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.
“The COVID-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis. Rather than waiting for a fourth coronavirus to emerge — or for the arrival of an especially dangerous SARS-CoV-2 variant — we must act now to develop better, longer-lasting and more broadly protective vaccines.”
-- Michael Osterholm of CIDRAP ([link removed])


** Share of People Who Completed the Initial COVID-19 Vaccination Protocol
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February 23, 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)
* New Roadmap for Coronavirus Vaccine Development (#New Roadmap for Coronavirus Vaccine Development)
* More Evidence Ivermectin Doesn’t Work for COVID-19 (#More Evidence Ivermectin Doesn’t Work for COVID-19)
* Understanding Research on COVID-19 and Masks (#Understanding Research on COVID-19 and Masks)
* Protection from Previous COVID-19 Infection (#Protection from Previous COVID-19 Infection)
* New Africa CDC Head Looks to “Post COVID” Health Challenges (#New Africa CDC Head Looks to “Post COVID” Health Challenges)
* Fauci on Preventing the Next Pandemic (#Fauci on Preventing the Next Pandemic)
* The Impact of 1 Million COVID-19 Deaths in the US (#The Impact of 1 Million COVID-19 Deaths in the US)
* Developing a Vaccine for Nipah (#Developing a Vaccine for Nipah)


* Bird Flu Continues to Spread Among Animals (#Bird Flu Continues to Spread Among Animals)
* COVID-19’s Impact on the Heart (#COVID-19’s Impact on the Heart)
* New Data on Merck’s COVID-19 Pill (#New Data on Merck’s COVID-19 Pill)
* Mpox Vaccines to Finally Arrive in Africa (#Mpox Vaccines to Finally Arrive in Africa)
* Marburg Virus Outbreak and Vaccine Testing (#Marburg Virus Outbreak and Vaccine Testing)
* Paxlovid Does Not Increase Rebound (#Paxlovid Does Not Increase Rebound)
* Planning for the Next Pandemic (#Planning for the Next Pandemic)
* US FDA Panel to Discuss RSV Vaccines (#US FDA Panel to Discuss RSV Vaccines)

Mpox has largely fallen out of media coverage as the cases have fallen drastically in most of the world. But the virus persists in some parts of Latin America and the WHO last week said it continues to be a global emergency. Now new evidence presented at the Conference on Retroviruses and Opportunistic Infections shows the potentially devastating link between mpox and HIV. The New York Times ([link removed]) (US) reports, “In people with advanced HIV disease, the mpox virus — formerly known as monkeypox — often causes severe illness, with a death rate of about 15 percent. The seriousness of the infection warrants the inclusion of mpox among the opportunistic conditions that are particularly dangerous to people with advanced HIV” The Times quotes Dr. Chloe Orkin, who led the study: “These findings make it very, very clear that every single person with mpox should have an HIV test.”

In The Lancet ([link removed](23)00273-8/fulltext) (UK) Orkin and colleagues write, “people with HIV and high risk of mpox infection should be prioritised for a preventive vaccine. Moreover, two-thirds of the deaths that we reported had occurred in Latin America. Our findings are particularly pertinent for countries with low levels of HIV diagnosis or without universal free access to ART and intensive care units, where the interaction of uncontrolled HIV infection and mpox is more prevalent.”




** If You Are in a Hurry
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* Read Health Policy Watch ([link removed]) on a new Roadmap for corona virus vaccines and Read the Roadmap. ([link removed])
* Read CIDRAP ([link removed]) on new evidence ivermectin doesn’t work for COVID-19.
* Read Health Policy Watch ([link removed]) on the challenges faced by the new head of Africa CDC.
* Read Bloomberg ([link removed]) on how countries are likely to respond to the next pandemic.
* Read Health Policy Watch ([link removed]) and Devex ([link removed]) on the new Africa CDC head and then read Devex ([link removed]) on the exclusion of Africa CDC from the Pandemic Fund as an implementing entity.
* Read Nature ([link removed]) on the impact and inequity of one million COVID-19 deaths in the US.
* Read AP ([link removed]) on news that mpox vaccines may finally reach African countries.




