AVAC's weekly COVID News Brief provides a curated perspective on what COVID news is worth your time.

"Data sharing in health research and surveillance is undoubtedly a scientific and ethical necessity. Genomics research has reaffirmed this especially during the COVID-19 pandemic. However, such communal scientific practices must be embedded within a moral context of solidarity and social justice that serves to reduce, rather than exacerbate, global health inequities."

— Professor Keymanthri Moodley and colleagues in The Lancet Global Health


** Latest Global Stats
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November 2, 2022
Source: Our World in Data ([link removed])


** Table of Contents
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* Zambia Reaches Vaccine Milestone
* A Nasal Spray a Day?
* Variant Soup
* Ethics of Genomic Data Sharing
* The Search for New COVID Treatments
* Uganda's Ebola Outbreak
* Virus Hunters
* COVID Grants and the Informal Sector in South Africa
* New Hope for Malaria Prevention
* Cholera Outbreaks Surge
* Monkeypox Still Global Threat
* New RSV Vaccine
* Pandemic Preparedness
* Politics and Public Health


We know COVID disrupted health systems around the world and now WHO has documented the impact on tuberculosis cases. VOA ([link removed]) (US) reports, “Tuberculosis case numbers increased from 2019 to 2021, reversing years of progress as the COVID-19 pandemic disrupted access to treatment and testing… A WHO report released Thursday stated that more than 10 million people got tuberculosis in 2021, a 4.5 percent increase from 2020. Roughly 450,000 cases involved individuals infected with the drug-resistant TB strain, a 3 percent increase from 2020 to 2021. Most of these cases were reported in India, Indonesia, Myanmar and the Philippines.” The Independent ([link removed]) (Zimbabwe) quotes WHO’s Tedros who “warned African countries to be wary of the deadly respiratory disease saying: ‘If the (COVID-19) pandemic has taught us anything, it’s that with solidarity, determination, innovation and the equitable use of tools we can overcome severe health threats. Let’s apply those lessons to TB and stop this long-time killer.’ WHO attributes the increase in TB cases to disturbances in TB services after resources were diverted to the COVID-19 pandemic.”



** If You Are in a Hurry
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Read Nature ([link removed]) on COVID “variant soup” and The Atlantic ([link removed]) on what that could mean for antibody treatment and prevention.

Read ABC News ([link removed]) on WHO’s continuation of a Monkeypox as a global public health emergency and Reuters ([link removed]) on the undercounted toll of Monkeypox in African countries.

Read The Washington Post ([link removed]) about the search for new COVID treatments and why some are skeptical about these new approaches.

Read NBC News ([link removed]) on promising news about an RSV vaccine to protect infants.

Check out a special collection of commentaries and features looking at pandemic preparedness in Nature ([link removed]).

Read STAT ([link removed]) on what outcomes of the US midterm elections could mean for the COVID response and science in the US.


** Zambia Reaches Vaccine Milestone
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The Lusaka Times ([link removed]) (Zambia) reports, “President Hakainde Hichilema has commended the efforts of various stakeholders for Zambia’s attainment of the 70 percent COVID-19 vaccination set target across the country… Estimating over four thousand lives lost in the country due to the pandemic, the Head of State stressed the need for government to spearhead the fight with the partnerships of various stakeholders. He noted this included dealing with the misconceptions of the vaccine, sensitisation among communities as well as the appointment of a COVID Advisor, who he commended for the tremendous job done.”



** A Nasal Spray a Day?
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Nature ([link removed]) (UK) reports on a nasal spray developed by researchers at Columbia University in the US: “The sprays would be fast-acting and would be applied frequently, perhaps once or twice a day, to the site where the virus first takes hold — the nasal lining and throat. Unlike vaccines, which train the recipient’s immune system to build long-lasting protection, the sprays are short-lived compounds that would directly block the virus’s ability to enter cells. Multiple research teams have shown that such sprays are effective at warding off SARS-CoV-2 infection in animals… Vaccines protect against severe COVID-19, but they’re less adept at preventing infection, and current antivirals treat infection rather than preventing it. The sprays could offer people another way to avoid infection on top of — or instead of — wearing a face mask, especially in high-risk settings such as hospitals and restaurants.”


