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Lalita Panicker

Food supplies run low in Shanghai COVID-19 lockdown; the latest health stories from around the world

April 12, 2022 By Lalita Panicker Leave a Comment

A citywide COVID-19 lockdown in China’s financial capital of Shanghai has disrupted food supplies badly, causing a wave of anxiety as residents ration dwindling stores of vegetables and staples. COVID-test requirements for truckers entering Shanghai have caused delays in the delivery of foods and other commodities. Within the city, many food delivery workers have been confined to their homes or choose not to work for fear of catching the virus, leaving fewer people to distribute food once it makes it into the city. Local authorities have banned private deliveries because they fear infected drivers might spread the virus in her residential compound.

https://www.wsj.com/articles/shanghai-in-lockdown-struggles-to-feed-itself-11649353336

Shanghai is transforming conference centres and conscripting neighbouring provinces to create isolation facilities for hundreds of thousands of people, a sign of its commitment to a zero-tolerance approach to COVID-19 amid China’s worst outbreak to date. The Chinese financial hub is adding tens of thousands of beds to what are already some of the world’s biggest isolation sites as it sticks to a policy of quarantining all those positive for the virus, regardless of severity, plus everyone they interacted with while infected. Nearly 150,000 people have been identified as close contacts and put into isolation. More than 100,000 others are considered secondary contacts and are being monitored, according to the government. It’s a strategy that grew out of the original outbreak in Wuhan, which China successfully quelled, but is proving more challenging to maintain in the face of ongoing outbreaks and more transmissible variants.

https://www.bloomberg.com/news/articles/2022-04-07/shanghai-racing-to-build-hundreds-of-thousands-of-isolation-beds

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India’s first case of Coronavirus variant XE was reported in Mumbai last week. One case of the Kappa variant has also been detected. The patients with the new variants of the virus don’t have any severe symptoms so far (www.reuters.com/business/healthcare-pharmaceuticals/india-reports-first-case-Covid-variant-xe-report-2022-04-06/)

The new mutant may be more transmissible than any strain of Covid-19, the World Health Organization (WHO) had said earlier this month. The Indian government, however, disagreed, saying the present evidence does not suggest that it is XE variant.

The Mumbai patient is a 50-year-old costume designer who returned from South Africa in February. She tested positive for COVID on March 2.

The new strain was detected in the United Kingdom at the start of the new year. Britain’s health agency said on April 3 that XE was first detected on January 19 and 637 cases of the new variant have been reported in the country so far.

XE is a “recombinant” which is a mutation of the BA1 and BA.2 Omicron strains. Recombinant mutations emerge when a patient is infected by multiple variants of COVID. The variants mix up their genetic material during replication and form a new mutation, UK experts said in a paper published in British Medical Journal.

The WHO had said that the new mutation XE appears to be 10 per cent more transmissible than the BA.2 sub-variant of Omicron.

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The WHO last week suspended shipments through UN channels of a COVID-19 vaccine made in India after an inspection revealed manufacturing deficiencies. (www.science.org/content/article/news-glance-sobering-climate-alert-research-beagles-and-fast-radio-bursts)

WHO said Bharat Biotech, maker of the Covaxin vaccine, which uses an inactivated virus, promised to stop exporting it to any customer until the firm addresses the problems. But the company said it will continue to sell doses from the plant for use in India. The country is the largest consumer of Covaxin, with 308 million doses administered so far. India’s drug regulatory body, the Central Drugs Standard Control Organization, has not taken regulatory action or commented on WHO’s move. WHO’s action is significant because it authorized Covaxin’s use in November 2021, and several low-income countries have also authorized it; the vaccine is easier for them to distribute than messenger RNA vaccines because it does not need to be stored at low temperatures.

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An online advertisement created by political scientists and economists that featured former President Donald Trump recommending COVID-19 shots led to increased uptake of the vaccines in US counties that had low vaccination rates, an analysis has concluded. COVID-19 vaccine hesitancy is higher in US regions that voted heavily for Trump in the 2020 election, so the research team targeted them by creating a 30-second YouTube ad that featured a Fox News TV interview in which Trump recommends the vaccine. The team spent nearly $100,000 on Google Ads to place it online in 1,083 US counties in which fewer than 50% of adults were vaccinated; an additional 1,085 similar counties that did not receive the ads served as a control group. Compared with control counties, the study found an increase of 104,036 people receiving first vaccinations in areas that observed the ad, a statistically significant difference. The intervention’s cost was just under $1 per vaccinated person. In contrast, US locales that used lottery tickets as a reward spent $60 to $80 per vaccination, according to the preprint study posted at the National Bureau of Economic Research.

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www.science.org/content/article/new-crop-COVID-19-mrna-vaccines-could-be-easier-store-cheaper-use

The two COVID-19 vaccines based on messenger RNA (mRNA) have been the breakout stars of the pandemic. Both trigger impressive immune responses with minimal side effects, and both did exceptionally well in efficacy trials. But the vaccines, produced by the Pfizer-BioNTech partnership and Moderna, have also split the world. Because of their high prices and their need to be stored at extremely low temperatures, few people in lower and middle-income countries have had access to them.

