Thursday, November 16, 2023

Johns Hopkins weekly newletter 11-16-2023

Roundup and analysis of the top headlines on health security, pandemic preparedness, COVID-19, and other news from the Johns Hopkins Center for Health Security

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November 16, 2023



Note: We will not publish on November 23 in observance of the US Thanksgiving holiday. We will resume publication on November 30.

TOP NEWS

US respiratory virus season in full swing; other nations see increased flu activity

The respiratory virus season in the US is in full swing, with the “tripledemic” diseases—RSV, flu, and COVID-19—increasing nationwide, especially in the South. Influenza-like illnesses (ILI) have exceeded the baseline, marking the onset of flu season. This is its second earliest start in 6 years, with 2.9% of doctor visits nationwide being for symptoms like fever, cough, or sore throat. Puerto Rico has declared an influenza epidemic, with high levels of activity and numerous hospitalizations and deaths, particularly among unvaccinated older adults and children. RSV is also at a very high level, with some US states experiencing intense seasons despite expectations of a calmer year.

For the first time in US history, vaccines for all 3 major respiratory viruses are available this fall, but vaccination rates for COVID-19 and RSV remain significantly lower than for flu. Experts continue to highlight the importance of vaccination, especially for those at higher risk of developing serious complications, including older adults and those with underlying medical conditions. About 36 million adults in the US—about 14% of the US adult population—have received the updated 2023-24 COVID vaccine, whereas nearly 35% of the US adult population have received the flu vaccine. As for those aged 65 years and older, 57.6% have received the flu vaccine and 13.5% of adults aged 60 and older have gotten an RSV vaccine.

Among children, only 4.9% have received the updated COVID vaccine and 32.6% have received a flu vaccine. Though there is a new monoclonal antibody shot to lower the risk of RSV-related hospitalization among newborns, premature infants, or young children with health conditions that put them at higher risk, shortages of the new tool have raised concern as the nation enters what could be another severe RSV season.

Flu activity is up in some other Northern Hemisphere locations and tropical countries. In East Asia, China and South Korea saw increased flu levels, while several nations in Southeast Asia, Southern Asia, and the Americas also reported rises. In the last half of October, 86% of positive flu samples were influenza A, including the H3N2 and 2009 H1N1 subtypes.

Climate change poses serious risks to human health, wellbeing, Lancet Countdown report, other groups warn ahead of COP28

Several new reports were released this week ahead of the global climate summit known as COP28, taking place in Dubai November 30 to December 12. In addition to reports from the UN Framework Convention on Climate Change, the World Economic Forum, a group of 7 climate organizations, and the US government, the Lancet Countdown on health and climate change published its eighth report. Together, the reports warn in no uncertain terms, that rising temperatures are already impacting human health and, if left unabated, will have catastrophic consequences for human survival.

Among some of the impacts seen already: heat-related deaths are rising; air pollution is increasing the risk of death and adverse outcomes from various conditions; serious and life-threatening bacteria are spreading into new areas due to warming waters; disease-carrying insects and dangerous fungal spores are moving into new territories; and food insecurity is affecting a record number of people worldwide.

As part of its Fifth National Climate Assessment—which says climate change-associated threats pose risks to the economy, human health, ecosystems, buildings, homes, and infrastructure like roads, with impacts that could exacerbate existing inequalities—the US government published an interactive atlas to help Americans anticipate how changing climate conditions might affect their homes and businesses. There are some signs of progress, but experts agree that more actions must be taken on climate and health to avoid a “dangerous future.”

MORE HEADLINES

PAHPA reauthorization unlikely this year due to political disagreements, lack of engagement; 100 stakeholder groups call for quick action; commentary proposes how to best prepare for next pandemic

Axios: Pandemic prep bill falls victim to COVID politics

The Telegraph: How to break the cycle of panic and neglect surrounding pandemics (commentary)

US House approves amendment to HHS spending bill that would ban on federal funding for so-called gain-of-function research; scientists worry provision could hinder important research if passed

STAT+: House moves to limit so-called gain-of-function research

Science: House approves ban on gain-of-function pathogen research

See also: Hopkins Bloomberg Public Health Magazine: Gain-of-Function Research: Balancing Science and Security

WHO says Israeli military incursion of Gaza hospital ‘totally unacceptable’; UN human rights chief says disease outbreaks, hunger ‘inevitable’

Reuters: WHO says Israeli raid on Gaza hospital is totally unacceptable

New York Times: Israel Seizes Gaza Hospital That Became Symbol of the War Itself

Health Policy Watch: Israeli Troops Enter Shifa Hospital – WHO Decries Move as “Totally Unacceptable”

Reuters: U.N. human rights chief says widespread disease, hunger inevitable in Gaza

NBC News: Disease runs rampant in Gaza as clean water runs out

International Committee of the Red Cross: The protection of hospitals during armed conflicts: What the law says

