Pandemic Watch News Brief: The News You Need To Know

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As we continue our work in HIV, in COVID and among multiple pandemics in a changing global health architecture, we are delighted to expand our news brief to Pandemic Watch, a new, weekly round-up of pandemic-related news. Pandemic Watch folds COVID-19 news into a curated digest that expands beyond COVID to reflect the evolving field of pandemic prevention preparedness and response.
"When the World Health Organization first described COVID-19 as a pandemic just over three years ago, it marked the culmination of a collective failure to prepare for pandemics, despite many warnings. And I worry that we’re making ‌‌the same mistakes again. The world hasn’t done as much to get ready for the next pandemic as I’d hoped. But ‌‌it’s not too late to stop history from repeating itself."
-- Bill Gates in The New York Times ([link removed])


** Table of Contents
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* If You Are in a Hurry (#If You Are in a Hurry)
* The Pandemic’s Aftermath Needs Attention (#The Pandemic’s Aftermath Needs Attention)
* Transformational Change Needed to Combat Pandemics (#Transformational Change Needed to Combat Pandemics)
* The Future of Vaccines to Serve Public Needs (#The Future of Vaccines to Serve Public Needs)
* Calls for More Data on Climate and Health (#Calls for More Data on Climate and Health)
* Warning About Growing Number of High Containment Labs (#Warning About Growing Number of High Containment Labs)
* Deadly Fungus Spreads a “Alarming Rate” (#Deadly Fungus Spreads a “Alarming Rate”)
* COVID-19 and Pregnancy Deaths (#COVID-19 and Pregnancy Deaths)
* Vaccine Derived Polio from New Vaccine in African Countries (#Vaccine Derived Polio from New Vaccine in African Countries)
* An End to the Pandemic? (#An End to the Pandemic?)
* ‘Novids’ or ‘Resisters’ (#‘Novids’ or ‘Resisters’)
* Climate Change and Spreading Disease (#Climate Change and Spreading Disease)
* Marburg in Tanzania (#Marburg in Tanzania)

More than three years on, we’re still not sure how SARS-CoV-2 jumped into humans and sparked a pandemic. The search for the origins has been challenged by the Chinese government’s roadblocks to sharing scientific information and politicized like much of the pandemic response.

This week, some new evidence suggests a possible link to racoon dogs (which are neither racoons, nor dogs) in a Wuhan market. The New York Times ([link removed]) (US) reports the link adds “evidence to the case that the worst pandemic in a century could have been ignited by an infected animal that was being dealt through the illegal wildlife trade…. In samples that came back positive for the coronavirus, the international research team found genetic material belonging to animals, including large amounts that were a match for the raccoon dog, three scientists involved in the analysis said.” Nature ([link removed]) (UK) reports that the genetic samples don’t provide conclusive evidence of Racoon Dogs (or another animal at the market) being the link, but one researcher notes, ““The most logical hypothesis is that raccoon dogs were infected by SARS-CoV-2 and shed the virus.” But another
says, “There is no evidence that the virus came from an infected raccoon dog; it could just as easily have come from an infected person.” The data have been hidden on an international genomics database, but Nature reports a publication is forthcoming and there is additional data, that if shared, could provide more clues.

On the political front this week, US President Joe Biden signed a bill that will require the release of intelligence data that earlier linked the pandemic origins to a lab in Wuhan. The Guardian ([link removed]) (UK) quotes a statement from the President: “In implementing this legislation, my administration will declassify and share as much of that information as possible, consistent with my constitutional authority to protect against the disclosure of information that would harm national security.” The Guardian notes, “the issue has become a rallying point in particular for Biden’s Republican opponents.”