That might soon change. More than a dozen new mRNA vaccines from 10 countries are now advancing in clinical studies, including one from China that’s already in a phase 3 trial. Some are easier to store, and many would be cheaper. Showing they work won’t be easy: The number of people who don’t already have some immunity to COVID-19 because of vaccination or infection is dwindling. But if one or more of the candidates gets the green light, the mRNA revolution could reach many more people.

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https://view.e.economist.com/?qs=d5c7801119a97100e0c224d518039be5f31048b5b3b370015eb4c3014317c6d084b8a9b90b063a6ceaf14e2a3bb471a5e534212c59f7752710f41e0b7cf94b8fddaf2b3bd815e2144f8a341fc33e2959

In 2020, around 240m people contracted malaria. More than 627,000 of them died, the vast majority of them children in Africa.

Malaria has been afflicting people since ancient times: Cleopatra was known to sleep under a bed net to keep herself out of reach of night-time mosquitoes. Chinese texts going back to the fourth century talk about treating fever with artemisia, a plant that nowadays is the basis of artemisinin, one of the most important drugs in the fight against malaria.

Throughout the middle of the 20th century, people found success in eradicating malaria in specific countries and regions—wherever they could afford campaigns to get into homes and spread insecticides such as DDT. In the first decade of the 21st century, thanks to cheap, effective interventions such as bed nets, antimalarial drugs and insecticides, the dreaded disease seemed to be in something of a decline. “This kickstart of our eradication efforts really worked,” says Jennifer Gardy, deputy director for surveillance, data and epidemiology in the malaria team at the Bill and Melinda Gates Foundation. “We estimate that we’ve saved something like almost 11m lives, preventing close to 2bn malaria cases since the year 2000.”

Fortunately, hope is on the horizon, in the form of two new scientific tools. The first of these is vaccines: last year the world’s first vaccine for malaria was approved. Known as RTS,S and made by GlaxoSmithKline, it came after work on malaria vaccines had faltered for decades. The vaccine is by no means perfect, only reducing the number of severe malaria cases by 30 per cent, but it is a start. The better news is that there are already better vaccines in the works. 

One of those new vaccines is being designed at the University of Oxford, by the same team that developed the AstraZeneca vaccine for COVID. In phase 2 clinical trials, the Oxford malaria vaccine was around 77 per cent effective. And further down the line, BioNTech, a German pharmaceutical company and co-creator of another COVID vaccine, is planning to develop a malaria vaccine based on its highly successful mRNA platform.

The second tool is genetic modification. Vaccines will help prevent illness but one thing they cannot do is tackle the mosquitoes that are transmitting parasites in the first place. Scientists at Imperial College London have taken up that part of the challenge. In their labs they have been genetically modifying mosquitoes in two ways: in one experiment they make female insects sterile; in another trial they push females to produce more male offspring when they reproduce. (Male mosquitoes do not spread malaria.)

The idea is that, over the course of several generations, the vast majority of the mosquitoes in a population will be either sterile females or male. Their number should thus quickly collapse and those that remain will not be able to spread the disease. So far these ideas have only been trialled in laboratories, but field trials could be on their way in just a few years.

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Lalita Panicker is Consulting Editor, Views, Hindustan Times, New Delhi

Shanghai becomes COVID-19 hotspot; the latest health stories from around the world

April 4, 2022 By Lalita Panicker Leave a Comment

Stock Photo - Inscription COVID-19 on blue background. World Health Organization WHO introduced new official name for Coronavirus disease named COVID-19. COVID-19 outbreak concept. Image credit: nunataki / 123rf
Image credit: nunataki / 123rf

COVID-19 cases in China’s largest city of Shanghai have risen again as millions remain isolated at home under a sweeping lockdown ̐(www.theguardian.com/world/2022/apr/03/covid-cases-rise-in-shanghai-as-millions-remain-in-lockdown)

Health officials on Sunday reported 438 confirmed cases detected over the previous 24 hours, along with 7,788 asymptomatic cases, up slightly from the day before.

While small by the standards elsewhere in the world’s large countries, the daily case numbers are some of China’s largest since the virus was first detected in the central city of Wuhan in late 2019.

Shanghai with its 26 million people last week began a two-stage lockdown, with residents of the eastern Pudong section supposed to be allowed to leave their homes Friday, while their neighbours in the western Puxi section underwent their own four-day isolation period.

Despite that assurance, millions in Pudong continue to be confined to their homes amid complaints over food deliveries and the availability of medications and health services.

Notices delivered to residents said they were required to self-test for COVID-19 daily and take precautions including wearing masks at home and avoiding contact with family members — measures not widely enforced since the early days of the pandemic.

