multimedia article in The New York Times (US) reports, “Millions of people continue to suffer from exhaustion, cognitive problems and other long-lasting symptoms after a coronavirus infection. The exact causes of the illness, known as long COVID, are not known. But new research offers clues, describing the toll the illness takes on the body and why it can be so debilitating…. Studies estimate that perhaps 10 to 30 percent of people infected with the coronavirus may develop long-term symptoms. It’s unclear why some people develop long COVID and others don’t, but four factors appear to increase the risk: high levels of viral RNA early during an infection, the presence of certain autoantibodies, the reactivation of Epstein-Barr virus and having Type 2 diabetes.”
 

 
Ugandan health journalist Esther Nakkazi writes in Wired (US), “Ebola has flared up intermittently in Africa for more than 40 years, most notably during an outbreak between 2013 and 2016 that infected 28,000 people and took more than 11,000 lives. During that outbreak, experimental vaccines against the most common form of the virus—the Zaire species—could be tested. They worked well, and have since been approved and used to protect people. But developing vaccines for rare viruses like Ebola is always a game of cat and mouse. The Sudan virus behind the current outbreak has caused only a handful of human cases over the past two decades. Work to develop vaccines to target this virus is underway, but none have been fully tested, let alone finished…. If COVID-19 was a big reminder of the threat of emerging infectious diseases, then Ebola is a quieter but equally dire warning. To a degree, the world got lucky with the pandemic: If something as transmissible as SARS-CoV-2 and as deadly as Ebola emerged in the future, the resulting outbreak would change the course of history. To prepare for the worst-case scenario, lessons must be learned from this outbreak—and where it came from. Ebola and COVID-19 are both diseases that jumped to humans because humanity continues to encroach on wild areas of the planet.”
 
Devex (US) reports, “Shortages of health workers in Uganda have fueled the spread of Ebola, said World Health Organization Regional Director for Africa Dr. Matshidiso Moeti during the World Health Summit on Sunday. The spread of the virus ‘continued for a couple of months in a peripheral area before it was detected,’ she said, adding that this is because there is not enough capacity in these areas for community health workers or nurses to pick up on and report unusual patterns of disease. Because of this, she argued, the global community should prioritize ensuring countries have adequate levels of health workers as not only important to the country where they reside, but also as a broader public good, as they serve as a base-level network of disease surveillance.”
 
Reuters (UK) reports, “Uganda President Yoweri Museveni said on Saturday the government was implementing an overnight curfew, closing places of worship and entertainment, and restricting movement into and out of two districts affected by Ebola for 21 days. The measures aimed at curbing the spread of the disease will be introduced immediately in Mubende and Kassanda districts in central Uganda, the epicentre of the epidemic, he said in a televised national address.
 

 
NPR (US) reports on a rapid decline in monkeypox cases in the US: “The virus has continued to circulate almost entirely within gay and queer sexual networks. And vaccine supply is plentiful, even outstripping the current demand…. Health experts attribute the success to changes in behavior among those at high risk for monkeypox and quick uptake of vaccines. But a growing body of evidence suggests another factor is also helping slow down the outbreak: the virus can spread only under very particular circumstances…. In a study, published last month in the journal Science, researchers found that monkeypox spreads at very different rates in different groups of people – and that rate depends greatly on people's sexual activity. Researchers from Nagasaki University and London School of Hygiene & Tropical Medicine built a mathematical model of the global outbreak. Then they looked to see how the number of sexual partners alters the transmission of monkeypox in their network. Overall, monkeypox outbreaks were highly likely in only one particular type of sexual network: where a small number of people have a high number of sexual partners.”
 
The US may have more vaccines than demand, but that is far from true everywhere. Reuters (UK) reports, as monkeypox continues to impact gay and bisexual men in dozens of countries around the world, at-risk Mexicans are going abroad for vaccines they say their government has not bothered to make available at home. Mexico ranks ninth globally in total cases, according to the World Health Organization, but officials have not announced plans to acquire vaccines even as other Latin American countries receive shipments.”
 

