Health Issues in Africa

Health Issues in Africa

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COVID-19 sourced to a market in Wuhan? The latest health stories from around the world

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Test and sample virus crown covid virus 19. COVID-19 tests illustration. Image credit: ambrozinio / 123rf
Image credit: ambrozinio / 123rf

Scientists released a pair of extensive studies on Saturday that point to a market in Wuhan, China, as the origin of the coronavirus pandemic. Analysing data from a variety of sources, they concluded that the coronavirus was very likely present in live mammals sold in the Huanan Seafood Wholesale Market in late 2019 and suggested that the virus twice spilled over into people working or shopping there. They said they found no support for an alternative theory that the coronavirus escaped from a laboratory in Wuhan (www.nytimes.com/interactive/2022/02/26/science/covid-virus-wuhan-originsl)

“When you look at all of the evidence together, it’s an extraordinarily clear picture that the pandemic started at the Huanan market,” said Michael Worobey, an evolutionary biologist at the University of Arizona and a co-author of both studies.

The two reports have not yet been published in a scientific journal that would require undergoing peer review.

Together, they represent a significant salvo in the debate over the beginnings of a pandemic that has killed nearly 6 million people globally and sickened more than 400 million. The question of whether the coronavirus outbreak began with a spill over from wildlife sold at the market, a leak from a Wuhan virology lab or some other way has given rise to pitched geopolitical battles and debates over how best to stop the next pandemic.

But some outside scientists who have been hesitant to endorse the market origin hypothesis said they remained unconvinced. Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center, said in an interview that there remained a glaring absence of direct evidence that animals at the market had themselves been infected with the coronavirus.

In their new study, Dr. Worobey and his colleagues present evidence that wild mammals that might have harboured the coronavirus were being sold in December 2019. But no wildlife was left at the market by the time Chinese researchers arrived in early 2020 to collect genetic samples.

The authors of the new study include researchers who previously published smaller reports that had pointed toward a similar conclusion, but were based on much less detail. Their earlier analysis suggested that the first known case of the coronavirus was a vendor at the Huanan market.

In a separate line of research, scientists at the Chinese Center for Disease Control and Prevention carried out a new analysis of the genetic traces of coronaviruses collected at the market in January 2020. Previous studies have shown that the viruses sampled from early cases of Covid belonged to two main evolutionary branches. The Huanan market samples included both branches, the scientists reported in a study they posted online last weekend.

Dr. Worobey, who said he was not aware of the study until it was made public, said that their findings are consistent with the scenario he and his colleagues put forward for two origins at the market.

The Huanan Seafood Wholesale Market was an early object of suspicion when Covid first swept across Wuhan. Towards late December 2019, a few people who worked at the market developed a mysterious form of pneumonia. On Dec. 30, public health officials told hospitals to report any new cases of pneumonia linked to the market.

It also became clear at the end of December that a new coronavirus was to blame for the mysterious pneumonia. Coronaviruses have a disturbing history in China: In 2002, another coronavirus sparked the SARS epidemic, which killed 774 people. Scientists later concluded that the virus originated in bats, spread to wild mammals, and then jumped to humans at markets where the mammals were sold.

Fearing a replay of SARS, Chinese officials ordered the Huanan market closed. Wuhan police shut it down on Jan. 1, 2020. Workers clad in hazmat suits washed and disinfected the stalls.

Chinese scientists said they found the virus in dozens of samples taken from surfaces and sewers in the market, but not in any swabs taken from animals in the market.

The link to the market seemed to weaken as the coronavirus spread. Meanwhile, questions arose about the research carried out at a lab in the city, the Wuhan Institute of Virology, where scientists studied coronaviruses.

For the new studies, Dr. Worobey and his colleagues estimated the latitude and longitude of 156 cases of Covid in Wuhan in December 2019. The highest density of cases centred around the market.

The researchers then mapped cases in January and February. They used data collected by Chinese researchers from Weibo, a social media app that created a channel for people with Covid to seek help. The 737 cases drawn from Weibo were concentrated away from the market, in other parts of central Wuhan with high populations of elderly residents.

The patterns pointed to the market as the origin of the outbreak, the studies found, with the coronavirus then spreading to the surrounding neighbourhoods before moving out farther across the city. The researchers ran tests that showed it was extremely unlikely that such a pattern could be produced merely by chance.

“It’s very strong statistical evidence that this is no coincidence,” Dr. Worobey said.

The researchers also presented evidence that in late 2019, vendors at the market were selling raccoon dogs and other mammals known to be potential hosts of coronaviruses. Genetic samples collected from floors, walls and other surfaces at the Huanan market in January 2020 reveal traces of SARS-CoV-2 in the southwest corner of the market, where the vendors were clustered.

