Researchers and others have been trying to understand the origins of COVID-19 from even before it was declared a pandemic. Now the origin story is back in the news with a new finding from the US Department of Energy that the pandemic was caused by an accidental lab leak in Wuhan China. The finding comes from new intelligence. As the New York Times (US) reports, “Some officials briefed on the intelligence said that it was relatively weak and that the Energy Department’s conclusion was made with ‘low confidence,’ suggesting its level of certainty was not high. While the department shared the information with other agencies, none of them changed their conclusions, officials said.” Low confidence aside, the announcement generated a lot of media coverage and reopened political discussions about the origins of the virus.

The Guardian (UK) reports, “gleeful Republicans seized on the findings to claim vindication in their pursuit of the lab leak theory, triggering a fresh round of toxic debate in Washington and on social media…. It is the latest chapter in a long fight over the origin of a virus that has caused close to 7m deaths worldwide, clouding efforts to pursue a neutral, fact-based inquiry. In its loud opinions, blue v red certainties and lack of nuance, the melee echoes clashes over pandemic lockdowns, masks and vaccines, as well as the investigation into Trump’s alleged collusion with Russia.”
 
While we may never know the origins of the pandemic, it remains clear that this pandemic and likely the next one too will always have a political dimension to navigate.
 
 

If You Are in a Hurry 

• Read Vox on the growing risk of another pandemic whether from a lab leak or a natural spillover.
• Then read an opinion piece in The Hill that calls for sustained support for pandemic preparedness.
• Read VOA on the latest on the Marburg virus outbreak in Equatorial Guinea.
• Read CIDRAP on case studies that may show where COVID-19 is most likely to spread widely.
• Read Harvard Kennedy School on a new report about how political beliefs influence the treatment doctors prescribe for COVID-19.
• Read The Economist on estimating the toll of COVID-19 in China.
• Read an opinion in PLOS Global Public Health that outlines anti-Blackness in global health and the COVID-19 response.

 

Pandemic Risks Growing

 
Vox (US) reporting on the latest conversations about the origins of COVID-19 notes, “While investigators may never get a sharper picture of how SARS-CoV-2 erupted, the risks of future pandemics — from laboratories and from natural spillovers — is mounting…. The odds of a virus jumping from animals to humans has surged in the past several decades. The risk is increasing further as humanity encroaches into plains, forests, and swamps, raising the odds of encountering a new pathogen. Even prior to COVID-19, scientists warned for years that a coronavirus from bats could infect humans via an intermediary. The world’s growing appetite for meat is also worsening pandemic risks as high-density farms with nearly identical cattle, pigs, and chickens packed close together proliferate. These facilities can incubate dangerous pathogens, allow them to spread rapidly, and potentially infect people. Human activity is increasing the likelihood of both of these scenarios, so a spillover is hardly a ‘natural’ event.”
 

Looking for the Next Pandemic

 
The Scientist (US) reports on one way researchers are looking for the next pandemic -- metagenomic sequencing. “This ability to quickly read a range of genomes has proven useful in fields from ecology to cancer treatment. And the COVID-19 pandemic has pushed some researchers to use metagenomics to try to spot new diseases and respond to them earlier—before they become epidemics, and potentially before they even infect people. Some of these experts say the early spread of COVID-19 in the United States could have been curbed more quickly if the medical community had applied this technology…. Beyond those financial and medical hurdles, politics might present a higher one: Even if the tool were widespread, governments have to share the information in order for it to be useful. The debate over the origins of COVID-19 “has gotten so toxic, people are less likely to collaborate now,” said Holmes. “If you had a novel infection in Russia, do you think we’ll ever hear about it? If there’s a novel infection in China, do I think the Chinese government will allow studies? No way. We’re in a worse situation now than we were before the pandemic.” DeRisi said the uncoordinated nature of the U.S. health system also stymies the kind of coordinated response needed to quickly stop outbreaks.”
 

