-- GAVI’s Seth Berkley in World Economic Forum

We’re not out of the COVID-19 pandemic yet, but experts are warning that we need to be preparing for the next pandemic now. In a commentary ahead of the annual World Economic Forum – where political, business philanthropy leaders discuss world issues and sometimes identify solutions – GAVI’s Seth Berkley warns climate change is “now also one of the main driving forces increasing the risk of pandemics” and asks us to “consider how differently this pandemic might have played out if there had been a well-funded, comprehensive research effort into universal coronavirus vaccines before COVID-19 struck, given that we had two dry runs with SARS and MERS, such that they were ready for clinical testing and made available to people everywhere at the very start of the pandemic. With the right vaccines and a rapid response, it might have been possible to contain the spread and prevent global escalation. Speculation can only get us so far, but research suggests that more than 1.3 million deaths could have been prevented if COVID-19 vaccines had been shared more equitably during the first year that they became available. The bottom line is that being better prepared save lives.”
 
But Zambian journalist Zarina Geloo (a convener of the Media Science Café in Zambia) warns in Resolve Global Health (Hong Kong), “Preoccupied with managing day-to-day crises, healthcare-related and otherwise, African countries struggle to plan for tomorrow, let alone the next pandemic lurking around the corner. Better preparedness depends on developing flexible funding models and self-reliance.” She quotes Kenyan microbiologist Walter Jaoko: “Crucially, he says, given African countries are generally preoccupied with managing day-to-day health issues, they may struggle to plan for the long term, let alone set aside funds for it.”
 

If You Are in a Hurry

 

• Read a commentary in BMJ on the challenges of rebuilding Brazil’s public health system.
• Check out The Bulletin of the Atomic Scientists illustrated history of the world’s deadliest epidemics, from ancient Rome to COVID-19.
• Read a Lancet editorial that argues COVID-19 is far from over in 2023.
• Read Nature on how your first brush with COVID-19 may impact your later response to the virus.
• Read The Age on long COVID risk and CBC on long COVID and stigma.
• Read aidsmap on mpox and people living with HIV.
• Read Devex on the links between climate change and pandemics.

 

Far From Over

 
A Lancet (UK) editorial argues the COVID-19 pandemic is far from over, citing growing cases in China, noting that “Understandably, Chinese people want to lead normal lives again and see friends and family after such a long period of restrictions, but the health consequences could be dire.” In addition, the omicron subvariant XBB1.5 is cause for concern. “Maria Van Kerkhove, WHO’s COVID-19 technical lead, called it the most transmissible yet with mutations in the protein spike that allow a closer binding to the ACE-2 receptor and facilitate immune evasion, although so far there are no signs that it causes more severe disease. However, there are some early indications that hospital admissions are increasing in the northeast of the USA, where it is most prevalent.” The Lancet argues, “Rather than hoping for the end, letting our guard down, and thinking that the problem is somewhere else, everyone needs to remain alert; encourage maximum transparency in reporting cases, hospital admissions, and deaths; and accelerate collaborative surveillance of variant testing and vaccinations. The pandemic is far from over.”
 

Climate Change and Pandemics

 
An opinion piece by Arnaud Bernaert in Devex (US) argues, “According to epidemiology and predictive modeling experts, there is a 47-57 percent chance the world will experience another pandemic or epidemic that kills at least as many people as COVID-19 in the next 25 years, with a 22-28 percent chance within the next 10 years.” This is made more likely because of climate change. Bernaert argues, “All of us would rather see a way to turn the climate change tide as the way to save millions of lives in decades to come. Unfortunately, we have already passed that tipping point, and the only viable path forward will be to adapt to a new normal for epidemics and pandemics. The strengthening of outbreak monitoring with increased local genome sequencing capacity, the deployment of epidemics surveillance cockpits able to link early outbreak signals with travelers’ migration maps, the innovation of research and development pathways for equitable distribution of vaccines and treatments in the first one hundred days of an epidemics — will all be necessary tools as part of this adaptation arsenal.
 