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At least 5.2 million children globally have lost a parent, grandparent or family caretaker to Covid-19, a new study says. The study, published on 24 February in The Lancet Child & Adolescent Health, said this “heart-breaking hidden pandemic” is nearing the total number of Covid-19 deaths, which currently stands at about 5.9 million people, according to latest World Health Organization totals. While plummeting Covid-19 case counts across the US are leading to a lifting of mask mandates, data shows more people are dying of Covid-19 now than during most points of the pandemic. More than 2,000 Covid-19 deaths have been reported in the US each day for the past month as the Omicron variant remains a heightened concern.

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The drive to help African countries produce vaccines with messenger RNA (mRNA) technology got big boosts last week from the World Health Organization (WHO) and the company BioNTech (www.science.org/content/article/news-glance-african-vaccine-n)

The success of mRNA COVID-19 vaccines made by the Pfizer-BioNTech collaboration and Moderna led to intense global demand, but African countries have had little access because of limited supply and high prices. Campaigns by several governments and nongovernmental organizations failed to convince the companies to freely share their technologies with economically strapped countries. So last year WHO launched a hub in South Africa to produce mRNA vaccines independently. The agency, which hopes the hub licenses a product by 2024, last week announced plans to train scientists from South Africa, Egypt, Kenya, Nigeria, Senegal, and Tunisia. BioNTech, which has been criticised for trying to undermine the WHO effort, separately announced that later this year it will train local scientists and send modular, shipping container–size vaccine factories to Ghana, Rwanda, and Senegal.

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In a setback to the global polio eradication campaign, a wild poliovirus has leapt from Pakistan to the African continent, where it has paralyzed a 3-year-old girl in Malawi(www.science.org/content/article/news-glance-african-n)

The case, announced on 17 February by the Malawi government, is the first wild polio case in the country since 1992. Pakistan and Afghanistan are the last two countries where the wild virus is endemic, which means circulation there has never stopped. Occasionally, however, the virus spills over from these entrenched reservoirs. Africa’s last known case of wild polio occurred in 2016 in Nigeria’s Borno state. The continent is still battling big outbreaks of vaccine-derived polio, however, which occur in areas of low immunization when the live but attenuated virus in the oral polio vaccine regains its ability to paralyse and spread.

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As people across the world grapple with the prospect of living with the coronavirus for the foreseeable future, one question looms large: How soon before they need yet another shot?

Not for many months, and perhaps not for years, according to a flurry of new studies (www.nytimes.com/2022/02/21/health/covid-vaccinel)

Three doses of a Covid vaccine — or even just two — are enough to protect most people from serious illness and death for a long time, the studies suggest.

“We’re starting to see now diminishing returns on the number of additional doses,” said John Wherry, director of the Institute for immunology at the University of Pennsylvania. Although people over 65 or at high risk of illness may benefit from a fourth vaccine dose, it may be unnecessary for most people, he added.

US Federal health officials have said they are not planning to recommend fourth doses anytime soon.

The Omicron variant can dodge antibodies produced after two doses of a Covid vaccine. But a third shot of the mRNA vaccines made by Pfizer-BioNTech or by Moderna prompts the body to make a much wider variety of antibodies, which would be difficult for any variant of the virus to evade, according to the most recent study, posted online last week.

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

Queen Elizabeth tests positive for COVID-19; the latest health stories from around the world

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Coronavirus outbreak concept. Novel coronavirus disease called 2019-nCoV handwriting on blue paper. protective mask and surgical gloves on blue background Image credit: Epov / 123rf covid
Image credit: Epov / 123rf

Queen Elizabeth II has been infected with the coronavirus, Buckingham Palace said on Sunday, becoming one of the world’s most prominent figures to battle the virus and rattling the country she has led for seven decades.


The palace issued few details about the condition of the queen, who turns 96 in April.


“Buckingham Palace confirm that the queen has today tested positive for Covid,” the palace said in a statement. “Her Majesty is experiencing mild cold like symptoms but expects to continue light duties at Windsor over the coming week. She will continue to receive medical attention and will follow all the appropriate guidelines.”


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US National Public Radio describes the present as a confusing stage of the pandemic. And it’s not just confined to the US.
On Sunday, police continued to push back at protestors in Ottawa, Canada’s capital, finally clearing a portion of the city that had been blockaded for three weeks. Around 100 arrests were made on Friday and 47 more on Saturday. The demonstrations were started by lorry drivers upset at COVID-19 rules. The government has invoked never-before-used emergency powers to quash the protests. Police began arresting protesters in Ottawa on Friday in a crackdown against the truck convoy that has blockaded the Canadian capital’s downtown for nearly three weeks. The protesters were angry about COVID-19 restrictions and vaccine mandates. This week Justin Trudeau, Canada’s prime minister, invoked a 34-year-old emergency law for the first time in order to quell the demonstrations.