Pandemic Preparedness

 
An opinion piece in The Hill (US) argues, “Too often Congress has seen pandemic preparedness as a luxury at best or simply a sunk cost at worst — something that can be eliminated when the risk or threat is reduced or gone. This has seen our country lurch from crisis to crisis, accelerating spending in the face of an emergent disease only to reduce the rates or even zero out spending once the threat has passed. This inconsistent funding is reflected in our response to novel diseases — little is done at first and then everything is done all at once. This is a costly and risky approach to disease management. Even worse, if we start to see pandemic preparedness and response through a political lens, we become divided on an issue related to the fundamental health of our nation — and our ability to defend ourselves.”
 

RSV Vaccine for Older Adults

 
CNN (US) reports, “Vaccine advisers to the US Food and Drug Administration narrowly voted Tuesday in favor of Pfizer’s RSV vaccine for adults over the age of 60, paving the way for approval of the first nation’s RSV vaccine, despite some safety concerns. The committee members voted 7-4, with one abstention, that there is adequate data to support the safety and effectiveness of Pfizer’s vaccine for the prevention of lower respiratory tract disease caused by respiratory syncytial virus among older adults…. Although a majority of the committee voted in favor of the vaccine, some members expressed concerns about the vaccine’s “important potential risk: of Guillain-Barre syndrome. Two adults among the 20,000 vaccine recipients in Pfizer’s Phase 3 clinical trial developed symptoms consistent with the rare neurological disorder within nine days of receiving the shot.” The FDA is expected to approve the vaccine at a meeting in May and it must also be evaluated by the US CDC for a recommendation.
 

Long COVID

 
CIDRAP (US) reports, “The vast majority—84.2 percent—of COVID-19 survivors in a Swedish cohort reported persistent symptoms affecting daily life 2 years after hospital release, according to a follow-up study published late last week in The Lancet Regional Health Europe…. About half of long-COVID patients who were on sick leave at 4 months were still on sick leave at 2 years. The number of patients who were employed or studying was significantly lower at 2 years than before COVID-19.”
 
CIDRAP (US) reports, “Structural changes in the brain may explain the persistent fatigue and neuropsychiatric complications associated with long COVID, finds an observational study published yesterday in eClinicalMedicine…. ‘By showing that the subjective symptom of fatigue has an underlying structural correlate in the brain, we provide an insight into the brain changes related to post-COVID syndrome and report a potential longitudinal biomarker for recovery,’ the researchers wrote.”
 

Avian Flu

 
UN News reports, “Cambodian authorities reported two cases of avian flu, including an 11-year-old girl who died of the virus…. These are the first cases of avian influenza, known as H5N1, reported in Cambodia since a widespread outbreak in 2014, the World Health Organization (WHO) said. ‘The infection, which largely affects animals, has a 50 percent mortality rate in humans. The global H5N1 situation is worrying given the wide spread of the virus in birds around the world,’ said Sylvie Briand, Director for Epidemic and Pandemic Preparedness and Prevention at the UN health agency.  ‘We are in close communication with the Cambodian authorities to understand more about the outbreak.’”
 
The Daily Mail (UK) reports, “US health officials are ramping up their pandemic preparedness plans after a bird flu scare in Cambodia. The Centers for Disease Control and Prevention (CDC) said it is in a 'posture of readiness' with several vaccine and drug candidates in the works. National testing capacity is also being built-up in case the H5N1 strain that has devastated bird populations around the world spills over into people. And Reuters (UK) reports, “the very changes that have allowed the virus to infect wild birds so efficiently likely made it harder to infect human cells, leading disease experts told Reuters. Their views underpin global health officials' assessments that the current outbreak of H5N1 poses low risk to people.”
 