More on the Link Between Politics and Science

 
Deisy Ventura, professor of global health ethics at the University of Sao Paulo, writes in a commentary in BMJ (UK): “The return of Luís Inácio Lula da Silva as president represents an opportunity for Brazil to rebuild its public health system (SUS) and resume its leadership in global health, relaunching cooperation with the global south. However, President Lula will face even greater challenges than those in his previous presidency (2002-10), considering that Brazilian public health was recently described by experts as ‘scorched earth.’… The timing of Brazil’s comeback could not be more appropriate as the World Health Organization is currently negotiating reform of the International Health Regulations and pandemic treaty.15 The world needs leaders who have faced the challenge of free and universal healthcare for all, as is the case of the [Brazil’s public health system], with all its achievements and setbacks. Brazil is also able to warn the international community about the threat posed to human life by far-right political ideologies.”
 

Priorities for a New Africa CDC Director

 
Dr. Ebere Okereke writes in Devex (US) “Whatever the appointee’s professional credentials as a scientist and public health expert, he or she will need to have a clear understanding of, and ability to influence and navigate through the Africa Union political leadership and commission, and global health politics. They will be tasked with leading Africa CDC through its consolidation phase as it becomes an established autonomous agency, expected to deliver on its early promises and successes.”
 

Targeting Activists on Twitter

 
The Intercept (US) reports that COVID-19 drug makers mounted a pressure campaign to push Twitter to censor activists pushing for a generic COVID-19 vaccine. It is unclear of pharma company requests to the Twitter were granted. “Nick Dearden, director of Global Justice Now, noted that at the time of BioNTech’s censorship request, much of the world was under various lockdown orders, making digital forms of protest all the more vital for influencing public policy. ‘To try and stifle digital dissent during a pandemic, when tweets and emails are some of the only forms of protest available to those locked in their homes, is deeply sinister,’ he said….
 

YouTube Videos and COVID-19 Facts in African Languages

 
A research article in the journal Global Health, Epidemiology and Genomics (UK) looks at the accuracy of YouTube videos on COVID-19 in 11 languages spoken in Africa. The researchers found a relatively low percentage of videos with misleading information. “The lower percentage seen in this study could be potentially accounted by the timing as it was conducted later than the previous studies, providing the opportunity for more robust infodemic curtailing measures…. Despite their modest number, misleading videos in our study had the highest likes: dislike ratio, whilst videos from government sources had the lowest. Similarly, misleading videos were proportionally liked five times more than their government counterparts.” The authors argue: “Various strategies need to be implemented to ensure a high caliber of medical information is available online to the public. Ultimately, this solution is the shared responsibility of the public, government, and YouTube itself.”
 

COVID-19 in China

 
Reuters (UK) reports the WHO “said on Monday it recommended that China monitor excess mortality from COVID-19 to gain a fuller picture of the impact of the surge in cases there. China said on Saturday that nearly 60,000 people with COVID-19 had died in hospital since it abandoned its zero-COVID policy last month, a big jump from the figures it reported prior to facing international criticism over its COVID-19 data.”
 
FT (UK) reports, “Xi Jinping has expressed concern about the spread of COVID-19 to rural China on the eve of the lunar new year, in the Chinese president’s most direct acknowledgment of the worsening health crisis since suddenly abandoning his zero-Covid strategy in early December…. Experts have warned that the period could become the biggest super spreader event since the virus first emerged in Wuhan, central China, in late 2019.”
 
Nature (UK) reports on what China’s newly opened borders may mean for research, noting that foreign researchers want to collaborate with Chinese colleagues and many Chinese researchers look forward to traveling outside the country for conferences and other meetings. Yet, “for some researchers, the excitement of China opening up is tempered by geopolitical tensions. The United States, Europe, the United Kingdom and Australia have increased their focus on national security and competitiveness, which might deter researchers in those regions from collaborating with their Chinese peers… The pandemic has also politicized specific areas of research, including the origins of SARS-CoV-2, making scientific engagement difficult.”
 

Long COVID and Stigma

 
CBC (Canada) reports on a new Lancet study that looked at stigma and people living with long COVID. “The study found that long COVID patients with higher levels of symptoms were more likely to have higher stigma levels than people who were relatively symptom-free. It also found people who reported high levels of stigma had reduced quality of life. These respondents had reduced perception of social support and reported experiencing more loneliness.
 