Meanwhile, swinging radically in the opposite direction, as surges of COVID-19 cases driven by the highly infectious Omicron variant recede, parts of the US, Canada, and Europe are moving swiftly to lift constraints on a pandemic-fatigued public. Sweden, Denmark, and Norway have abolished nearly all ¬COVID-19–related restrictions in recent weeks, and the United Kingdom announced it would do the same this month, dropping even the legal requirement that people quarantine after testing positive for SARS-CoV-2. In the US, despite persistently high numbers of COVID-19–related deaths and busy hospitals, 10 governors, many known for being cautious in their pandemic response, last week announced immediate or impending ends to their states’ indoor or school mask mandates.


Some of those moves came with assertions that it’s time to “live with the disease” and treat the coronavirus as endemic—a stable, enduring figure in the panoply of human pathogens, alongside cold viruses and influenza. That suggestion troubles many scientists, who warn it is eroding governments’ commitment to tracking and responding to the pandemic—which could leave countries flying blind and unprepared for any new variant.

And true to the pandemic’s form, a subvariant of Omicron known as BA.2 is spreading fast and may cause severe disease, research from Japan suggests. New lab experiments show BA.2 is capable of thwarting some of the key weapons we have against Covid-19, including being able to escape the immunity created by vaccines. It also appears to be resistant to some monoclonal antibody treatments currently being used to fight Omicron. BA.2 is highly mutated when compared with the original virus that emerged in Wuhan, China. It has been detected in 74 countries and 47 US states, and about 4% of Americans now have infections caused by BA.2, according to data from the Centers for Disease Control & Prevention (CDC).


“Endemic delusion is probably what captures it the best,” says Kristian Andersen, an infectious disease researcher at Scripps Research who has been especially critical of recent moves by his home country of Denmark, which include an announcement that as of this month COVID-19 would no longer be categorized as a “socially critical disease” even though related death and hospitalization rates were still climbing there.

(www.science.org/content/article/it-time-live-covid-19-some-scientists-warn-endemic-delusion)


And it’s not just new variants but the older ones as well that could prove intractable. The COVID booster shots lose much of their potency after about four months, raising the possibility that some people— specifically those at high risk of complications or death — may need a fourth dose, data published on Friday by the US CDC suggest.


Still, many scientists acknowledge the challenges of steering public restrictions during the reign of the more infectious but generally less severe Omicron variant, when some of the metrics that previously guided policy have become less informative.
Denmark’s recent moves are a case in point. Michael Bang Petersen, a political scientist at Aarhus University and pandemic adviser to the Danish government, supports its decision to lift measures such as limits on nightlife hours, caps on attendance at indoor public events, and mandatory face masks or proof of vaccination for indoor venues. He argues the government could no longer justify the economic, social, and constitutional trade-offs of those restrictions amid promising signs, such as numbers of intensive care unit (ICU) patients that remain stable and below the health system’s capacity.

In the US, governors cited various metrics to justify recent decisions to lift or let expire indoor mask mandates. California Governor Gavin Newsom noted stable hospitalization rates and a 65% reduction in cases since Omicron’s peak in announcing the state’s mandate would end this week. But leaders also face political and economic pressures. States’ moves may be driven largely by the public’s impatience with restrictions, says epidemiologist Dustin Duncan of Columbia University.


Still, with the US logging more than 2,000 daily deaths last week, “We cannot say we are at a level that’s tolerable to live with this virus,” Emory University epidemiologist Jodie Guest says. Her team has been developing rough guidelines for when a true endemic stage of COVID-19 has been reached: daily case rates below 30 per 100,000, ICUs below 80% of capacity, vaccination rates of at least 75%, and fewer than 100 COVID-19 deaths a day nationwide.


Some governments are limiting efforts to find and report cases. Sweden, long an outlier among European countries for its laissez-faire approach to the pandemic, ended widespread testing at mobile centres as cases declined from their Omicron peak. The United Kingdom is reportedly weighing ending free public testing for the virus in the coming weeks. Meanwhile, the Canadian province of Saskatchewan last week switched from providing daily to weekly reports of COVID-19 cases. And Tennessee last month joined several states already reporting case counts weekly.