** New Roadmap for Coronavirus Vaccine Development
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Health Policy Watch ([link removed]) (Switzerland) reports, “Fifty influential scientists have developed a coronavirus vaccines research and development (R&D) roadmap aimed at developing broadly protective vaccines to combat fast-evolving coronaviruses threatening humans.” Professor Michael Osterholm of CIDRAP who led the efforts, is quoted: “The COVID-19 pandemic marks the third time in just 20 years that a coronavirus has emerged to cause a public health crisis. Rather than waiting for a fourth coronavirus to emerge — or for the arrival of an especially dangerous SARS-CoV-2 variant — we must act now to develop better, longer-lasting and more broadly protective vaccines.” In a CIDRAP ([link removed]) statement, The Rockefeller Foundation’s Bruce Gellin, who helped develop the Roadmap “said there's an urgency to carve out what to do next. He
said the push for a more broadly protective vaccine needs to be some sort of equivalent to Operation Warp Speed (OWS), a public-private partnership that accelerated the development, production, and distribution of COVID-19 vaccines in the United States.” Read the Roadmap. ([link removed])



** More Evidence Ivermectin Doesn’t Work for COVID-19
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CIDRAP ([link removed]) (US) reports, “A randomized, controlled trial (RCT) shows that even at a higher dose and longer treatment duration, the antimalarial drug ivermectin didn't shorten the time to a sustained recovery from COVID-19. Read the study at JAMA ([link removed]) .



** Understanding Research on COVID-19 and Masks
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There has been a fair amount of media coverage of a new meta-analysis of mask use and COVID-19. Vox ([link removed]) (US) looks at the study and what it may and may not mean. “A few weeks ago, a Cochrane team published ([link removed]) “Physical interventions to interrupt or reduce the spread of respiratory viruses,” their latest review of the evidence for masking and hand-washing, and whether they reduce flu-like illness (including COVID-19). Thanks to COVID-19, the debate over how well masks work against respiratory illness has gone from a niche disagreement to a question on which everyone in the country now has an opinion. It’s a question ripe for a good, rigorous meta-analysis…. according to the Cochrane review: ‘Wearing masks in the community probably
makes little or no difference to the outcome of laboratory-confirmed influenza/SARS-CoV-2 compared to not wearing masks.’” Yet Vox argues that the review has many limitations. “The review includes 78 studies. Only six were actually conducted during the COVID-19 pandemic, so the bulk of the evidence the Cochrane team took into account wasn’t able to tell us much about what was specifically happening during the worst pandemic in a century…. Only two of the studies are about COVID-19 and masking in particular.”



** Protection from Previous COVID-19 Infection
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CNN ([link removed]) (US) reports, “For at least 10 months after a COVID-19 infection, your immune system can provide good protection against symptomatic illness the next time around, a new study found ([link removed](22)02465-5/fulltext) , and the risk of severe illness is even lower…. The study, published Thursday in The Lancet, is a meta-analysis that looks at 65 studies from 19 countries….’There’s quite a long-sustained protection against severe disease and death, almost 90 percent at 10 months. It is much better than I had expected, and that’s a good thing for the world, right? Given that most of the world has had Omicron,’ said Dr. Chris Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington. ‘It means there’s an awful lot of immunity out there.’” Read The Lancet study ([link removed]
0140-6736(22)02465-5/fulltext) .



** New Africa CDC Head Looks to “Post COVID” Health Challenges
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Health Policy Watch ([link removed]) (Switzerland) reports the Africa CDC head Jean Kaseya “immediately underlined his intention to work closely with [WHO] on challenges that range from expanding universal health coverage in Africa, to strengthening local manufacturing capacity as well as disease surveillance in the post-COVID period…. But now that Kaseya has been named to the position, he will face a formidable series of challenges in advancing a “new public health order” for Africa, as per the Africa CDC strategy elaborated over the past few months, said Dr. Javier Guzman, Director of Global Health Policy at the Center for Global Development. Kaseya will need to find new ways to make the Africa CDC and its public health priorities stand out in the post-COVID era – amongst the multiple other challenges that Africa faces in trade, finance, climate change and diplomacy.”

Devex ([link removed]) (US) reports on Kaseya’s vision for Africa CDC outlined in a manifesto he submitted as part of his candidacy: “A technically strong Africa CDC that counts leading experts among its staff, is adequately funded and efficient at budgeting, has reliable rapid-response teams on the ground at times of crisis, and contributes to building a resilient Africa that is capable of effectively detecting, preventing, and controlling diseases for the achievement of [universal health coverage], the SDGs, and the realization of the AU’s 2063 agenda.”