Meanwhile, residents of the city of Jilin were be able to move about freely starting Friday for the first time in more than three weeks, state broadcaster CCTV said, citing a notice issued by the city. They will be required to wear masks and, when indoors, stay one meter (three feet) apart. Public gatherings in parks and squares are prohibited.

https://apnews.com/article/covid-business-health-china-shanghai-ef1a875b77200fb005b10aaa1fac0c0b

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www.nytimes.com/live/2022/04/01/world/covid-19-mandates-cases-vaccine?

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Senate Democrats and Republicans in the United States have neared an agreement to slash an emergency coronavirus response package to $10 billion from $15.6 billion, as they worked to break a logjam over a stalled package of federal money urgently requested by President Joe Biden for vaccines, therapeutics and preparation against future variants.

The day after Mr. Biden pleaded with Congress to approve the money, senators on Thursday were discussing removing as much as $5 billion in aid for the global vaccination effort as they scrambled to resolve disputes over how to finance the package. Republicans have refused to devote any new funding to the federal pandemic response effort, arguing that unspent money that has already been approved should be used, but the two parties have been unable to agree on which programs should be tapped.

Without that consensus, it was not clear that they would have the votes to move forward in the evenly divided Senate, where 60 votes — including at least 10 Republicans ones— would be needed. The package now under consideration would be less than half the White House’s original $22.5 billion request.

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www.nytimes.com/2022/04/02/health/covid-testing-uk-denmark.html?

The British government on Friday shut down or scaled back a number of its Covid surveillance programs, curtailing the collection of data that the United States and many other countries had come to rely on to understand the threat posed by emerging variants and the effectiveness of vaccines. Denmark, too, renowned for insights from its comprehensive tests, has drastically cut back on its virus tracking efforts in recent months.

As more countries loosen their policies toward living with COVID rather than snuffing it out, health experts worry that monitoring systems will become weaker, making it more difficult to predict new surges and to make sense of emerging variants.

Since the Alpha variant emerged in 2020, Britain has served as a bellwether, tracking that variant as well as Delta and Omicron before they arrived in the United States. After a slow start, American genomic surveillance efforts have steadily improved with a modest increase in funding.

At the start of the pandemic, Britain was especially well prepared to set up a world-class virus tracking program. The country was already home to many experts on virus evolution, it had large labs ready to sequence viral genes, and it could link that sequencing to electronic records from its National Health Service.

In March 2020, British researchers created a consortium to sequence as many viral genomes as they could lay hands on. Some samples came from tests that people took when they felt ill, others came from hospitals, and still others came from national surveys.

That last category was especially important, experts said. By testing hundreds of thousands of people at random each month, the researchers could detect new variants and outbreaks among people who didn’t even know they were sick, rather than waiting for tests to come from clinics or hospitals.

By late 2020, Britain was performing genomic sequencing on thousands of virus samples a week from surveys and tests, supplying online databases with more than half of the world’s coronavirus genomes. That December, this data allowed researchers to identify Alpha, the first coronavirus variant, in an outbreak in south-eastern England.

A few other countries stood out for their efforts to track the virus’s evolution. Denmark set up an ambitious system for sequencing most of its positive coronavirus tests. Israel combined viral tracking with aggressive vaccination, quickly producing evidence last summer that the vaccines were becoming less effective — data that other countries leaned on in their decision to approve boosters.

But Britain remained the exemplar in not only sequencing viral genomes, but combining that information with medical records and epidemiology to make sense of the variants.

Even in the past few weeks, Britain’s surveillance systems were giving the world crucial information about the BA.2 subvariant of Omicron. British researchers established that the variant does not pose a greater risk of hospitalization than other forms of Omicron but is more transmissible.

On Friday, two of the country’s routine virus surveys were shut down and a third was scaled back, baffling many researchers, particularly when those surveys now show that Britain’s Covid infection rates are estimated to have reached a record high: one in 13 people. The government also stopped paying for free tests, and either cancelled or paused contact-tracing apps and sewage sampling programs.

The cuts have come as Prime Minister Boris Johnson has called for Britain to “learn to live with this virus.”

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The highly contagious Omicron subvariant known as BA.2, which led to a surge of coronavirus cases in Europe, is now the dominant version of the virus in new US cases, according to estimates from the Centers for Disease Control and Prevention (CDC) on Tuesday.

Last week, the World Health Organization reiterated that BA.2 was the dominant version of Omicron around the world, and Dr. Rochelle Walensky, the director of the CDC, said she anticipated it would soon become dominant in the United States.

Scientists have been keeping an eye on BA.2, one of three genetically distinct varieties of the Omicron variant of the coronavirus, which was discovered by South African researchers in November 2021.

BA.2 was first identified in the United States in December, and it accounted for about 55 percent of new U.S. cases in the week ending Saturday, according to C.D.C. estimates on Tuesday. The figures are rough estimates subject to revision as more data comes in, as happened in late December, when the agency had to significantly decrease its estimate for the nationwide prevalence of the BA.1 Omicron variant. Before that, the Delta variant had been dominant.