In the growing number of “back to normal” messages, Christina Pagel, a health services researcher at University College London, sees leaders ignoring obvious next steps to protect public safety. Even researchers who aren’t speaking up to defend specific restrictions are urging governments to step up their COVID-19 fight, rather than scale it back. They want aggressive new pushes to reach the unvaccinated, distribute rapid tests, and make COVID-19 treatments much more accessible, for example. “Frankly, I don’t really think that 2 to 3 weeks more of a mask mandate is going to make much difference in the long run,” says KJ Seung, a health policy adviser at Partners In Health. “More alarming to me is that our public health system doesn’t seem to have any plan for dealing with the next surge.”
“I don’t particularly want to be in a future where I get COVID twice a year,” Pagel adds. Averting that future may mean adaptations such as technologies to improve indoor air quality and strong virus surveillance that can be ramped up at the first sign of another surge.


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For some, the idea of “living with the disease” may take on an entirely different connotation in the long run.
Dozens of papers have examined the lingering mental health effects of COVID-19, but many have measured conditions such as depression and brain fog only a few months after infection. Now, a giant new study shows people who contracted COVID-19 faced much higher risks of neuropsychiatric ailments one year later, including brain fog, depression, and substance use disorders.

(www.science.org/content/article/covid-19-patients-face-higher-risk-brain-fog-n)


The report, based on millions of people who used the U.S. Department of Veterans Affairs (VA) health system early in the pandemic, is published in The BMJ journal of the British Medical Association.


“Most of us experienced some sort of mental distress during the pandemic, but this shows that people with COVID-19 had a much higher risk of mental health disorders than their contemporaries,” says senior author Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and chief of research at the VA St. Louis Health Care system. “It’s a wake-up call.”


From very early in the pandemic, it was clear that SARS-CoV-2 can damage the heart and blood vessels while people are acutely ill. Patients developed clots, heart inflammation, arrhythmias, and heart failure.


Now, the first large study to assess cardiovascular outcomes one year after SARS-CoV-2 infection has demonstrated that the virus’ impact is often lasting. In an analysis of more than 11 million U.S. veterans’ health records, researchers found the risk of 20 different heart and vessel maladies was substantially increased in veterans who had COVID-19 one year earlier, compared with those who didn’t. The risk rose with severity of initial disease and extended to every outcome the team examined, including heart attacks, arrhythmias, strokes, cardiac arrest, and more. Even people who never went to the hospital had more cardiovascular disease than those who were never infected.

(www.science.org/content/article/covid-19-takes-serious-toll-heart-y)


The results are “stunning … worse than I expected, for sure,” says Eric Topol, a cardiologist at Scripps Research. “All of these are very serious disorders. … If anybody ever thought that COVID was like the flu this should be one of the most powerful data sets to point out it’s not.” He adds that the new study “may be the most impressive Long Covid paper we have seen to date.”


Others agree the results of the study, published in Nature Medicine on 7 February, are powerful. “In the post-COVID era, COVID might become the highest risk factor for cardiovascular outcomes,” greater than well-documented risks such as smoking and obesity, says Larisa Tereshchenko, a cardiologist and biostatistician at the Cleveland Clinic, who recently conducted a similar, much smaller analysis. She cautions that the new study will need to be replicated, and that it was retrospective, possibly introducing inaccuracies such as incorporating faulty diagnoses from patient records. “It looked back. We have to do prospective studies to calculate accurate estimates.” Nor do researchers know how the virus orchestrates this long-term damage. But they think the cardiovascular risks and the constellation of symptoms collectively known as Long Covid (which include brain fog, fatigue, weakness, and loss of smell) could have common roots.
“This is clearly evidence of long-term heart and vascular damage. Similar things could be happening in the brain and other organs resulting in symptoms characteristic of Long Covid, including brain fog,” says Ziyad Al-Aly.


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

“Human challenge” study grants insights into COVID treatments and variants; the latest health stories from around the world

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Earlier this month, researchers in the United Kingdom posted the results of a first-of-its-kind study in which healthy young volunteers were purposely infected with an early strain of the pandemic coronavirus (www.science.org/content/article/scientists-d)

As hoped, none of the participants got seriously ill, and scientists were able to closely track their symptoms and gain unique insight into how both SARS-CoV-2 levels and symptoms vary from start to finish during an infection.

The success of this initial “human challenge” study provides a strategy for testing COVID-19 treatments, vaccines, and viral variants going forward, the researchers say. The study may also help scientists understand why the pandemic coronavirus can breach the immune defences of some people but not others.

In the study, 34 healthy volunteers ages 18 to 29 were given nose drops with a small amount of the virus. Eighteen, or 53%, became infected, according to polymerase chain reaction (PCR) tests. Most volunteers developed mild to moderate symptoms but none needed hospitalization or treatment, showing the study could be done safely, according to the investigators who ran it. The study also found that after the first 1 to 2 days of infection, rapid antigen tests reliably indicated the presence of virus.

The results, posted on a preprint server, have not yet been peer reviewed but are under review at a Nature journal.