** Variant Soup
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Nature ([link removed]) (UK) reports, “Some call it a swarm of variants — others refer to it as variant soup. Whatever it’s called, the current crop of immunity-dodging offshoots of the Omicron variant of SARS-CoV-2 is unprecedented in its diversity. This complexity makes it harder to predict coming waves of infection. It might even lead to a ‘double wave’ in some places, as first one variant and then another overtakes a population. But amid the chaos, patterns are emerging. The swarm has helped scientists to pinpoint a handful of immunity-evading mutations that power a variant’s spread.”

The Atlantic ([link removed]) (US) looks at the impact of these variants on current treatments for COVID. “…for the subset of people who become sick enough to need clinical care, the consequences could get even worse. Some of our best COVID treatments are made from single antibodies tailored to the virus, which may simply cease to work as SARS-CoV-2 switches up its form. Past variants have already knocked out several such concoctions—among them, REGEN-COV, sotrovimab, and bamlanivimab/etesevimab—from the US arsenal. The only two left are bebtelovimab, a treatment for people who have already been infected, and Evusheld, a crucial supplement to vaccination for those who are moderately or severely immunocompromised; both are still deployed in hospitals countrywide. But should another swarm of variants take over, these two lone antibody therapies could also be obsolete within months, if not weeks.”


** Ethics of Genomic Data Sharing
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In a Viewpoint in Lancet Global Health ([link removed](22)00417-X/fulltext?dgcid=raven_jbs_aip_email) (UK) a group of Southern African researchers look at ethical issues around genomic data sharing: “During the COVID-19 pandemic, the transformative potential of genomic pathogen data sharing became obvious and advanced the debate on data sharing. However, when the genomic sequencing data of the omicron (B.1.1.529) variant was shared and announced by scientists in southern Africa, various challenges arose, including travel bans. The scientific, economic, and moral impact was catastrophic. Yet, travel restrictions failed to mitigate the spread of the variant already present in countries outside Africa. Public perceptions of the negative effect of data sharing are detrimental to the willingness of research participants to consent to sharing data in post pandemic research and future pandemics.”


** The Search for New COVID Treatments
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The Washington Post ([link removed]) (US) reports, “some scientists are seeking ways to blunt the coronavirus’s slippery evolution by blocking the human proteins it uses against us. If the strategy works, it has the potential to address several shortcomings of current treatments and vaccines, including their inability to prevent infections and maintain effectiveness in the face of a changing virus. The approach could also protect people with immune systems too weak to tolerate vaccines.” The Post reports there is some skepticism and concern about this strategy, quoting NIAID’s Carl Dieffenbach: ‘If you choose the right target, you can get things to work,’ Dieffenbach said, adding, ‘I have a healthy skepticism’ about developing drugs that target human proteins. He pointed out that both ivermectin and hydroxychloroquine target human proteins but have yet to show any value in fighting covid-19. In addition, he said
that aiming drugs at our own proteins ‘runs the significant risk of serious harm.’”


** Uganda’s Ebola Outbreak
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CIDRAP ([link removed]) (US) reports, “As Ebola cases steadily rise in Uganda, with a spate of cases recently reported in Kampala, the World Health Organization (WHO) said the latest developments increase the risk to Uganda and the surrounding region… [WHO] said though Uganda has experience responding to Ebola outbreaks and has taken quick actions, the lack of treatments and vaccines for the rarer Sudan Ebola strain that's fueling the outbreak poses a serious public health risk. The WHO is revising its formal risk assessment, but said given the geographical expansion to urban settings, the risk to Uganda has been elevated from high to very high, and the risk to the region has been increased from low to high. It added that the global risk remains low.”