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Lalita Panicker is Consulting Editor, Views, Hindustan Times, New Delhi

China announces city wide lockdown to curb COVID-19; the latest health stories from around the world

March 29, 2022 By Lalita Panicker Leave a Comment

Coronavirus, Wuhan Image ID: 108296823 (L) Image credit: keitma / 123rf
The epicentre of the coronavirus outbreak was Wuhan, China. Image credit: keitma / 123rf

Sticking to its “zero COVID” policy, China has announced its biggest city-wide lockdown since the COVID outbreak began more than two years ago. The city of Shanghai will be locked down in two stages over nine days while authorities carry out COVID-19 testing.

( www.bbc.com/news/world-asia-china-60893070)

The important financial hub has battled a new wave of infections for nearly a month, although case numbers are not high by some international standards.

Authorities had so far resisted locking down the city of some 25 million people to avoid destabilising the economy. But after Shanghai recorded its highest daily number of cases on Saturday since the early days of the pandemic, authorities appear to have changed course.

The lockdown will happen in two stages, with the eastern side of the city under restrictions from Monday until 1 April, and the western side from 1-5 April.

Public transport will be suspended and firms and factories must halt operations or work remotely, authorities said. The city government published the instructions on its WeChat account, asking the public “to support, understand and cooperate with the city’s epidemic prevention and control work”.

Other lockdowns during the pandemic have affected entire Chinese provinces, though people could often still travel within those regions. But Shanghai, due to its high population density, is the largest single city to be locked down to date. It is China’s commercial capital and by some calculations the biggest city in the country – but is now one of the worst-hit areas as China fights to contain a resurgence of the virus with Omicron, leading to a spike in new cases.

Officials had until now said the eastern Chinese port and financial hub must keep running for the good of the economy. The staggered approach to this lockdown means half the city will remain functioning at a time.

Millions of residents in other Chinese cities have been subjected to citywide lockdowns, often after a relatively small number of Covid cases.

Wuhan was sealed off at the very outset of this pandemic. Before Christmas it was Xi’an. Now China’s commercial and financial capital is being shut.

Just a few days ago officials here said Shanghai was too big and too important to lock down. The question now on many residents’ lips will be whether nine days is enough.

The recent surge in cases in China, although small compared to some countries, is a significant challenge to China’s “zero-Covid” strategy, which uses swift lockdowns and aggressive restrictions to contain any outbreak.

The policy sets China apart from most other countries which are trying to live with the virus.

But the increased transmissibility and milder nature of the Omicron variant has led to questions over whether the current strategy is sustainable in the long run.

Some Shanghai residents have complained about the seemingly endless cycles of testing, suggesting that the cost of zero-COVID had become too high.

China’s national health commission reported more than 4,500 new domestically transmitted cases on Sunday. China reported almost 5,000 COVID-19 cases on Friday, as authorities continued to battle an outbreak of the highly transmissible Omicron variant. Following the death of a nurse in Shanghai who was denied hospitalization after an asthma attack, many are angry that China’s COVID responses appear to be causing more deaths than the virus itself.

Domestically acquired COVID-19 infections jumped from 175 on 7 March to 3507 on 14 March. Asymptomatic infections, which China tracks separately, surged as well. The government has put 37 million people in the southern city of Shenzhen and the north-eastern province of Jilin under lockdown orders, with many elsewhere facing travel and other restrictions. www.science.org/content/article/news-glance-asia-s-covid-19-surge-melting-winter-sea-ice-and-inflammatory-arxiv-papers

Meanwhile in Hong Kong the “zero covid” policy seems to be having an impact exactly opposite to what’s expected. Nearly half the foreign businesses are planning to relocate. Foreign businesses have for decades reaped the benefits of setting up shop in Hong Kong, a historically stable, expat-friendly finance hub at the doorstep of mainland China. But lately, as Beijing has tightened its grip on the former British colony, those firms are increasingly eyeing the exits. Nearly half of all European businesses in Hong Kong are considering relocating in the next year, according to a new report. Companies cite the local government’s extremely strict COVID-19 protocols that mirror those on the mainland. Among the firms planning to leave, 25% said they would fully relocate out of Hong Kong in the next 12 months, while 24% plan to relocate at least partially. Only 17% of the companies said they don’t have any relocation plans for the next 12 months.

www.cnn.com/2022/03/24/business/hong-kong-expats-covid-restrictions/index.html

Elsewhere, South Korea and Vietnam, which managed to keep cases very low during the first 2 years of the pandemic, have also seen explosions due to Omicron, with South Korea now reporting more than 300,000 cases daily and Vietnam more than 200,000. Many European countries that recently relaxed or abandoned control measures are recording COVID-19 rebounds as well, with double-digit percentage increases in infections over the past 2 weeks.