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Last January, a team of researchers searching for the coronavirus in New York City’s wastewater spotted something strange in their samples. The viral fragments they found had a unique constellation of mutations that had never been reported before in human patients — a potential sign of a new, previously undetected variant (www.nytimes.com/2022/02/03/health/coronavirus-wastewaterl)

For the past year, these oddball sequences, or what the scientists call “cryptic lineages,” have continued to pop up in the city’s wastewater.

There is no evidence that the lineages, which have been circulating for at least a year without overtaking Delta or Omicron, pose an elevated health risk to humans. But the researchers, whose findings were published in Nature Communications on Thursday, still have no idea where they came from.

The researchers themselves are torn about the lineages’ origins. Some lean toward the explanation that the virus is coming from people whose infections aren’t being captured by sequencing. But others suspect that the lineages may be coming from virus-infected animals, possibly the city’s enormous population of rats. 

The researchers have been sampling wastewater from 14 treatment plants in New York City since June 2020. In January of 2021, they began doing targeted sequencing of the samples, focusing on part of the gene for the virus’s all-important spike protein.

Although this approach provides a limited look at the viral genome, it allows researchers to extract a lot of data from wastewater, in which the virus is typically fragmented.

Viral fragments with novel patterns of mutations appeared repeatedly at a handful of treatment plants, the researchers found. (They could not disclose the specific plants or areas of the city, they said.)

Researchers at the University of California at Berkeley have found similar sequences in one California sewer shed. 

The lineages could be coming from people whose infections have escaped detection or whose virus has not been sequenced.

But the fact that they kept turning up at the same few wastewater plants makes this theory less likely, the researchers said, given that New Yorkers, and any variants they may be carrying, tend to move throughout the city without restriction.

The lineages have been circulating for long enough now that they should have appeared in at least one sample sequenced from an infected person, some scientists said.

In May and June of 2021, when the number of human Covid-19 cases in the city was low, the mysterious lineages made up a greater proportion of the viral RNA in wastewater, suggesting that they may have come from a nonhuman source.

The researchers initially considered a diverse array of potential hosts, from squirrels to skunks. To narrow down the possibilities, they went back to the wastewater, assuming that any animal that was shedding virus might be leaving its own genetic material behind, too.

Although a vast majority of the genetic material in the water came from humans, small amounts of RNA from dogs, cats and rats were also present, the scientists found.

Some researchers have been considering rats, which roam the city by the millions. The original version of the virus does not appear able to infect rodents, although some other variants, like Beta, can.

Since last summer, the scientists have been working with Animal and Plant Health Inspection Service at the U.S. Department of Agriculture to look for signs of the virus in blood and faecal samples from local rats. So far, they’ve come up empty.

Scientists have repeatedly found that humans can pass the virus to animals, especially pets, zoo animals, farmed mink and others with which they are in frequent contact. That has raised concerns that the virus might establish itself in an animal reservoir, where it might mutate and get passed back to humans.

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Short Takes

 A new spinoff of the Omicron variant, called BA.2, has been found in at least 49 countries, including the United States — but medical professionals say there’s no need to worry because there is no evidence that it causes more severe illness than the original Omicron variant.

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Two makers of COVID-19 vaccines logged major milestones on 31 January. Moderna won full approval from the U.S. Food and Drug Administration (FDA) for its messenger RNA–based vaccine, 13 months after the agency granted the company an emergency use authorization (EUA). It is the country’s second fully authorized COVID-19 vaccine, after Pfizer’s, which won approval in August 2021 (www.science.org/content/article/news-glance-s)

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And after a months-long delay caused by manufacturing issues, Novavax applied to FDA for an EUA for its protein-based vaccine. Last month, it won conditional marketing authorization in Europe, and the World Health Organization granted it an emergency use listing, opening up an avenue to buttress global vaccine supplies.

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Britain has granted a licence to researchers to study the therapeutic effects of cannabis on patients with long covid-19. It is not such a wild idea—a recent study suggested that cannabis compounds prevent the virus from entering healthy human cells. Drug Science, an independent scientific body running the test, says that long covid shares many symptoms with other post-viral conditions that seem to respond to cannabis, including exhaustion, pain, fluctuating blood pressure and a reduced ability to exercise.

Patients on the trial will be offered daily doses of an oil form of cannabis that contains 5% cannabidiol, also known as CBD, and only 0.2% tetrahydrocannabinol, the drug’s main psychoactive compound. Patients will log their responses and if this small-scale trial, involving just 30 people, is successful, a large-scale randomised controlled trial will follow. Only after a more rigorous second trial will it become clear whether it’s high time cannabis was prescribed to covid patients.

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India has placed a purchase order with Biological E for 50 million doses of COVID vaccine Corbevax each costing ₹145 ($1.94) excluding taxes, official sources said on Saturday (www.thehindu.com/news/centre-places-purchase-ordere)

The government hasn’t yet decided on which segment of beneficiaries this new vaccine would be administered.

