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.
""It’s inspiring to see when community, political will and science come together,” said Demetre Daskalakis, the deputy coordinator of the White House monkeypox response, who has spent decades on the front lines of gay sexual health."
-- More in The Washington Post ([link removed])


** Share of People Who Completed the Initial COVID-19 Vaccination Protocol
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January 5, 2023
Source: Our World in Data ([link removed])


** Table of Contents
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* If You Are in a Hurry (#If You Are in a Hurry)
* China’s COVID-19 Crisis (#China’s COVID-19 Crisis)
* Politics and Vaccine Misinformation (#Politics and Vaccine Misinformation)
* Long COVID Research and New Treatments (#Long COVID Research and New Treatments)
* COVID-19 and Mental Health (#COVID-19 and Mental Health)
* Malawi’s Cholera Outbreak (#Malawi’s Cholera Outbreak)
* The Potential of Antibody Drugs (#The Potential of Antibody Drugs)
* Monoclonal Antibodies Impact on COVID-19 Waning (#Monoclonal Antibodies Impact on COVID-19 Waning)


* Cameroon Adds COVID-19 Vaccines to Routine Immunizations (#Cameroon Adds COVID-19 Vaccines to Routine Immunizations)
* Barriers to Paxlovid Uptake (#Barriers to Paxlovid Uptake)
* WHO Approves Generic Paxlovid (#WHO Approves Generic Paxlovid)
* Moderna’s Mpox Vaccine Not a Priority (#Moderna’s Mpox Vaccine Not a Priority)
* Community Response to Pandemics and Outbreaks (#Community Response to Pandemics and Outbreaks)
* Dr. Fauci’s Legacy and His Warning (#Dr. Fauci’s Legacy and His Warning)

Early in the COVID-19 pandemic when vaccines were first proven effective and beginning to roll out the major barrier to global vaccine uptake was rich countries hoarding vaccines and lack of access to vaccines in low- and middle-income countries. But as we enter the fourth year of the global pandemic, access is no longer the main issue. Jeffrey Lazarus, Salim Abdool Karim, Carolina Batista and Kenneth Rabin write in a commentary in BMJ ([link removed]) (UK) that while COVID-19 remains a global health threat, vaccination rates remain low in many countries, “Just 24.6 percent of people in low-income countries have received at least one vaccine dose…. The issue is even more vexing in regions where vaccines are readily available, suggesting that low uptake is partly due to vaccine hesitancy that may be fueled by the unusual combination of reduced levels of mortality and intense anti-vaccination propaganda. These campaigns sow distrust in the science underpinning the
vaccines, the authorities recommending their use, and even the seriousness of getting COVID-19. Mistrust of governing bodies and drug companies contributes to vaccine hesitancy, and marginalised communities may avoid vaccination because of historically negative experiences with healthcare or a lack of effective health messaging.”




** If You Are in a Hurry
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* Read The Washington Post ([link removed]) on the potential of antibody drugs to treat and prevent infectious diseases even in low-income countries.
* Read Science ([link removed]) on the state of the COVID-19 outbreak and response in China.
* Read Nature ([link removed]) on barriers to Paxlovid uptake and Quartz ([link removed]) on WHO approval of generic Paxlovid that could make the drug available in low and middle income countries.
* Read physician journalist Keren Landman in Vox ([link removed]) on grassroots responses to disease that worked in 2022 and Wired ([link removed]) on the community response that led to sharp declines in Mpox cases in the US.
* Read a Washington Post ([link removed]) news analysis on politics and continuing vaccine misinformation in the US.
* Read Peter Staley on Dr. Fauci’s legacy in New York Times ([link removed]) .




** China’s COVID-19 Crisis
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The world is watching as China’s ending of the COVID-19 zero policy and loosened restrictions seems to be ushering in a steep rise in cases, but the extent of the outbreak is not being reported. STAT ([link removed]) (US) quotes Mike Ryan, head of the WHO’s health emergencies program: “We believe the current numbers being published from China underrepresent the true impact of the disease in terms of hospital admissions, in terms of ICU admissions, and particularly in terms of death. And we would like to see more data on a more geographic basis across China.” STAT reports, “As the disease races through the country, authorities are reporting low levels of deaths — five or fewer a day — which outside experts say defies credulity.”