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The virus is up to its old tricks, as it has the world at large  ever since the pandemic hit more than two years ago. It’s mutating pretty effectively. Barely two months after the Omicron wave, U.S. epidemiologists are already warning of another swell in the pandemic.

Though COVID case numbers are falling in many countries, scientists warn that the quiet may soon give way to another surge, driven by an Omicron subvariant, BA.2. It is already fuelling an increase in cases in 18 countries, including Britain, France, Germany and Italy.

BA.2 is more contagious than the version of Omicron that spread through last winter. And BA.2 is quickly becoming more prevalent in some places. But whether that turns into a wave — as some countries in Europe are seeing — is hard to know for sure.

Some experts in the U.S predict that a BA.2 wave could come as soon as April, or perhaps later in the spring or in the early summer.

Another possibility is that BA.2 slows down a decline in cases or produces only a slight uptick — but not a big wave. That could be because so many Americans got infected with the first version of Omicron over the winter, so there’s more immunity in the population.

There’s also some optimism that even if there is a more sizable bump in cases, because of all the immunity in the population, hospitalisation rates may not go up so much, according to The New York Times. That’s been true for some European countries where cases have been rising for a few weeks, but so far it hasn’t been accompanied by a surge of hospitalisations.

There have been some lab studies that suggested that vaccinated people infected with Omicron produce reasonably high levels of antibodies that probably protect against BA.2. And estimates out of the U.K. suggest that vaccines seem to protect about as well against BA.1 as they do against BA.2. The big variable is how long that protection, especially from a previous infection, is going to last.  

Biogen last week published data from two pivotal clinical trials of its controversial Alzheimer’s drug, Aduhelm, more than 2 years after it first announced their outcomes. The company faced criticism for both the long delay and its choice of outlet—the low-profile Journal of Prevention of Alzheimer’s Disease. The journal’s editor-in-chief, Paul Aisen, is also the second author on the study and has consulted for Biogen. (Aisen says he was not involved in the review of Biogen’s manuscript or the publication decision, and the company is one among many he has consulted for.) The U.S. Food and Drug Administration (FDA) approved the drug against the recommendation of an independent advisory group. FDA cited evidence that the treatment removes Alzheimer’s-associated protein plaques from the brain, even though only one of the two large trials showed clinical benefits from Aduhelm over a placebo. www.science.org/content/article/news-glance-webb-telescope-looking-sharp-omicron-s-burden-and-statues-female-scientists/////

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Lalita Panicker is Consulting Editor, View, Hindustan Times, New Delhi

China and Hong Kong report COVID-19 surge; the latest health stories from around the world

March 22, 2022 By Lalita Panicker Leave a Comment

Confirmed cases of COVID-19 concept. a covid-19 blood test tube with result of positive on yellow background the X has clipping path and can be removed. COVID-19 testing concept. Antibody tests concept. Image credit: 罗 宏志 / 123rf. COVID-19 cases now number at one million: concept. Testing illustration. Symptomatic COVID-19 illustration. Cases of COVID-19 in India concept. COVID-19 clusters concept.. new covid-19 variant mutant strain long covid. COVID-19 cases concept. Even after recovery from COVID-19, long-COVID symptoms may persist. Image credit: 罗 宏志 / 123rf. B.1.617 concept. black fungus. Delta plus variant concern. Delta variant concept. Excess mortality illustration. Fresh COVID-19 cases illustration.
Image credit: 罗 宏志 / 123rf

China and Hong Kong have become the new focal point of the latest COVID-19 surge. China is enduring its first big outbreak of the Omicron variant and its “zero COVID” policy is bringing more pain with little gain. The restrictions pose a threat to China’s economic rebound and the world’s supply chains. 

Hong Kong, once famed for its low covid-19 count, is now recording the world’s highest death rate from the virus. The city is facing a shortage of coffins; morgues are overflowing with victims; hospitals are struggling to cope. On 17 March, 279 deaths were recorded in the city of 7.4m people. The death rate is more than twice as high as at the peak of Britain’s second wave in early 2021.

(www.economist.com/graphic-detail/2022/03/18/hong-kong-is-now-the-centre-of-the-pandemic?)

In the past few months, the Omicron variant has swept through the Asia-Pacific region. But Hong Kong is an outlier in terms of deaths. Its case fatality rate of 2% is more than ten times higher than those of New Zealand, Singapore and South Korea, where cases are also far above previous peaks. The rate in Hong Kong for unvaccinated people over 80 is 12%.

Until recently this low vaccination rate has been of little consequence thanks to strict “zero COVID” policies across China. But as the virus sweeps through Hong Kong and several Chinese provinces report outbreaks, it is an increasing cause for concern. On the mainland, at least 40m people are under some form of lockdown. Relatively few people have natural immunity and China’s health system is not equipped to handle a large wave. Beijing may be worried about a broader wave on the mainland. 