However discussions are underway in technical groups and in the Health Ministry’s immunisation division about expanding the scope of the “precaution doses” (booster shots) which are currently being given to healthcare and frontline workers, and comorbid senior citizens. 

Late last year India had approved two new COVID vaccines, expanding its vaccination programme amid fears of a third wave fuelled by Omicron (www.bbc.com/news/world-asia-india-57437944?).

The new vaccines – Serum Institute of India’s Covovax and Biological E’s Corbevax – were both authorised for “restricted use in an emergency situation”.

Corbevax from Indian pharma company Biological E was developed in collaboration with US-based Dynavax and Baylor College of Medicine. It is India’s first indigenously developed recombinant protein sub-unit vaccine. That is, it’s made up of the coronavirus’ “spike protein”, which the virus uses to latch on and enter human cells. When injected, this is expected to trigger an immune response in the body.

Covovax is a local version of the Novavax vaccine, and will be produced by the Serum Institute of India (SII), which is also manufacturing the Oxford-AstraZeneca jab, known locally as Covishield. The vaccine was more than 90% effective in a late-stage US-based clinical trial, according to the company.

India has already approved six other vaccines.

It’s currently using only three – Covishield, Covaxin by Indian firm Bharat Biotech and Russian-made Sputnik V – for its vaccination drive. Of these, Covishield accounts for over 90% of the doses given so far.

It also approved ZyCoV-D vaccine – the world’s first DNA vaccine against Covid – by Indian firm Cadilla, but it’s not available yet.

The federal government had also approved Johnson & Johnson’s single-dose vaccine, which was to be introduced in India through a supply agreement with Biological E; and it had authorised Indian pharma company Cipla to import the Moderna vaccine.

But it’s unclear when either of those will be available in India.

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

Vaccine equity issues among Omicron surge; the latest health stories from around the world

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A year and twenty days since the first jab was given, 10 billion Covid shots have been administered globally. However, gaps persist in who gets the vaccine since the milestone has not been arrived at equitably.

Theoretically, 10 billion doses could have meant at least one shot for each of the world’s 7.9 billion people. However, in the wealthiest countries, 77 percent of people have received at least one dose. In low-income countries, the figure is less than 10 percent and as the currently raging Omicron variant has proved, the fight against any pandemic is not over until the last man (or woman) standing is jabbed. Omicron emerged from Africa, easily the least vaccinated continent on earth, apart from Antarctica that is.

Meanwhile, the average number of daily deaths in the U.S. during the Omicron wave has now surpassed the number during the Delta surge.

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While the Omicron wave is beginning to crest in some areas of Europe, infection rates are still skyrocketing in other parts of the continent, particularly in the east.

As the variant storms its way eastward, countries are largely responding in one of two ways: Some have been clamping down to curb a spike in cases, while others have been easing restrictions as cases or hospitalizations fall, or in some cases, even as cases soar.

In the Netherlands, where stringent lockdowns have put a strain on the population, the Dutch government said that it was “taking a risk” in easing restrictions despite a growing caseload. In Austria, the health minister has said that rules for unvaccinated people would end this week.

Similar announcements have come from England, Denmark and France, where restrictions will ease starting February. But farther east, record virus caseloads are prompting governments to ramp up rules and testing.

In Germany, which has recorded an average of more than 123,000 cases per day in the last week, lawmakers have discussed a proposal for a vaccine mandate.

Poland has stepped up testing and switched to remote learning until the end of February for some older students. Eastern European countries like Bulgaria, Hungary and Romania are reporting records for daily cases that are projected to keep rising in the coming days.

The divergent situations demonstrate that while the virus may be waning in parts of Europe and North America, many countries across the world are still in the middle of the Omicron wave.

New daily cases remain at record highs globally, averaging about 3.3 million — an increase of more than 25 percent over two weeks. Cases have continued to rise in Latin America, the Middle East and Asia.

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Early next year, following the passage of a ballot measure in 2020 and under conditions currently being carefully worked out, Oregonians will be able to avail themselves of therapy using psilocybin, the psychoactive compound in “magic mushrooms”. Several other states, including conservative ones such as Texas, have approved medical research into psychedelics, according to www.economist.com/leaders/2022/01/29/it

America’s drugs regulator may approve mdma, better known as Ecstasy, for treating post-traumatic stress disorder as early as next year, and has hailed psilocybin as a “breakthrough therapy” in treating severe depression. The European Medicines Agency is conducting large-scale trials of psilocybin to treat otherwise intractable depression.

This new spirit of openness is inspired by the drugs’ promise in the treatment of various maladies of the mind. Studies testifying to their benefits are admittedly small, but they are growing in number. What is more, the results are striking.