 
The Atlantic (US) reports that in the US COVID-19 case counts have become unreliable as more people test at home and as states move to weekly rather than daily reporting. “Official case numbers now represent ‘the tip of the iceberg’ of actual infections, Denis Nash, an epidemiologist at the City University of New York [says.] “How, then, is anyone supposed to actually keep track of the COVID-19 risk in their area—especially when cases are expected to increase this fall and winter? Using newer data sources, such as wastewater surveillance and population surveys, experts have already noticed potential signals of a fall surge: Official case counts are trending down across the US, but Northeast cities such as Boston are seeing more coronavirus in their wastewater, and the CDC reports that this region is a hot spot for further-mutated versions of the Omicron variant.”

 
AFP (France) reports, “Nasal vaccines could still be a powerful future weapon in the fight against COVID-19 despite ‘disappointing’ recent trial results for an AstraZeneca spray, experts say…. This could block people from getting infected in the first place -- and also potentially hamper those who have COVID-19 from spreading it further. That would represent a huge boost compared to traditional shots in the arm, which have proved very effective at preventing severe COVID-19 but perform far less well when it comes to stopping transmission…. Around 100 different intranasal COVID-19 vaccines are under development worldwide, according to analysis by health data firm Airfinity and Nature last month, with some 20 being tested on humans. Russia and Iran have also approved nasal vaccines. However, like China and India, they have not published trial data showing that their vaccines stop transmission in a peer-reviewed journal. And with falling inoculation rates worldwide leading some countries to destroy millions of expired doses, the demand for a new COVID-19 vaccine remains unclear.”

 
STAT (US) reports, “Biden health officials are bracing for the prospect that the country’s sole preventive COVID-19 treatment for immunocompromised people could be ineffective this winter. AstraZeneca’s Evusheld, the only monoclonal antibody authorized as a periodic injection to prevent infection, has become an essential shot for roughly 17,000 Americans with weakened immune systems. But news this month that it is not effective against a steadily climbing coronavirus strain sent health officials racing to game out other antibody options and convene a meeting with patient groups…. The internal deliberations reflect larger questions about the Biden administration’s ability to respond to evolving COVID-19 variants with a shrinking coronavirus response budget, according to six people familiar with the discussion. President Joe Biden last month declared the pandemic ‘over’ even as health officials pleaded with Congress for more cash and warned of a winter surge. Evusheld is still effective against many variants, but it is not possible for physicians to know which strains a patient using it as prophylaxis could be exposed to, an AstraZeneca spokesperson told STAT.”
 

 
The Guardian (UK) reports, “Vaccines that target cancer could be available before the end of the decade, according to the husband and wife team behind [the Pfizer/BioNTech vaccine]…. An mRNA COVID-19 vaccine works by ferrying the genetic instructions for essentially harmless spike proteins on the COVID-19 virus into the body. The instructions are taken up by cells which churn out the spike protein. These proteins, or antigens, are then used as “wanted posters” – telling the immune system’s antibodies and other defences what to search for and attack. The same approach can be taken to prime the immune system to seek out and destroy cancer cells, said Türeci, BioNTech’s chief medical officer. Rather than carrying code that identifies viruses, the vaccine contains genetic instructions for cancer antigens – proteins that stud the surfaces of tumour cells….Türeci told Kuenssberg that BioNTech had learned how to manufacture mRNA vaccines faster during the pandemic, and had a better understanding of how people’s immune systems responded to mRNA. The intense development and rapid rollout of the COVID-19 shot had also helped medicines regulators work out how to approve the vaccines. ‘This will definitely accelerate also our cancer vaccine,’ she added.”