SABC ([link removed]) (South Africa) quotes WHO’s Tedros: “WHO is concerned about the risk to life in China and has reiterated the importance of vaccination, including booster doses to protect against hospitalisation, severe disease and death.”

Science ([link removed]) (US) reports, “Models that predicted a massive wave of infection and death if China ended zero COVID-19 appear to have been correct. Press reports and social media posts have shown intensive care units stretched beyond capacity, with crowds of patients in wheelchairs and on gurneys in hallways. Doctors and nurses are reportedly working while sick. Crematoriums are overwhelmed. But China’s official COVID-19 death toll is widely considered laughably low. And some scientists worry a genomic monitoring plan unveiled last month doesn’t have the power to detect new SARS-CoV-2 variants arising as the virus works its way through one-fifth of the world population.”

As cases climb in China, several countries have put testing mandates in place for people traveling from China. The New York Times ([link removed]) (US) reports, “The Chinese government on Tuesday denounced COVID-19 testing requirements imposed by other countries on travelers arriving from China as unscientific or ‘excessive,’ and threatened to take countermeasures…. The countries have cited concerns about a surge in COVID-19 infections in China, the potential risk of variants emerging from its outbreak and the government’s perceived reluctance to share coronavirus data with other countries. The restrictions include requiring a negative COVID-19 test or mandatory testing upon arrival. In response, Chinese officials have accused the countries of introducing the restrictions for political reasons, imposing requirements on Chinese travelers that are not applied to others.”

International Business Times ([link removed]) (Singapore) reports, “Dead bodies are piling up in China and crematoriums are overwhelmed as the COVID-19 pandemic continues to remain unabated in the country, according to reports. While funeral homes in major cities are running at capacity, making relatives wait for long before they can complete the final rites of the deceased….”



** Politics and Vaccine Misinformation
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Misinformation about COVID-19 vaccines continues in many communities around the world. In the US, the latest manifestation follows the collapse of an American football player during a game. A Washington Post ([link removed]) (US) news analysis notes, “a number of injuries, illnesses and unexpected performances have been linked without evidence to the athletes’ having been vaccinated. It’s quite explicitly cherry-picking: Anything even remotely linked to circulatory issues has been lumped into a vast “just asking questions!!” universe of suspicion, generally by those on the political right. It’s not that there is a demonstrable increase in illness among athletes; it’s that any illness in any athlete at any level now becomes fodder for inclusion in that universe…. The idea that actual evidence from credentialed observers can be successfully rebutted with anecdotes and the musings of do-your-own researchers
extends in various directions besides simply pointing at athlete injuries with an eyebrow raised. A common argument is that there has been a surge in excess deaths (that is, deaths above what would otherwise be expected) that correlates with increased coronavirus vaccinations. But, of course, this is in large part because thousands of people died of COVID-19.”



** Long COVID Research and New Treatments
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Medscape ([link removed]) (US) reports, “Dozens of clinical trials nationwide are already underway or starting soon, many of which are aided by $1.5 billion in funding from the National Institutes of Health to help identify new treatments for common symptoms like brain fog, fatigue, sleep disturbances, and a hard time breathing. But it may take years for these trials to prove which drugs, devices, and behavioral therapies are safe and effective.”



** COVID-19 and Mental Health
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One of the enduring impact of the COVID-19 pandemic is mental health. CIDRAP ([link removed]) (US) reports, “A survey of nearly 45,000 college students in France reveals a high prevalence of stress, anxiety, depression, suicidal thoughts, and post-traumatic stress disorder (PTSD) 15 months after the COVID-19 pandemic began…. ‘These results suggest severe long-lasting consequences associated with the pandemic on the mental health of students,’ the researchers wrote. ‘Prevention and care access should be a priority.’"



** Malawi’s Cholera Outbreak
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Bloomberg ([link removed]) (US) reports, “Malawi’s worst cholera outbreak in two decades has left 625 people dead after the disease spread to all districts of the southeastern African country…. With the case fatality rate climbing to 3.4 percent, government has delayed the opening of schools for the year in both the political capital Lilongwe and in Blantyre, the nation’s center of finance and commerce.”