The conditions that psychedelics seem to ameliorate include depression, addiction and post-traumatic stress disorder. Precisely how they work is unclear, which is one reason more research is required. Users report an increased sense of connectedness, a decrease in anxiety (particularly for terminally ill patients nearing the end) and a reduction in depressive symptoms. It seems that these benefits persist. In one study, 14 months after taking psilocybin, users reported a heightened sense of well-being and a belief that taking the drug was among the most meaningful experiences of their lives.

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Two days after Sarah Palin tested positive for the coronavirus, the former Alaska governor and US vice presidential nominee dined outdoors in New York City, defying federal guidance that infected people isolate from others for at least five full days.

Palin, who is unvaccinated, returned to Elio’s, the Upper East Side restaurant where she had been seen dining indoors on an earlier day despite the city’s requirement that indoor guests show proof of vaccination. Noncompliance can result in a $1,000 fine for business owners.

Luca Guaitolini, a manager for the restaurant who confirmed both of Palin’s visits in the past week, said the restaurant had “just made a mistake.”

An attorney for Palin did not immediately respond to a request for comment.

The office of New York City Mayor Eric Adams urged New Yorkers who may have come in contact with Palin to get tested, and later shared an updated statement on the events.

“By repeatedly flouting C.D.C. guidelines, Ms Palin has shown a complete disregard for the health and safety of small business workers and her fellow patrons,” a spokesman for City Hall said Thursday over email.

Palin also dined outdoors on an earlier evening at Campagnola, another Upper East Side establishment, where she signed autographs and took selfies, according to Gothamist.

But unlike restaurants, there is no penalty for people who refuse to quarantine.

At a conservative conference last month in Phoenix, Palin told the crowd, “It’ll be over my dead body that I’ll have to get a shot.”

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Short takes

www.science.org/content/article/news-glance-welcoming-stem-students-silent-radar-satellite-and-china-s-gene-edited?

Two of the world’s largest foundations last week pledged $150 million each to the non-profit Coalition for Epidemic Preparedness Innovations (CEPI), a global partnership working to prevent, prepare for, and equitably respond to future epidemics and pandemics. Leaders of the Bill & Melinda Gates Foundation and the Wellcome Trust called on nations to pony up at a CEPI “replenishment” conference scheduled for March to help it raise $3.5 billion for the next 5 years. CEPI has financed the development of the University of Oxford–AstraZeneca and Novavax vaccines. Its 5-year plan starting this year aims to shorten vaccine development time to less than 100 days after a new pathogen is sequenced, far shorter than the 11 months it took for the first COVID-19 vaccine.

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Nearly 1.3 million people died in 2019 from antimicrobial-resistant infections, according to a comprehensive global estimate. Such infections are a leading killer, causing more deaths than AIDS and malaria, according to the study, published on 19 January in The Lancet.

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

Indonesia plans new global health agency; the latest health stories from around the world

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Covid-19. Red liquid vaccine in glass tubes.. Cases of COVID-19 illustration. Image credit: Ivan Uralsky. vaccine hesitancy concept. Also to illustrate article re: emergency use authorisation. Oxford/AstraZeneca vaccine. Also used in coverage of vaccine hoarding. Vaccination campaign concept. Cost of COVID-19 vaccine concept. vaccine shipments concept. Sputnik V illustration.. Also to illustrate vaccine stockpiling. vaccine drive concept. Blood clots concern concept. vaccine patent waiver Covaxin trials concept. Free vaccines concept. Covishield approval concept. Vaccination coverage concept. paediatric trials concept. Illustration of COVID-19 vaccines. Vaccine drive illustration.
Image credit: Ivan Uralsky / 123rf

Indonesia plans to propose the creation of a new global health agency when leaders meet at the Group of 20 Summit. The agency will set up standard operating procedures for international travel and health protocols, as well as procure vaccines and ensure access and investment in medical equipment and medicines for developing countries, President Joko Widodo said in a statement at the World Economic Forum event.

https://www.bloomberg.com/news/articles/2022-01-20/indonesia-to-propose-new-global-health-agency-at-g20-summit

New Zealand will tighten COVID-19 restrictions when the Omicron variant hits but won’t resort to lockdowns, Prime Minister Jacinda Ardern said. When Omicron starts to spread in the community, the country will move to “red” from “orange” in its COVID protection framework, which will see gathering limits of 100 imposed on events, social distancing in hospitality venues and greater use of face masks, Ardern told reporters. However, “we won’t use lockdowns,” she said.

https://www.bloomberg.com/news/articles/2022-01-20/new-zealand-won-t-resort-to-lockdowns-when-omicron-arrives