See also: The Telegraph: ‘Tragic milestone’ hit as 1,000 attacks against doctors and hospitals recorded in Myanmar

Americans’ trust in science, scientists lower now than before pandemic, survey finds; US CDC director works to restore trust in agency

Pew Research Center: Americans’ Trust in Scientists, Positive Views of Science Continue to Decline

STAT: One-quarter of Americans have little to no confidence in scientists to act in public’s best interests, per report

Washington Post: How CDC’s new director is trying to regain trust shattered by covid

Recent conference sessions, journal article, blog post address various aspects of rebuilding trust in science

American Public Health Association: Fighting for Public Health: Coming Together in a Divided World

International Science Council: Reframing Trust in Science for Multilateral Policy: Insights from the Science Journalists Forum

Psychological Science: Vaccine Nationalism Counterintuitively Erodes Public Trust in Leaders

Gavi VaccinesWork: To Prevent the Next Pandemic, Follow the Science

Generative AI could spread more convincing health misinformation, guardrails needed, experts warn

Axios: Deepfakes could supercharge health care's misinformation problem

Flinders University: Medical researchers find AI fails pub test

Review, commentary examine misinformation during COVID-19 pandemic, effectiveness of interventions, impacts

Health Affairs: A Systematic Review Of COVID-19 Misinformation Interventions: Lessons Learned

JAMA Internal Medicine: Health Disinformation—Gaining Strength, Becoming Infinite (commentary)

Routine vaccination exemptions at record high level among US kindergartners, CDC report shows

CBS: School vaccination exemptions now highest on record among kindergartners, CDC reports

ABC: Exemptions for routine childhood vaccination at highest level ever: CDC report

Your Local Epidemiologist: Drop in routine vaccinations

See also: AP: UK experts recommend chickenpox shot for kids for the first time, decades after other countries

Nations must redouble efforts to fill gaps in measles vaccination coverage to prevent future outbreaks, make progress toward elimination, report says

ABC News: "Staggering" rise in global measles outbreaks in 2022, CDC and WHO report

MMWR: Progress Toward Measles Elimination — Worldwide, 2000–2022

COVID-19 contributed to widening gender gap in US life expectancy, now 73.2 years for men, 79.1 for women

STAT: Life expectancy for men in U.S. falls to 73 years — six years less than for women, per study

JAMA: Widening Gender Gap in Life Expectancy in the US, 2010-2021

About 20% of COVID-19 patients experienced virologic rebound after taking Paxlovid, study shows; WHO releases 13th update of COVID-19 treatment guidelines

STAT: Study suggests Covid rebound is far more common with Paxlovid than without

See also: WHO release: WHO updates guidelines on treatments for COVID-19

Receiving COVID, flu vaccinations at same time safe, effective, and might produce more immune response against SARS-CoV-2, studies suggest; about 36M people in US have gotten updated COVID jab

CIDRAP: Coadministration of COVID, flu vaccines as effective as when given separately, data suggest

NBC News: Should you get your Covid and flu shots at the same time? New research suggests yes

ABC News: About 36M American adults have received the updated COVID vaccine: CDC

“The key thing is to see if this has any kind of meaningful clinical benefit – do the higher levels of antibody translate into more protection against infection or disease?” – Dr. Amesh Adalja, Senior Scholar at the Center for Health Security, told The Guardian about the study, which is not yet peer-reviewed.

COVID, flu vaccine uptake lagging among US healthcare workers, CDC studies show

CIDRAP: COVID, flu vaccine uptake in US healthcare workers lacking

MMWR: Influenza and Up-to-Date COVID-19 Vaccination Coverage Among Health Care Personnel — National Healthcare Safety Network, United States, 2022–23 Influenza Season

MMWR: Declines in Influenza Vaccination Coverage Among Health Care Personnel in Acute Care Hospitals During the COVID-19 Pandemic — United States, 2017–2023

As scientists learn more about how long COVID affects the brain, task force publishes consensus guidance on treatment of mental health symptoms in long COVID patients

NPR: Scientists are beginning to understand how long COVID symptoms affect the brain

NPR: Pain, fatigue, fuzzy thinking: How long COVID disrupts the brain

MedPage Today: Long COVID and Mental Illness: New Guidance

See also: New York Times: Can’t Think, Can’t Remember: More Americans Say They’re in a Cognitive Fog

Texas governor signs bill banning COVID-19 vaccine mandates for all private businesses, including hospitals

Texas Governor: Governor Abbott Signs COVID Vaccine Freedom Bill At Governor’s Mansion

Undark: Texas Implements a New Ban on Covid-19 Vaccine Mandates

Articles address steps companies, schools, individuals can take to improve indoor air quality

Harvard Business Review: It’s Time for Companies to Monitor Workplace Air Quality