Long COVID Risk

 
The Age (Australia) reports, “a new study showed one in 10 people will end up with “long COVID”. According to the report, published on Friday in the academic journal Nature Reviews Microbiology, at least 65 million people worldwide already have long COVID, or post-COVID conditions, which is when symptoms persist for more than 12 weeks after the initial infection. It is estimated more than 10 per cent of those who catch COVID-19 will experience chronic health issues, with women aged between 30 and 55 particularly at risk.” Read the study in Nature Reviews Microbiology.
 

Unlikely Pfizer Booster Poses Stroke Risk

 
CNBC (US) reports, “The Centers for Disease Control and Prevention on Friday said it is “very unlikely” the Pfizer omicron booster carries a risk of stroke for seniors after it launched an investigation into a preliminary safety concern detected by one of its monitoring systems…. No other surveillance system has detected a similar safety concern for the Pfizer booster so far, according to the CDC. Investigators have not found an increased risk of stroke following the Pfizer booster after reviewing data from the Center for Medicare and Medicaid Services, the Department of Veterans Affairs, the Vaccine Adverse Reporting System and Pfizer’s global safety database.”
 

Imprinting Immunity

 
Nature (UK) reports on “a quirk of the immune system known as imprinting — the tendency for someone’s initial exposure to a virus to bias their immune response when they meet the same virus again…. A crop of studies is now showing how imprinting is shaping people’s response to SARS-CoV-2. For example, those infected with the earliest strain or with the subsequent Alpha or Beta strains mount varying immune responses to a later Omicron infection, depending on the strain to which they were first exposed. It’s now relatively easy to update mRNA vaccines to match a new strain, but imprinting suggests that these tailored vaccines might not significantly improve protection against infection. And although they are clearly able to prevent serious illness, this puts a dampener on the hope that variant-tailored boosters will markedly reduce transmission of the virus.”
 

Hybrid Immunity

 
Yahoo News (US) reports, “So-called “hybrid immunity”—from vaccination and infection—offers better protection against severe disease and hospitalization from COVID-19 than immunity from infection alone, according to a new study published in The Lancet. The study provides public health officials and policy-makers with recommendations on priorities when running vaccination campaigns, and on the potential frequency of booster shots going forward.” Read The Lancet study.
 

People Living with HIV and Mpox

 
Aidsmap (US) reports, “A substantial proportion of people who contracted mpox (the newly designated name for monkeypox) in the 2022 outbreak were living with HIV, and recent studies have shown that HIV-positive people can develop more severe illness, especially if they are not on antiretroviral treatment and have a low CD4 count. The authors of one study said, ““People with HIV had higher rates of clinical manifestations and required greater utilization of healthcare resources for any reason compared to those without HIV. Our findings should prompt clinicians to consider the possibility of complications in people with HIV who have [mpox], particularly those with severe or atypical symptoms.”
 

Moderna, Pfizer and RSV Vaccines

 
CNBC (US) reports both Moderna and Pfizer “have released results from RSV vaccine trials with efficacy results strong enough to expect expedited approval from the FDA…. The RSV successes come after a particularly bad RSV season in the US last fall among children and older adults. It’s also a virus that previously received little attention from R&D labs.”
 

Pandemic Avian Flu?

 
The Guardian (UK) reports on concerns that multiple global waves of avian flu that have killed millions of birds over the past 15+ years could lead to a pandemic flu among humans. “The virus is currently considered a low risk to humans, [molecular virologist Wendy Blay Puryearsays. “But anything that has the ability to replicate and evolve rapidly, and anything that has that ability to infect a lot of different hosts is kind of on borrowed time.”
 

Epidemic History

 
The Bulletin of the Atomic Scientists (US) has published an illustrated history of the world’s deadliest epidemics, from ancient Rome to COVID-19, with information about origins, spread and impact of a number of deadly diseases. The Bulletin reports, “The risk of another pandemic similar to COVID-19 is about two percent per year; however, this estimate is expected to increase threefold in the future because of an increased risk of zoonotic spillover—when viruses move from animals to humans—caused by human activity. As David Quammen notes in Spillover, “We should recognize that [outbreaks] reflect things that we’re doing, not just things that are happening to us.” In other words, it’s foolish to think that epidemics occur randomly and spread without help. Climate change, conflict, and environmental degradation are all contributing factors.”