** The Potential of Antibody Drugs
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The Washington Post ([link removed]) (US) reports on the potential for antibody drugs, which were key components in the early response to COVID-19 in rich countries, for other infectious diseases, including those that primarily affect those in low-income countries, where the cost may be a limiting factor. “For more than three decades, monoclonal antibodies have been powerful, primarily first-world medicines with thousand-dollar price tags. The laboratory-brewed proteins are produced by living cells grown under controlled conditions in giant vats. The coronavirus pandemic showcased the largely untapped potential for monoclonal antibodies to be leveled against more-commonplace threats such as infectious diseases — if the impetus and money exist…. But the pandemic also exposed huge challenges: The drugs can cost thousands of dollars per treatment, are often given by onerous intravenous infusions and can quickly become
obsolete as pathogens evolve.



** Monoclonal Antibodies Impact on COVID-19 Waning
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Politico ([link removed]) (US) reports, “Once heralded as game-changers for COVID-19 patients considered at risk for getting seriously ill…monoclonal antibodies are now largely ineffective against current COVID-19 variants. Easier-to-administer antiviral drugs have largely taken their place, but the most widely used option isn’t safe for all immunocompromised people because it interacts with many other drugs…. The FDA pulled authorizations for four antibody treatments in 2022 as Omicron and its myriad subvariants wiped out their effectiveness. The treatments were geared toward adult and pediatric patients with mild-to-moderate COVID-19 who were considered at risk of developing severe disease and ending up hospitalized.”



** Cameroon Adds COVID-19 Vaccines to Routine Immunizations
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Journal du Cameroun ([link removed]) (Cameroon) reports, “The permanent secretary of the Expanded Programme on Immunisation (EPI), Dr Shalom Tchokfe Ndoula, reports that the integration of COVID-19 vaccination into routine immunisation targeting people at risk is planned for 2023…. On 30 December, the Minister of Public Health, Manaouda Malachie, prescribed the ‘reinforcemen’” of vaccination against COVID-19 in hospitals and vaccination centres to avoid the end-of-year celebrations being risk factors for a resurgence of cases, particularly through the importation of new variants of the disease.”



** Barriers to Paxlovid Uptake
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Nature ([link removed]) (UK) reports that despite the high efficacy of the antiviral treatment Paxlovid, “the drug’s rollout has been hampered by worries about ‘rebound’ (the mysterious return of symptoms or detectable virus days after a person starts to feel better) and side effects — as well as by declining concern about the risk of COVID-19. Inadequate funding for distribution, the drug’s high price tag and the need for it be taken soon after infection have also slowed its uptake…. Paxlovid relies on a robust COVID-19 testing infrastructure and access to primary-care physicians and pharmacies, she notes. This amplifies pre-existing disparities resulting from race and income. For example, Black and Hispanic populations were about 36 percent and 30 percent less likely to be prescribed Paxlovid, respectively, compared with white populations, according to an analysis of almost 700,000 people who sought COVID-19 care across 30 US sites. Fears about
hesitancy, says [Anne Sosin, a public-health-policy specialist], provide an excuse to blame individuals rather than policymakers and to deflect ‘attention away from the system that needs to be in place to deliver the drugs’.”



** WHO Approves Generic Paxlovid
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Quartz ([link removed]) (US) reports, “The World Health Organization (WHO) gave preapproval on Dec. 26 to Hetero, an Indian pharmaceutical company, for nirmacom, the generic version of Paxlovid…. Paxlovid has been available for a little over a year in the US, but limited supplies, approval delays, and high prices have kept it out of reach for many low- and middle-income countries. Hetero entered an agreement to produce its generic version of Paxlovid through Medicines Patent Pool (MMP).”