China’s “zero COVID” policy is facing its stiffest challenge after a rapid rise in cases caused by the Omicron variant that has forced authorities to take draconian control measures. Domestically acquired COVID-19 infections jumped from 175 on 7 March to 3507 on 14 March. Asymptomatic infections, which China tracks separately, surged as well. The government has put 37 million people in the southern city of Shenzhen and the north-eastern province of Jilin under lockdown orders, with many elsewhere facing travel and other restrictions. Public health experts worry the increases might overwhelm the country’s heath system, as it already has in Hong Kong. South Korea and Vietnam, which managed to keep cases very low during the first 2 years of the pandemic, have also seen explosions due to Omicron, with South Korea now reporting more than 300,000 cases daily and Vietnam more than 200,000. Many European countries that recently relaxed or abandoned control measures are recording COVID-19 rebounds as well, with double-digit percentage increases in infections over the past 2 weeks.

www.science.org/content/article/news-glance-asia-s-covid-19-surge-melting-winter-sea-ice-and-inflammatory-arxiv-papers?

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COVID-19 took more than 18 million lives by the end of 2021, roughly three times as many as the officially reported toll, according to a controversial new estimate. Several earlier studies indicated that tallies by the World Health Organization (WHO) vastly underestimate deaths, but the new one, published in The Lancet last week, is the first peer-reviewed examination of the period through December 2021. Researchers from the Institute for Health Metrics and Evaluation (IHME) analysed figures from 74 countries and territories to estimate excess mortality—deaths exceeding those expected from other causes. India’s official numbers omit 3.5 million COVID-19 deaths, the largest gap between reported and estimated ones. But Egypt and several other countries in Africa with smaller populations have bigger ratios of estimated to reported deaths. The IHME analysis has been criticized for overestimating excess COVID-19 deaths, particularly in some higher-income countries. WHO plans to release its own revised estimates in the next few weeks. The five top contenders:

COUNTRYREPORTEDESTIMATED EXCESSREPORTED/EXCESS
India489,0004,070,0008.33
USA824,0001,130,0001.37
Russia651,0001,070,0001.64
Mexico418,000798,0001.91
Egypt21,800265,00012.19
    

Things haven’t changed much. A little over a century ago, the Spanish Flu killed 50-100 million (1918-20). According to GAVI the vaccine alliance, the seven deadliest plagues to hit the world were: the Black Death: 75-200M (1334-1353), 1918 Flu: 50-100 M (1918-1920), New World Smallpox: 25-56 M (1520 – early 1600S), Plague of Justinian: 30-50 M (541-549), The Third Plague: 12 M (1855 – 1959), HIV/AIDS: 27.2-47.8 M (1981 – current) and COVID-19: 5-17 M (2020 – current).

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US President Joe Biden last week got his wish for a new agency to fund high-risk, cutting-edge biomedical research when Congress created the Advanced Research Projects Agency for Health (ARPA-H) and gave it a $1 billion start-up investment. That’s a fraction of the $6.5 billion Biden had proposed, but advocates say it’s plenty to launch ARPA-H.( www.science.org/content/article/u-s-just-created-big-new-biomedical-research-agency-questions-remain?)

ARPA-H will have 3 years to spend its initial $1 billion. “The expectation is that this is the beginning of a ramp” to higher funding, acting White House Science Advisor Collins says. For now, he says, the agency needs to find an interim director who can work out hiring, contracting processes, and office space. ARPA-H likely won’t make awards until it has a permanent director. But Collins says that appointment could come in just “a couple of months” because the position does not need Senate confirmation, and names are already “kicking around.”

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A flurry of high-profile coronavirus cases in the US capital — including in people who have been around President Biden — has raised new questions about the trajectory of the two-year-old pandemic, even as the White House has signalled confidence in the country’s ability to resume normal activities. (www.nytimes.com/2022/03/17/us/politics/washington-coronavirus-cases.html?

On Thursday, Biden cancelled face-to-face meetings with Prime Minister Michael Martin of Ireland after the prime minister received a positive result from a coronavirus test during a gala event on Wednesday night that both men attended.

In the past week, Doug Emhoff, the husband of Vice President Kamala Harris, tested positive for the virus, as did former President Barack Obama. At least nine House Democrats received positive tests this week after a party retreat in Philadelphia and late-night voting at the Capitol.

White House officials said Mr. Biden, 79, had not been in close contact with anyone who tested positive and did not appear worried about his safety. They said that the administration was monitoring a highly transmissible subvariant known as BA.2, which is spreading rapidly in parts of China and Europe, but that there appeared to be little reason to think there would be a U-turn back to social distancing and universal mask wearing in the United States.

But the recent cases in Washington, and the spread of yet another variant around the world, highlight a challenge for Biden and his team: how to embrace the country’s desire to move on while being careful not to declare victory over a virus that is still making people sick and killing more than 1,000 Americans each day.