WHO’s Tedros tweeted ([link removed]) : “Progress in containing #Ebola in the original epicentre in #Uganda is welcome but rising cases in new geographical areas, including urban centres, are concerning. Ebola control in urban areas can be complex & requires coordinated & sustained efforts to interrupt transmission.”

The Monitor ([link removed]) (Uganda) reports, “The Minister of Health, Dr Jane Ruth Aceng, has asked the Ministry of Education and Sports to consider early examinations for non-candidate classes so that schools can close early for the third term holidays. Dr Aceng said the move is aimed to decongest schools and minimise the risk of spreading Ebola… Last week, the Ministry of Health announced that at least six pupils from three schools in Rubaga Division in Kampala were among the 47 Ebola patients fighting for their lives at various treatment centres in the country.”

The Hill ([link removed]) (US) reports, “Three experimental Ebola vaccine candidates are being shipped to Uganda to aid in combatting the ongoing outbreak in the country… The three experimental vaccine candidates being sent to Uganda are currently in development to protect against [Sudan ebolavirus]. As they help fight the current outbreak, their use in the country will also supply additional data for clinical trials.


** Virus Hunters
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CBS News ([link removed]) (US) travels along with a group of US and Ugandan researchers looking for the spillover of viruses from animals into humans in the Impenetrable Forrest of Uganda. “Ebola is among the deadliest of pathogens capable of jumping from wild animals to humans—just as COVID-19 likely did. It's called spillover. Disease detectives warn the threat of spillover has never been higher as urban populations grow and come into contact with wild animals and their viruses. Since 2009, American scientists have discovered more than 900 new viruses. Now, the U.S. government is doubling down, sending virus hunters to global hotspots to find the next deadly virus before it finds us.”


** COVID Grants and the Informal Sector in South Africa
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A group of researchers write in News24 ([link removed]) (South Africa) about the impact of government COVID grants for informal traders. “Informal traders were among the approximately six million people who qualified during the first phase of the Special Covid-19 Social Relief of Distress (SRD) grant introduced by the government in mid-2020. (Coverage reached 8.5m in September 2021, and during the follow-up phases of the grant, most informal traders no longer met the qualifying criteria.) The grant amounted to R350 a month and was designed to cushion the blow of the pandemic in extremely vulnerable households… No matter the circumstances and challenges, traders were able to parlay the SRD into supporting and even in some cases, growing their businesses. Given that the SRD (which was extended several times) may soon fall away entirely, it is essential to highlight how this
relatively small amount can make a genuine difference among traders — and to local economies. These "shock absorbers" need sustained and sustainable assistance.”


** New Hope for Malaria Prevention
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Science ([link removed]) (US) reports, “A study published today in The New England Journal of Medicine (NEJM) showed a single dose ([link removed]) of lab-produced monoclonal antibodies can protect recipients from infection for up to 6 months during Mali’s intense malaria season. Monoclonal antibodies are expensive to produce and can be cumbersome to administer if they are infused straight into the bloodstream. That makes some researchers skeptical that the new ones to thwart malaria will be of much use except to protect travelers from high-income, nonendemic countries, who now often take tablets to prevent parasitic infection transmitted by mosquitoes. But the team behind the study is working on an easier way to administer the protective proteins and hopes costs will come down.”


** Cholera Outbreaks Surge
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The New York Times ([link removed]) (US) reports, “A record number of cholera outbreaks around the globe, driven by droughts, floods and armed conflicts, has sickened hundreds of thousands of people and so severely strained the supply of cholera vaccines that global health agencies are rationing doses. Outbreaks have been reported in the Caribbean, Africa, the Middle East and South Asia, putting the health of millions at risk and overwhelming fragile health systems. Untreated, the disease, which is commonly spread through contaminated water, can cause death by dehydration in as little as one day…”


** Monkeypox Still Global Threat
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ABC News ([link removed]) (Australia) reports WHO “says the monkeypox outbreak is still as a global health emergency of the highest alert level… The Emergency Committee noted that data from low-income settings was largely lacking. In Africa, there is minimal information available to determine whether transmission is mainly zoonotic or to determine the role of human-to-human transmission, including through intimate or sexual contact. There's concern low-income settings have inadequate diagnostic capacity and do not have access to vaccines or therapeutics, despite clearly having the highest reported case fatality of all regions.”