** If You Are in a Hurry
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* Read Atul Gawande on why we need to focus as much on the pandemic aftermath as the pandemic itself in New York Times ([link removed]) .
* Then read Bill Gates in New York Times ([link removed]) on what we need to do to prepare for the next pandemic.
* Read two views from global experts of how we need to transform research and health to prepare for coming pandemics in The Lancet ([link removed](23)00526-3/fulltext#%20) and Vaccine ([link removed]) .
* Read Science Africa ([link removed]) on how the response to climate change and health is coming together in some African countries.
* Read Medscape ([link removed]) on the toll of COVID-19 for pregnant people.
* Read STAT ([link removed]) on climate change and the spread of vector diseases in the US.




** The Pandemic’s Aftermath Needs Attention
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USAID’s Atul Gawande writes in a New York Times ([link removed]) (US) guest essay that the pandemic not only killed millions around the world, it had a huge damaging impact on the healthcare. He argues, “We can reclaim our lost ground and resume the past decades of advancement in human survival and health. But that requires holding on to our sense of urgency and doing more than simply hoping things will turn around. The aftermath of pandemics requires as much focus and response as the start. And the United States’ leadership is crucial. We rallied the world to invest in emergency relief. Now we must rally the world to invest in recovery…. As the World Health Organization has put it, we need countries “to make a radical reorientation of their health systems toward primary care.” This is how we will make a real recovery from the pandemic — and be prepared for the next one. And it is the only path we have back to a world of longer
and healthier lives.”

In an opinion piece in The New York Times ([link removed]) (US), Bill Gates writes, “When the World Health Organization first described COVID-19 as a pandemic just over three years ago, it marked the culmination of a collective failure to prepare for pandemics, despite many warnings. And I worry that we’re making ‌‌the same mistakes again. The world hasn’t done as much to get ready for the next pandemic as I’d hoped. But ‌‌it’s not too late to stop history from repeating itself. The world needs a well-funded system that is ready to spring into action at a moment’s notice when danger emerges. ‌We need a fire department for pandemics.”



** Transformational Change Needed to Combat Pandemics
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An international panel of global health experts write in The Lancet ([link removed](23)00526-3/fulltext#%20) (UK): “To protect people and reduce the risk of pandemics, health threats must be rapidly contained with appropriate health countermeasures where and when they occur. Now is the time for an ambitious, transformative approach to epidemic and pandemic health technologies. A transformative approach requires a fundamental change in why, how, where, and by whom these technologies are developed and produced, and about who has access to this knowledge and know-how.



** The Future of Vaccines to Serve Public Needs
------------------------------------------------------------

In a review article in a special issue of the journal Vaccine ([link removed]) (US) focusing on the future of epidemic and pandemic vaccines a group of global vaccine experts say, “There is talk of flexible, modular pandemic preparedness, of technology access pools based on non-exclusive global licensing agreements in exchange for fair compensation, of WHO-supported vaccine technology transfer hubs and spokes, and of the creation of vaccine prototypes ready for phase I/II trials, etc. However, all these concepts face extraordinary challenges shaped by current commercial incentives, the unwillingness of pharmaceutical companies and governments to share intellectual property and know-how, the precariousness of building capacity based solely on COVID-19 vaccines, the focus on large-scale manufacturing capacity rather than small-scale rapid-response innovation to stop outbreaks when and where they occur, and the inability of many resource-limited countries to afford
next-generation vaccines for their national vaccine programmes.”

Reuters ([link removed]) (UK) reports, “Some of the world's leading makers of flu vaccines say they could make hundreds of millions of bird flu shots for humans within months if a new strain of avian influenza ever jumps across the species divide…. Less reassuring, however, is that most of the potential human doses are earmarked for wealthy countries in long-standing preparedness contracts, global health experts and the companies said…. An international framework for pandemic flu allocates 10 percent of global supply for the World Health Organization to share with low- and middle-income countries. By contrast, the WHO is seeking guarantees of 20 percent global supply for other types of pandemic in the wake of COVID-19.”