** Moderna’s Mpox Vaccine Not a Priority
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Fierce Biotech ([link removed]) (US) reports, “Moderna CEO Stéphane Bancel says data from the company's preclinical monkeypox, or mpox, vaccine are ‘fantastic,’ but don't expect to see it on the market any time soon, if at all. ‘Given where monkeypox is, an innovative vaccine that's working pretty well on the market, we want to use our resources … to do things that are going to help people,’ Bancel said in an interview with Fierce Biotech Tuesday. ‘I could do whatever it is, A and B vaccine using mRNA; I think it’s no use to the planet.’” Mpox infections have declined sharply in the US and Europe. The disease remains endemic in parts of Africa. FB notes, “Emblematic in the lack of vaccine and therapeutic access is the continent’s 18.6 percent case-fatality ratio (CFR), with the vast majority of deaths coming from Congo. In the US, the CFR is less than 0.1 percent.”



** Community Response to Pandemics and Outbreaks
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Physician and journalist Keren Landman writes in Vox ([link removed]) (US) that amid all of the public health failures in the US in 2022, “a handful of public health victories gave me hope. In particular, these wins reinforced the importance of an undervalued and, usually, underfunded public health strategy: using grassroots, community-led campaigns to save lives and improve health. These mostly local campaigns subdued an outbreak of a disease traveling fast through sexual networks, extended COVID-19 vaccines to those underserved by the status quo, and overcame stigma and provider shortages to soften the impacts of mental illness, substance use, and overdoses. What they had in common: a “for us, by us” public health approach in which people working with community-led groups provided health outreach to members of their own, often marginalized, communities.”

Wired ([link removed]) (US) looks at why Mpox cases declined so sharply in the US. “The US, which had recorded 29,740 cases as of December 21—more than a third of the global total—was registering barely a handful each day. While one reason is that access to vaccines and testing improved, and another is that mpox is inherently much harder to transmit than COVID-19, the biggest, most agree, is that the people most at risk took their protection into their own hands in those crucial early weeks when the authorities were flailing. “The success was the community mobilization,” says Joseph Osmundson, a queer activist, molecular microbiologist, and clinical assistant professor at New York University.”

The Washington Post ([link removed]) (US) reports, “within months, the viral [Mpox] outbreak, which spurred U.S. and global agencies to declare public health emergencies, began disappearing almost as quickly as it had arrived…. One lesson from the monkeypox response is clear, especially after fierce disagreement about coronavirus sharply divided Americans: A common sense of purpose can be a powerful weapon against a microscopic enemy. ‘It’s inspiring to see when community, political will and science come together,’ said Demetre Daskalakis, the deputy coordinator of the White House monkeypox response, who has spent decades on the front lines of gay sexual health. ‘This is what we all signed up to do.’”


** Dr. Fauci’s Legacy and His Warning
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Activist Peter Staley writes in a New York Times ([link removed]) (US) about the Dr. Fauci’s legacy and his work with Staley and other activists to confront the HIV pandemic and later the COVID-19 pandemic. “Dr. Fauci walked through the fire with us, and his friendships with AIDS activists deepened with time, bound by a shared trauma…. Beyond today’s frightening anti-science minority, there’s a majority that spans the world. Among them are HIV-positive gay men like me who survived the earliest plague years — now, amazingly, aging into our 60s and 70s. We belong to a much wider community of people living with HIV in America today, most of whom are people of color. And beyond our borders, we are bound to millions of men, women and children in sub-Saharan Africa whose lives have been saved by science and advocates for public health. Our majority includes millions of Americans who listened to Dr. Fauci’s advice during that first scary
year of COVID-19 and kept listening as we got ourselves vaccinated and boosted, and we survived this plague. We draw hope from the progress of science. We are blessed with heroes willing to stand up for truth, unbowed by withering assaults.”

In an interview with LA Times ([link removed]) (US) when asked about the impact of partisanship on science Dr. Fauci warned: “We’re living in a progressively anti-science era, and that’s a very dangerous thing when you’re dealing with a very deadly pandemic that has already killed more than a million people in this country…. An example is if you look at the number of people vaccinated in red states versus blue states. There is absolutely no reason whatever that you’d make a decision about whether or not you are going to avail yourself of a lifesaving intervention for yourself and your family based on your ideological persuasion. It just doesn’t make any sense.”
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