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Short Takes

Figures showing a global rise in COVID-19 cases could herald a much bigger problem as some countries also report a drop in testing rates, the WHO said on Tuesday, warning nations to remain vigilant against the virus. After more than a month of decline, COVID cases started to increase around the world last week, the WHO said, with lockdowns in Asia and China’s Jilin province battling to contain an outbreak. A combination of factors was causing the increases, including the highly transmissible Omicron variant and its BA.2 sub-lineage, and the lifting of public health and social measures, the WHO said.

https://www.reuters.com/business/healthcare-pharmaceuticals/who-says-global-rise-covid-cases-is-tip-iceberg-2022-03-16/

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South Korea has reached two seemingly contradictory pandemic milestones: It recorded more than 600,000 new COVID-19 infections on Thursday, the most of anywhere in the world. At the same time, the country has one of the lowest virus death rates globally. While anywhere else an infection surge of this size would signal an out-of-control outbreak soon to be followed by a spike in fatalities, in South Korea — which is about the size of Indiana — the picture is more complex. The sky-high caseload reflects the nation’s consistent deployment of mass testing, largely abandoned by many places as Covid becomes endemic but a key reason behind Korea’s sliding death rate, according to its virus fighters.

https://www.bloomberg.com/news/articles/2022-03-17/how-south-korea-is-beating-covid-despite-600-000-new-cases-a-day

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African countries are also struggling to get people jabbed against covid. Just 13% of the continent has been fully vaccinated. Africa has plenty of covid doses but the increased deliveries are exposing logistical defects in the distribution of vaccines. 

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To end on a sliver of good news: COVID has led to other vaccine victories.  A jab against malaria is arriving at last. It could save as many lives as covid has taken. And attitudes are changing towards the human papillomavirus vaccine in Japan as inoculations become more routine.

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Lalita Panicker is Consulting Editor, View, Hindustan Times, New Delhi

China COVID-19 cases double in a day; the latest health stories from around the world

March 14, 2022 By Lalita Panicker Leave a Comment

COVID-19 SARS-CoV-2 Coronavirus superspreaders blood test 2019-nCoV,SARS-CoV, MERS-CoV chinese infection blood test in Laboratory. COVID-19 cases concept. Illustration of first coronavirus death in India. Representation of coronavirus testing. Image credit: photovs / 123rf COVID-19 testing concept. Mutations illustration. antibodies concept.
Image credit: photovs / 123rf

China reported nearly 3,400 daily COVID-19 cases on Sunday, double the previous day, forcing lockdowns in virus hotspots as the country contends with its gravest outbreak in two years www.theguardian.com/world/2022/mar/13/china-battles-worst-covid-outbreak-for-two-years-as-cases-double-in-24-hours?

A nationwide surge in cases has seen authorities close schools in Shanghai and lock down several north-eastern cities, as almost 19 provinces battle clusters of the Omicron and Delta variants.

The city of Jilin has been partially locked down, with hundreds of neighbourhoods sealed up, an official announced Sunday, while Yanji, an urban area of nearly 700,000 bordering North Korea, was fully closed off.

China, where the virus was first detected in late 2019, has maintained a strict zero-COVID policy enforced by swift lockdowns, travel restrictions and mass testing when clusters have emerged.

But the latest flare-up, driven by the highly transmissible Omicron variant and a spike in asymptomatic cases, is challenging that approach.

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Hong Kong is paying a heavy price for the vaccine hesitancy among its older residents, as a comparison with New Zealand underscores. (www.science.org/content/article/news-glance-hong-kong-s-high-covid-19-death-rate-biden-s-test-and-treat-and?)

Both countries minimized COVID-19 cases until the Omicron variant spread in February, but are now enduring big surges. Although New Zealand’s deaths from COVID-19 have remained flat—at 65 for the whole pandemic as of 7 March—Hong Kong’s have skyrocketed, with the weekly average nearing 200 per day, among the world’s highest recorded fatality rates. The key difference seems to be vaccination: New Zealand authorities say 100% of residents 75 and older are fully vaccinated (and 96% of those ages 12 and up), but in Hong Kong only about 30% of those 80 and older have received two doses of a COVID-19 vaccine. (The figure is 70% for all adults and children ages 3 and above.)

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The United States government this week began to ship antiviral pills for a program of free testing and immediate, free drug treatment for those with COVID-19 at hundreds of pharmacy clinics and long-term care facilities. (www.science.org/content/article/news-glance-hong-kong-s-high-covid-19-death-rate-biden-s-test-and-treat-and?)

The “test to treat” plan—one of several new proposals announced last week by President Joe Biden’s administration to manage the pandemic as U.S. caseloads drop—is aimed at helping people who lack ready access to a physician. The antiviral pills being dispensed work best if given quickly after diagnosis. Many public health officials and scientists applauded the proposal. But the American Medical Association complained that COVID-19 drugs could interact harmfully with drugs for other conditions and that physicians, who don’t typically staff pharmacies, are best equipped to prescribe them safely.

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In March 2020, the Austrian ski town of Ischgl suddenly became infamous as the site of one of the first COVID-19 superspreading events. Hundreds of infected skiers took the virus home and seeded outbreaks all around Europe.