The Monitor ([link removed]) (Uganda) reports, “After promising a vaccine for coronavirus by the end of 2021, Ugandan scientists on the project now say the country requires 15-25 years to build capacity and be ready to produce jabs. Uganda is years away from making its own Covid vaccine, the principal investigator has said, pointing out that countries manufacturing vaccines took anywhere between 15 to 25 years to build capacity.”



** Calls for More Data on Climate and Health
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Devex ([link removed]) (US) reports on discussions at the Africa Health Agenda International Conference (AHAIC) where “health experts said policymakers are asking for more data on cost-effective strategies they can roll out…. ‘There's an enormous gap in terms of data in Africa and data generated by Africans,’ said Marina Romanello, executive director of the Lancet Countdown on health and climate change. And it's not just about producing the evidence, but ensuring it’s produced in a way that promotes uptake in decision-making, [Eliya Zulu, the executive director of the African Institute of Development Policy] said. Evidence previously generated has often focused on outlining the problems.

Science Africa ([link removed]) (Kenya) reports, “A growing number of African countries are making commitments to integrate climate change into their health policies and strategies. More than 24 countries on the continent including Rwanda have already made commitments to assess climate change vulnerabilities within the context of strengthening their health systems. These countries are also working to build capacities within their health workforce including community-based health workers, to enable them to deal with health challenges as a result of climate change. The most immediate challenge being the exponential rise in cholera cases on the continent amid a global surge…. Health experts at the Africa Health Agenda International Conference 2023 said that Africa is grappling with the issue of vulnerability, capacity, adaptation and planning. This calls for the need to take into account contextual factors that have to be addressed in order to
develop contextually relevant solutions. This will enable health systems on the African continent to rise to the challenges emerging from the climate crisis.”



** Warning About Growing Number of High Containment Labs
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Science ([link removed]) (US) reports, “The number of high-containment labs studying the deadliest known pathogens is booming. A new analysis warns the growing number of labs is raising risks of an accidental release or misuse of germs such as the Ebola and Nipah viruses.” Several other labs are slated to open in the next few years and “many countries, particularly those building their first BSL-4 labs, lack strong policies and methods to monitor such labs, the report says. Only Canada has legislation overseeing all experiments, even those with no government funding, that are considered ‘dual use’ because the results could potentially be used to cause harm.”



** Deadly Fungus Spreads a “Alarming Rate”
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Washington Post ([link removed]) (US) reports, “A deadly and highly drug resistant fungus is spreading at “an alarming rate” in long-term care hospitals and other health facilities caring for very sick people, the Centers for Disease Control and Prevention announced Monday. Fungal infections from the yeast strain known as Candida auris tripled nationally from 476 in 2019 to 1,471 in 2021…. Scientists believe the fungus is not a threat to healthy people whose immune systems can fight it off. But it poses a danger to medically fragile people, including nursing home patients on ventilators and cancer patients on chemotherapy…. Fungi often cannot withstand the temperature of the human body, but one leading theory posits that Candida is now capable of doing so because it has evolved to survive in a warming world
([link removed]) .”



** COVID-19 and Pregnancy Deaths
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Medscape ([link removed]) (US) reports that in the US, “Pregnancy-related deaths have surged as much as 40 percent during the pandemic, with the increase entirely linked to COVID-19, according to a pair of new reports. The rise in deaths was most pronounced among Black mothers. In 2021, 1,205 women died from pregnancy-related causes, making the year one of the worst for maternal mortality in US history, according to newly released CDC data ([link removed]) …. COVID was the driver of the increased death rate, according to a study ([link removed]) published Thursday in the journal Obstetrics & Gynecology. The researchers noted that unvaccinated pregnant people are more likely to get severe COVID, and that prenatal and postnatal care were disrupted during the early part of the pandemic.”