Ebola

 
In a statement The Coalition for Epidemic Preparedness Innovations (CEPI) announced it “is supporting the development of an international antibody standard against Sudan ebolavirus (SUDV) – a critical tool which will be used to assess and compare the performance of vaccines against the deadly disease responsible for a recent outbreak of Ebola disease in Uganda…”
 

COVID-19 Spread

 
CIDRAP (US) reports, “A case-series investigation of more than 44,000 COVID-19 patients in Tokyo in 2020 reveals that SARS-CoV-2 transmission events in healthcare and nightlife settings (eg, bars and nightclubs) were most likely to involve at least five infections, with nightlife cases more likely to generate further spread…. ‘Surveillance and interventions targeting nightlife settings should be prioritized to disrupt COVID-19 transmission, especially in the early stage of an epidemic,’ the researchers wrote.”
 

Doctors Pushing Ivermectin for Flu and RSV

 
Washington Post (US) reports, “First, the group of doctors championed ivermectin as a covid panacea. It failed to live up to the hype. Now, they’re promoting the anti-parasitic to prevent and treat the flu and RSV…. There is no clinical data in humans to support using ivermectin for flu or RSV, according to the Centers for Disease Control and Prevention and other medical experts.” The group of doctors pushing the unproven treatment continue to refer patients to doctors and pharmacies that will provide the drug.
 
In a related story, the Harvard Kennedy School reports  on a new report which found “Physicians’ political views—and the media they consume—may affect their treatment recommendations for COVID-19 patients…. Ultimately, the authors find strong evidence that polarized views about COVID-19 can influence even “highly trained professionals making informed judgments within their area of expertise” and that doctors’ views of a scientific study may be influenced by political views and associated media consumption (conservatives in the study reported a strong preference for Fox News). ‘These results,’ they write, ‘also provide insight into the causes of regional variation in the use of hydroxychloroquine and ivermectin, both of which have been prescribed by physicians at much higher rates in conservative counties.’” Read the report in Proceedings of the National Academy of Sciences.
 

Marburg Virus

 
VOA (US) reports, “Two more people in Equatorial Guinea have died of Marburg hemorrhagic fever, a cousin of the Ebola virus, bringing the toll of fatalities to 11, the authorities say…. Fatality rates in confirmed cases have ranged from 24 percent to 88 percent in previous outbreaks, depending on the virus strain and case management, according to the WHO. There are currently no approved vaccines or antiviral treatments. Potential treatments, including blood products, immune therapies and drug therapies, as well as early candidate vaccines are being evaluated, the WHO says.”
 

Gauging the True Toll of COVID-19 in China

 
The Economist (UK) looks at what the true death toll of COVID-19 may be following the lifting of China’s Zero Covid policy late last year. “Officially, deaths since the start of the pandemic stand at just 87,468—or 0.006 percent of the population.” The Economist estimates “that there were between 1.4m and 2.4m excess deaths on the mainland in December…. Our global excess deaths model… currently estimates that the pandemic has killed between 180,000 and 2.7m people in China since 2019 (given China’s patchy data, the range is very wide). That would mean a true toll, so far, of between twice and thirty times the official count.”
 

Anti-Blackness in Global Health

 
An opinion in PLOS Global Public Health (US) argues, “Global health evolved from colonial medicine and hence deeply rooted in the white supremacy mindset. Anti-Blackness is an inescapable consequence…. The COVID-19 pandemic offers a stunning recent example of anti-Blackness. No continent is less vaccinated and boosted than the African continent [3]. While wealthy nations rushed to clean up the shelves, hoard vaccines, and even throw away millions of expired vaccines, the African region was left last in the line. Despite the efforts of activists and the support of most countries, a few rich countries blocked the TRIPS waiver that could have significantly expanded vaccine manufacturing in the Global South. Two years after vaccination began in wealthy nations, and even as second and third booster shots are being offered in the Global North, barely one in four people in the African region are vaccinated with two doses (as of January 2023). The African region has also had the lowest Covid-19 testing rate, and access to anti-viral medications such as Paxlovid is practically non-existent.”
 

COVID-19 and HIV

 
The Body Pro (US) reports, “Researchers at the Centers for Disease Control and Prevention estimated that due to COVID-19, 1,448 more people living with HIV (PLWH) died in the U.S. in 2020 than would have otherwise. This is based on a method they developed for estimating excess deaths from limited data.