More than two dozen generic-drug manufacturers have agreed to produce low-cost versions of Merck & Co.’s COVID-19 pill, a key step in bringing virus-fighting tools to lower-income countries that have struggled to get vaccines. Companies in Bangladesh, China, India, Kenya, South Africa, Vietnam and other countries signed pacts to supply more than 100 low- and middle-income nations, the United Nations-backed Medicines Patent Pool said Thursday.

https://www.bloomberg.com/news/articles/2022-01-20/drugmakers-sign-pacts-to-widen-access-to-merck-s-covid-pill

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Arguments over compulsory covid-19 vaccinations are raging across Europe. Austria is in the vanguard, having made vaccination obligatory for adults from February. Others may soon follow.

A new study by economists at Simon Fraser University in British Columbia, suggests that vaccine mandates work and that there may not be any need for nationwide blanket vaccine regulations. In the week after the announcement of a vaccine requirement to enter bars, gyms and restaurants in Canadian provinces, the researchers found that first-dose vaccinations increased by 42% over the previous week and by 71% over two weeks. They estimated that 287,000 more people were vaccinated within six weeks as a result. They also found rises in vaccination rates once mandates were announced in France, Germany and Italy in the summer of 2021.

Meanwhile, China, which has largely kept the coronavirus at bay since 2020, is going to ever more extreme lengths with lockdowns to quell outbreaks that have proliferated around the country in recent weeks, and a growing number of people are finding their lives suddenly upended as a result.

At least 20 million people in three cities were under full lockdown as recently as last week, and many more cities across the country have been subjected to partial lockdowns and mass testing. During the past month, at least 30 major Chinese cities have reported locally transmitted COVID cases.

The case numbers themselves are minuscule by global standards, and no COVID deaths have been reported in China’s current wave. On Friday, the health authorities reported a total of 23 new locally transmitted cases in five cities.

But many cases have involved the highly transmissible Omicron variant, and with each passing day, the government’s dogged pursuit of “zero Covid” is looking harder to achieve. Many wonder how long it can be maintained without causing widespread, lasting disruptions to China’s economy and society.
Meanwhile, the Omicron variant continues its march around the world. It has now come to Mexico, a place that never really shut down.
The highly transmissible Omicron variant has swept the globe since it was first detected in South Africa in November. But the fact that it is less likely to cause severe disease than previous coronavirus variants has led to heavy speculation over whether it might mark a turning point, or a conclusion, to the pandemic.

WHO Director-General Tedros Adhanom Ghebreyesus poured cold water on that theory on Tuesday, saying: “This pandemic is nowhere near over.”

Omicron is continuing to infect the world at a startling speed, with more than 18 million cases reported last week alone, according to WHO. The number of COVID patients in the United States is at a record high and continues to climb, overwhelming hospitals. From Australia to Germany, infections are surging to never-before-seen levels, putting a significant strain on health care systems.

“Omicron may be less severe — on average, of course — but the narrative that it is mild disease is misleading, hurts the overall response, and costs more lives,” Tedros said. “Make no mistake, Omicron is causing hospitalizations and deaths and even the less severe cases are inundating health facilities. The virus is circulating far too intensely with many still vulnerable.”

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China announced on last week that its birth-rate had plummeted for a fifth straight year, moving the world’s most populous country closer to the potentially seismic moment when its population will begin to shrink, and hastening a demographic crisis that could undermine its economy and even its political stability.

China is reaping the whirlwind of the one-child policy sown in 1980. The falling birth-rate, coupled with the increased life expectancy that has accompanied China’s economic transformation over the last four decades, means the number of people of working age, relative to the growing number of people too old to work, has continued to decline. That could result in labour shortages, which could hamper economic growth, and reduce the tax revenue needed to support an aging society.

The situation is creating a huge political problem for Beijing, which is already facing economic headwinds. Along with the demographic data, the country reported on Monday that growth in the last quarter of the year slowed to 4 percent.

China’s ruling Communist Party has taken steps to address the birth rate decline, by relaxing its notorious “one child” policy, first allowing two children in 2016 and as many as three since last year. It is also offering incentives to young families and promising improvement in workplace rules and early education.

A decline in the birth rate and an increase in life expectancy means there will soon be too few workers able to support an enormous and aging population. The estimated contraction would begin in 2027, some experts say, though others believe it would come sooner or has already begun.

The government has recognized the worrisome demographic trend and in 2013 began easing enforcement of the “one child” policy in certain circumstances. It then raised the limit to two children for all families in 2016, in hopes of encouraging a baby boom. It did not work.

The one-child policy was introduced in 1980. Growing affluence and social conditioning since then have made millions of Chinese couples appreciate the joys of a double income no kid (or one child at best) lifestyle.

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