US Green Building Council: Takeaways and next steps for school district leaders after IAQ workshop

Forbes: How Spending Long Winter Days Indoors Can Impact Your Health

BMJ investigation examines concerns over informed consent for pregnant women who participated in Pfizer RSV vaccine trial

The BMJ: The BMJ investigates concerns over informed consent for pregnant women in Pfizer’s RSV vaccine trial

The BMJ: Concerns over informed consent for pregnant women in Pfizer’s RSV vaccine trial

US CDC updates 2014 guidelines for preventing, treating naturally occurring anthrax

CIDRAP: CDC updates advice for preventing, treating anthrax

CDC MMWR: CDC Guidelines for the Prevention and Treatment of Anthrax, 2023

DRC continues fight against mpox as disease fades from global spotlight; researchers develop mpox severity scoring system for all clinical settings

Gavi VaccinesWork: Fading from global headlines, mpox continues to trouble its ‘cradle’ – DRC

CIDRAP: Scientists develop mpox severity scoring system that could improve care, research

Georgetown center launches open-access database to track wildlife diseases; researchers confirm CWD for first time in Yellowstone National Park mule deer

Georgetown University School of Medicine: Georgetown Global Health Center Launches First Open-Access Wildlife Disease Database

See also: CIDRAP: CWD confirmed in Yellowstone National Park for first time

Avian flu not impacting turkey, egg prices in US ahead of Thanksgiving; Italy, Peru, South Africa report on bird flu outbreaks, containment

Axios Des Moines: Avian flu isn't gouging turkey, egg prices this Thanksgiving

Reuters: Italy reported bird flu outbreak on farm, WOAH says

Emerging Infectious Diseases: Highly Pathogenic Avian Influenza A(H5N1) from Wild Birds, Poultry, and Mammals, Peru

Reuters: S.Africa says bird flu under control, egg supply improving

See also: CIDRAP: Major poultry producers agree to antimicrobial stewardship principles

US FDA approves first vaccine for mosquito-borne chikungunya virus

Washington Post: FDA approves first vaccine against mosquito-borne virus chikungunya

Fox News: First vaccine for chikungunya virus, an 'emerging global health threat,' gets FDA approval

See also: Mercury News: Southern California confirms 1st human case of mosquito-borne St. Louis Encephalitis since 1984

Warmer, wetter weather contributes to longer, more widespread dengue outbreaks in Asia

Reuters: Rising temperatures, longer monsoon drive Bangladesh's worst dengue outbreak

Nikkei Asia: Dengue fever sweeps through Asia, helped by hotter and wetter weather

See also: Duke NUS Medical School: New research shows maternal dengue immunity worsens birth defects caused by Zika virus

US FDA authorizes first home test for 2 STIs; UK panel recommends use of meningitis vaccine for gonorrhea; new antibiotic, developed under new model, could treat drug-resistant gonorrhea

CNN: FDA authorizes first home test for chlamydia and gonorrhea

STAT: U.K. recommendation could lead to world’s first use of meningitis vaccine to curb gonorrhea

New York Times: Gonorrhea Is Becoming Drug Resistant. Scientists Just Found a Solution.

UK authorizes world’s first-ever CRISPR-based gene therapy for 2 blood disorders

Reuters: UK authorises gene therapy for blood disorders in world first

STAT+: U.K. approves world’s first CRISPR-based medicine, giving greenlight to therapy for sickle cell, thalassemia

Series examines ways to ‘fix’ US hospitals; low-income countries’ healthcare systems hold lessons for those in high-income nations, doctor says

Third Way: Fixing America's Broken Hospitals

NPR: What the Global South could teach rich countries about health care — if they'd listen

See also: Global Health NOW: Africa’s Contribution to Global Health Security

FROM THE CENTER

More than 100 stakeholder groups join Center for Health Security in calling on US Congress leadership to reauthorize PAHPA

This week, more than 100 stakeholders, including the Johns Hopkins Center for Health Security, Biotechnology Innovation Organization (BIO), Association of State and Territorial Health Officials (ASTHO), and other groups representing academia, industry, and research institutes, sent a letter to congressional leadership urging them to reauthorize the Pandemic and All-Hazards Preparedness Act (PAHPA) before the end of the calendar year and with the same bipartisan support it has had since its original authorization 17 years ago.

“Our nation’s changing health security threat landscape and the federal government’s responsibility to protect the American people demand that we work together now to find a strong bipartisan path forward to reauthorize this critical legislation,” write the signatories. “Failing to reauthorize PAHPA would have serious effects on our country’s economic well-being, national security, and health security given the rapidly changing threat landscape.”

See a full list of signatories and read the full letter here: https://centerforhealthsecurity.org/2023/more-than-100-stakeholder-groups-call-on-us-congress-leadership-to-reauthorize-pahpa

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