In a sperate story Devex ([link removed]) (US) reports Africa CDC “said its inability to serve as an ‘implementing entity’ for the new Pandemic Fund ([link removed]) cripples its ability to protect the health of African citizens. The Pandemic Fund, which is hosted by the World Bank, and is led from a technical standpoint by the World Health Organization, is a pool of public and private financing aimed at helping low- and middle-income countries in pandemic preparedness and response. But Africa CDC has not been accredited by the fund as an ‘implementing entity’ — which is necessary for it to access this funding independently on behalf of African nations…. As Devex previously reported ([link removed]) , there has been resistance to Africa CDC taking on expanded
roles in the global health infrastructure. WHO’s Regional Office for Africa said "more discussion, further analysis and a full consideration of its implications" was needed before Africa CDC took on greater responsibilities, such as declaring when there is a Public Health Emergency of Continental Security.”



** Fauci on Preventing the Next Pandemic
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In an interview from CROI Tony Fauci tells BioWorld ([link removed]) (US), “There is a big effort now that has been triggered by the terrible experience we have all had with COVID-19 to be prepared from a scientific and a public health standpoint for the next pandemic. Because we will have another pandemic. Whether it is going to be next year, five years from now, or 10 years from now, we do not know…. About 75 percent of new infections are zoonotic. They jump from an animal reservoir to a human. HIV with chimpanzees, SARS, COVID-1, and MERS from a bat to an intermediate host. Influenza from birds and pigs. We will continue to have outbreaks. I do not think you are going to stop the emergence of new infections, but you can prevent them from becoming a pandemic…. There has to be a global response to a pandemic, not any individual country. You have to have the capability of
identification, of isolation of the virus, of sharing of sequences, of uniform accessibility to vaccines, so that not only the rich countries have vaccines, but vaccines are available to everyone. That is the way you prepare for a pandemic.”



** The Impact of 1 Million COVID-19 Deaths in the US
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A study in Nature ([link removed]) (UK) reports on the impact of one million COVID-19 deaths in the US. “The COVID-19 pandemic has exposed health system frailties and exacted a terrible death toll in the United States; as of May 12, 2022, over a million Americans had died of COVID-19. Not only have those deaths been a source of both personal tragedy and social disruption, but they have also resulted in unprecedented economic losses. Because of longstanding socioeconomic inequities, these losses have not been evenly distributed.” The authors conclude: “this analysis highlights the massive economic losses resulting from excess deaths from COVID-19, with Hispanic and Black Americans disproportionately impacted. The scale of welfare losses underscores the pressing need to invest in health in the United States to prevent further economic shocks from future pandemic threats.”



** Developing a Vaccine for Nipah
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The Telegraph ([link removed]) (UK) reports on efforts to develop a vaccine for Nipah, a zoonotic virus “which is deemed by the World Health Organization (WHO) and others to have ‘serious epidemic potential’…. The virus, which inspired the film Contagion about a global pandemic, attacks the brain and has a fatality rate as high as 70 percent. Now, survivors from the first outbreak are giving their blood to scientists racing to develop vaccines, in a push to prevent a similar scenario ever unfolding again.” WHO ([link removed]) reports a seasonal outbreak of Nipah in Bangladesh has a higher rate of infections and deaths than usual with 11 cases, including 8 deaths reported. “WHO assesses the risk as high at the national level, moderate at the regional level, and low at the global level.”



** Bird Flu Continues to Spread Among Animals
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Reuters ([link removed]) (UK) reports, “Bird flu has killed tens of thousands of birds, mostly pelicans, and at least 716 sea lions in protected areas across Peru, the authorities said, as the H5N1 strain spreads throughout the region. Peru recorded its first case of the virus in November in birds in the north of the country. Since then, it has killed 63,000 birds, according to government data.