 
CBC (Canada) reports, “New research from the University of Alberta tracked conspiracy theories about monkeypox on TikTok that made false claims about everything from vaccines to Bill Gates. A study published Tuesday in health journal JAMA Network identified misinformation trends in videos published on the social media site in May 2022, a few weeks after media began reporting on outbreaks of monkeypox around the world…. The study identifies 11 different themes and types of misinformation, the most common being the false assertion that monkeypox is the next planned pandemic. A number of videos brought up misinformation about vaccines, while others suggest a conspiracy about vaccines or that Bill Gates speaking about the need to prepare for future pandemics is a sign of his involvement. Other conspiracy theories tied monkeypox to news of monkeys escaping following a car crash, while some suggest the virus is a sign that the rapture is coming.”
 

 
VeryWell Health (US) looks at why studying sex differences in COVID-19 vaccine research matters. “A review of Phase 3 clinical trials of COVID-19 vaccines suggests we could be doing a better job of examining how that safety and effectiveness might differ between men and women. Authors of the review, published in the journal Contemporary Clinical Trials, found that only 30 percent of the studies they analyzed reported on significant sex differences regarding vaccine effectiveness and side effects…. The studies that did present sex-disaggregated data—data analyzed by sex—showed there were differences in how well the vaccine worked between men and women. Men were conferred stronger levels of protection than women after receiving their first COVID-19 vaccine dose. And women were more likely to experience more serious and unpleasant vaccine side effects, including blot clots (although blood clotting events occur in less than 1 out of 10,000 people).”
 

 
In an interview with The Nation (Kenya) Dr Patrick Osewe, chief of the Health Sector Group, Asian Development Bank says, “Beyond COVID-19, there are opportunities to produce other vaccines. GAVI, the Vaccine Alliance, purchases vaccines for low-income countries and many of these countries are becoming wealthier. GAVI’s requirement is that they only supply to low-income countries and those that are just emerging from the low-income bracket. As countries become richer, the less support they receive from Gavi. By 2026, more countries will stop receiving subsidised vaccines from Gavi. In Kenya, for example, once support from Gavi ends, the Treasury will have to allocate funds for the purchase of vaccines.”
 
A GAVI blog post reports, “More than 11 billion doses of COVID-19 vaccine were produced last year, in theory enough to protect everyone. But because of vaccine hoarding and export restrictions combined with the lack of regional vaccine supply across the continent, Africans died because of delays in access to doses. If left unchecked this represents a serious threat to global health security. If Africa's limited vaccine industry were to be significantly expanded, this kind of market failure could be avoided. Not only should it improve global pandemic preparedness, which ultimately benefits everyone, but in periods between pandemics it should also help to create greater vaccine supply resilience for African nations for a wide range of vaccine-preventable diseases. However, realising that means the creation of a sustainable, multi-billion-dollar industry practically from scratch.”
 

 
A flurry of headlines and reporting on research on the SARS-CoV-2 virus at Boston University in the US raises questions about whether the research was safe and might have released a new pathogen. STAT (US) looked at the research and implications, reporting: There is no evidence the work, performed under biosecurity level 3 precautions in BU’s National Emerging Infectious Diseases Laboratories, was conducted improperly or unsafely. In fact, it was approved by an internal biosafety review committee and Boston’s Public Health Commission, the university said Monday night. But it has become apparent that the research team did not clear the work with the National Institute of Allergy and Infectious Diseases, which was one of the funders of the project. The agency indicated it is going to be looking for some answers as to why it first learned of the work through media reports…. [The research] involved creating a hybrid or chimeric virus — in which the spike protein of an Omicron version of SARS-2 was fused to a virus of the Wuhan strain, the original version that emerged from China in 2020. Omicron viruses first emerged in late 2021 and have since splintered into multiple different subvariants. The goal of the research was to determine if the mutations in the Omicron spike protein were responsible for this variant’s increased ability to evade the immunity to SARS-2 that humans have built up, and whether the changes led to Omicron’s lower rate of severity.”