As the pandemic progressed, however, Ischgl was on the vanguard for a more positive reason: Health officials and scientists in the state of Tyrol were among the first to monitor levels of the pandemic coronavirus in sewage—and base health policy decisions on them (www.science.org/content/article/pandemic-signals-sewer-what-virus-levels-wastewater-tell-us?)

Because the region is so dependent on tourism, officials were eager to know whether the virus was truly on the decline so they could lift key restrictions. They also wanted to catch the earliest possible signals that it might be coming back. Wastewater analysis, which picks up fragments of virus shed in faeces, was invaluable, says Stefan Wildt, a wastewater expert at the state’s department of water management. Following Tyrol’s lead, a national program has recently expanded to cover more than half of Austria’s population.

Although wastewater monitoring has been used to track polio and other pathogens for decades, the COVID-19 pandemic has led to an explosion of interest. The technique takes advantage of the fact that SARS-CoV-2 replicates in the digestive system and is shed in high quantities, often before symptoms appear. 

That provides an inexpensive way to monitor infections in thousands or even millions of people without annoying nose or throat swabs, or to predict where cases might be about to surge and hospitals risk getting overburdened. The genetic sequences of the shed virus can also provide hints about how it is evolving.

Scientists in the Netherlands, which has had a nationwide network of wastewater monitoring for decades, were among the first to show fragments of SARS-CoV-2 virus in wastewater samples could accurately reflect its levels in the community. Since then, monitoring projects for SARS-CoV-2 have sprung up in at least 58 countries, according to a dashboard set up by Colleen Naughton and colleagues at the University of California (UC), Merced. The European Union recommended all member countries establish monitoring systems for SARS-CoV-2 by October 2021, and 26 of 27 have complied, says Bernd Manfred Gawlik, who is helping coordinate efforts through the European Commission. 

In the United States, the National Wastewater Surveillance System includes 400 sites in 19 states. Last month, the U.S. Centers for Disease Control and Prevention added a national dashboard of wastewater data, and on 2 March, President Joe Biden’s administration said the monitoring system will be part of the effort to detect new variants. In India, a successful project in Bengaluru is expanding to half a dozen new cities.

Still, the jury is out on just how useful the technology is. Reliably determining viral levels in wastewater has posed logistical and technical challenges, and interpreting the data can be difficult. (For one, a good downpour will send dilute virus concentrations in sewers). Establishing collection, testing, and reporting systems can be time consuming and expensive as well. And although policymakers have welcomed the results of wastewater monitoring, few have used them to take action; typically, they have waited for cases to rise and intensive care units to fill up.

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As the Omicron coronavirus surge subsides, researchers are keeping an eye on a highly transmissible subvariant known as BA.2. Although it doesn’t appear to have the capacity to drive a large new wave of infections, the variant could potentially slow the current decline of Covid cases and make treatments more difficult.

Scientists first discovered the Omicron variant in November, and it quickly became clear that the viral lineage already existed as three genetically distinct varieties. Each branch of Omicron had its own set of unique mutations. At the time, the most common was BA.1, which quickly spread across the world. BA.1 was almost entirely responsible for the record-shattering spike in cases this winter.

At first, BA.1 was a thousand times as common as BA.2. But in early 2022, BA.2 started to be found in a larger proportion of new infections.

All versions of Omicron are highly contagious, which is why the variant swiftly crowded out earlier forms of the coronavirus, like Delta. But a number of studies have found that BA.2 is even more transmissible than BA.1.

In Denmark, for example, scientists examined the spread of both subvariants in households. They found that people infected with BA.2 were substantially more likely to infect people they shared a house with than those with BA.1. In England, researchers found that it took less time on average for someone with BA.2 to infect another person, accelerating its spread through communities.

In early 2022, BA.2 was growing more common in a number of countries. By February, it had become dominant worldwide, driving down the once-dominant BA.1. In the United States, the Centres for Disease Control and Prevention estimated that BA.2 jumped to 11 percent in early March from 1 percent in early February. It could soon become dominant in this country as well.

But that does not mean that Americans are riding a new BA.2 wave that is infecting a lot of new people. As BA.2 became more common in the United States, the total number of new cases fell by about 95 percent. Worldwide, the number of daily new cases had fallen to half of what they were at their peak in late January.

As many countries relax their protections against the spread of Covid, they may make it easier for BA.2 to drive a new increase in cases. A March 10 report from British researchers suggests that may be happening there now.

But there are a number of reasons that epidemiologists doubt that BA.2 will drive a massive new surge.

One of Omicron’s most striking features was its ability to partly evade the protection of vaccines. “Breakthrough” infections became more common, helping to drive the case surge to its record high. But the vaccines continued to protect people against severe disease, especially those who received a booster. Throughout the Omicron surge, vaccines remained highly effective against hospitalization.

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Lalita Panicker is Consulting Editor, Views, Hindustan Times, New Delhi

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