** COVID-19’s Impact on the Heart
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NBC News ([link removed]) (US) reports, “COVID-19 can cause damage to the heart on a cellular level that can lead to lasting problems, including irregular heartbeats and heart failure, preliminary research suggests. COVID-19’s effects on the heart have been well documented, but a new study zooms in on the microscopic changes thought to be caused by the virus. Researchers from Columbia University in New York City examined autopsied heart tissue from people who had COVID-19, and found that the infection damaged the way cells in the heart regulate levels of calcium, a mineral that plays an important role in how the organ contracts and pumps blood throughout the body. In another part of the study, the same damage was seen in mice with COVID-19.”



** New Data on Merck’s COVID-19 Pill
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Reuter’s ([link removed]) (UK) reports, “Merck & Co Inc said on Tuesday its COVID-19 pill was not effective at cutting the risk of coronavirus infections in people living with someone infected with the virus. The results were similar to data from rival Pfizer Inc (PFE.N), whose COVID-19 pill Paxlovid also failed to prevent infections among household contacts. The two antiviral drugs are approved as treatments for individuals at risk of severe disease, but enthusiasm for the Merck pill has waned since it was shown to be only 30 percent effective versus 90 percent for Pfizer's Paxlovid.”



** Mpox Vaccines to Finally Arrive in Africa
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AP ([link removed]) (US) reports the Africa CDC, “says it hopes Mpox vaccines will finally arrive on the continent ‘in another two weeks, tops’ after months of seeking doses…. Mpox has sickened people in parts of West and Central Africa since the 1970s but it wasn’t until the disease triggered the outbreaks in Europe and North America that public health officials even thought to use vaccines. Rich countries rushed to buy nearly all the world’s supply.




** Marburg Virus Outbreak and Vaccine Testing
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Nature ([link removed]) (UK) reports, “Health officials worldwide are sprinting to test whether experimental vaccines can protect against a deadly illness, after Equatorial Guinea confirmed its first outbreak of Marburg virus disease on 13 February. The virus is related to Ebola, and causes similar symptoms of haemorrhagic fever. It has a fatality rate of up to 88 percent. The World Health Organization (WHO) in Geneva, Switzerland, convened an urgent meeting yesterday to discuss the feasibility of testing Marburg vaccines that are in various stages of development. But the odds are against a successful trial, they say, because other control measures such as quarantine could end the outbreak before a single vaccine dose can be administered.”



** Paxlovid Does Not Increase Rebound
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Medscape ([link removed]) (US) reports, “People who took the antiviral Paxlovid to treat COVID-19 infections were not more likely to get back-to-back bouts of the virus, a new study shows. The findings offer clarity amid concerns that the use of Paxlovid, which works by stopping the spread of the virus in the body, increased the risk of COVID-19 rebound. Researchers found that patients who received Paxlovid, another antiviral called Lagevrio, or no antiviral medication had rebounds at similar rates, ranging from 4.5 percent to 6.6 percent.”



** Planning for the Next Pandemic
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Bloomberg ([link removed]) (US) reports, “With some medical experts doubting whether airborne respiratory pathogens can be suppressed, global public health officials are now without a consensus on how best to contain new infectious diseases…. A unified global response is now even less likely in the next pandemic. The number of emerging infectious diseases continues to grow due to global warming and development in rural areas that are home to wild animals, which act as hosts for many viruses….Countries that were able to initially follow an elimination strategy are likely to pursue it again, while those that couldn’t are unlikely to be swayed by the example set during Covid, said Chen Xi, an associate professor specializing in aging and public health at Yale University in
Connecticut. ‘It all comes down to a country’s culture and political governance structure.’”



** US FDA Panel to Discuss RSV Vaccines
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USA Today ([link removed]) (US) reports, “As pediatric hospital wards continue to combat one of the worst RSV seasons the country has ever seen, a federal advisory panel is set to discuss vaccine options Thursday to prepare for next season…. On Thursday, the CDC’s Advisory Committee on Immunization Practices will discuss two RSV vaccines by pharmaceutical giants GlaxoSmithKline and Pfizer, and a monoclonal antibody by Sanofi and AstraZeneca…. [The FDA] announced Wednesday it has agreed to review Pfizer’s vaccine candidate, RSVpreF, for approval and set an action date for August 2023. If approved, the vaccine would be for pregnant people to help protect against RSV severe disease in infants from birth through 6 months…. The federal advisory panel will also discuss an RSV vaccine for adults 60 and older developed by GSK called AReSVi 006, which the FDA also accepted for priority review in November to
approve.”
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