Reuters ([link removed]) (UK) reports, “Global health bodies have counted far fewer cases [of Monkeypox] in Africa during the current outbreak than in Europe and the United States, which snapped up the limited number of vaccines this year when the illness arrived at their shores. But the outbreak, and death toll, in Congo could be much greater than recorded in official statistics, Reuters reporting shows, in large part because testing in underequipped, rural areas is so limited and effective medicines are unavailable… In the West, only about 10 people have died of monkeypox this year, figures from the US CDC show. Europe and the United States have been able to vaccinate at-risk communities… But in poorer African countries where many people do not have quick access to health facilities, or are not aware of the dangers, over 130 have died, almost all in Congo, according to the
Africa CDC. No monkeypox vaccines are publicly available in Africa.”

The New York Times ([link removed]) (US) reports, “Nearly all Americans hospitalized for monkeypox infection had weakened immune systems, most often because of HIV infection, the Centers for Disease Control and Prevention reported… Of 57 hospitalized patients described in the report, 82 percent had HIV More than two-thirds of the patients were Black and nearly one-quarter were homeless, reflecting racial and economic inequities seen in the outbreak overall. The finding suggests that although most cases of monkeypox are mild, doctors should test patients with suspected cases for HIV as well, and be prepared to offer prompt treatment for both infections.”


** New RSV Vaccine
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NBC News ([link removed]) (US) reports, “An experimental RSV vaccine for pregnant women from Pfizer is effective at protecting newborns against severe illness for at least six months, the company said in a press release… The results were announced in a news release and have not been published in a medical journal or reviewed by outside scientists. Pfizer said it plans to submit the data to the Food and Drug Administration by the end of the year. The company's CEO, Albert Bourla, said on a call with investors Tuesday that he expects the vaccine could be available by late 2023 or early 2024. An independent group of outside experts monitoring the trial recommended that the company end trial enrollment early because of the vaccine’s potential benefits.


** Pandemic Preparedness
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Nature ([link removed]) (UK) has published a special collection of articles looking at Pandemic Preparedness. (Note: Although editorially independent, the supplement is sponsored by two pharmaceutical companies.) In one commentary ([link removed]) “Mastering the art of persuasion during a pandemic,” the author says, “Although COVID-19 isn’t yet in the rear-view mirror, policymakers are already discussing how its lessons should shape our response to future pandemic threats, including the current outbreak of monkeypox. A fresh flood of behavioural-science research supports their plans. This work lends insight into which policies and campaigns are most effective at convincing people to follow health guidance that helps to stop the spread of disease. The messages that have the most influence are not always the ones that policymakers assume will work. Appeals to the empathy and responsibility of the public, delivered by people whom listeners trust, can work better
than outright mandates. Offering rewards for vaccination might be less effective than simply issuing reminders.”


** Politics and Public Health
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STAT ([link removed]) (US) reports, “In this year’s midterms, the future of federal science policy is in Republicans’ crosshairs. Some of the most vocal critics of scientists and science agencies like the NIH and the CDC, including Sen. Rand Paul of Kentucky, are poised to ascend to powerful committee chairmanships that will enable them to conduct sweeping investigations and put health officials on public trial. The new chairmanships could also give them the ability to tighten the purse strings for health agencies’ budgets—and to deny funding outright for new COVID-19 measures or other Biden health priorities. At the same time, some of the Republican party’s biggest defenders of science and science policy are poised to retire.”
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