** Vaccine Derived Polio from New Vaccine in African Countries
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Science ([link removed]) (US) reports, “Last week, the Global Polio Eradication Initiative (GPEI) reported seven children, six in the Democratic Republic of the Congo (DRC) and one in neighboring Burundi, had recently been paralyzed by poliovirus strains derived from a vaccine meant to prevent the disease. Unfortunately, such cases are so common—786 were reported last year in Africa, Yemen, and elsewhere—that these seven might not have stood out against the noise. But there was a key difference, GPEI said in a 16 March statement: These are the first cases linked to a new polio vaccine that was painstakingly designed to avoid just this problem.” Researchers say this is still a rare event and more surveillance is needed to understand it, but wider vaccination is also needed. One expert says, “If there is persistently poor immunization coverage in a community, there is always a risk that a live, attenuated
vaccine virus will revert.”



** An End to the Pandemic?
------------------------------------------------------------

Medscape ([link removed]) (US) reports, “The leader of the World Health Organization said Friday that he expects the organization to declare an end to the COVID-19 pandemic later this year because statistics on the virus keep declining. ‘I am confident that this year we will be able to say that COVID-19 is over as a public health emergency of international concern,’ WHO Director General Tedros Adhanom Ghebreyesus [said]…. For the first time, the weekly number of reported COVID deaths over a four-week period was lower than when WHO declared COVID a global pandemic three years ago.”

In a separate article Medscape ([link removed]) (US) asked several experts if it is finally time to call COVID endemic. Experts including Eric Topol say, “that all indications -- from genomic surveillance of the virus to wastewater to clinical outcomes that are still being tracked -- point to a new reality: "[W]e've (finally) entered an endemic phase." But some experts warn that endemicity may be links to geography. Johns Hopkins’ Stuart Ray notes, “’We don't have much information about what's happening in China, so I don't know that we can say what state they're in, for example.’… Epidemiologist Katelyn Jetelina…. Said we haven't had enough time with COVID to call it endemic…. For influenza, she said, which is endemic, ‘It's predictable and we know when we'll have waves.’ But COVID-19 has too many unknowns, she said. What we do know is that moving to endemic does not mean an end to the suffering, said Jetelina…”



** ‘Novids’ or ‘Resisters’
------------------------------------------------------------

Medscape ([link removed]) (US) looks at people who have not had COVID and why that may be. “While the exact number of people who have remained uninfected isn't known with certainty, a review of comprehensive serologic data shows about 15 percent ([link removed]) of Americans may not have gotten infected with COVID…. Some scientists bristle at the term NOVIDs. They prefer the term ‘resisters,’ according to Elena Hsieh, MD, associate professor of pediatrics and immunology at the University of Colorado Anschutz School of Medicine in Aurora. Currently, she said, there is much more information on who is more susceptible to contracting severe COVID than who is resistant…. ’I don't think we know a lot so far,’ Hsieh said about resisters. ‘I do believe that just like there are genetic defects that make someone more susceptible, there are likely to be genetic defects that make somebody less
susceptible.’''



** Climate Change and Spreading Disease
------------------------------------------------------------

STAT ([link removed]) (US) reports, “With climate change accelerating…shifting the ranges of many disease-carrying species and sharply increasing infections, scientists and others warn that [US] public officials, as well as hospitals and doctors, are underprepared for a potentially devastating surge in infections. Research on vector-borne diseases and disease surveillance, they note, are underfunded by federal and local governments, leaving the country vulnerable to outbreaks…. Dengue had been absent from the continental United States for decades before reappearing in 2009. But cases of local transmission of dengue fever are now being documented in three continental US states: Arizona, Texas and Florida. In 2022, 57 people ([link removed]) in Florida were infected by locally transmitted dengue.”



** Marburg in Tanzania
------------------------------------------------------------

AP ([link removed]) (US) reports, “Tanzania’s health ministry on Tuesday confirmed that five people have died and three others are being treated for the Ebola-like Marburg disease. Health Minister Ummy Mwalimu said the cases were identified in the western region of Kagera and the government had managed to control its spread to other regions…. There are no authorized vaccines or drugs to treat Marburg, but rehydration treatment to alleviate symptoms can improve the chances of survival.”
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