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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August 3, 2023
TOP NEWS
Amid 4th COVID-19 summer wave, US plans for updated vaccines remain unclear; experts recommend some individuals get boosted now
As previously discussed in this newsletter, COVID-19 indicators, including hospital admissions, emergency department visits, test positivity, and wastewater levels, are increasing nationally. Currently, the numbers remain low, and experts largely agree that this summer bump will not reach the significant highs seen in past waves, primarily due to existing immunity from both vaccines and previous infections. The increases, for the fourth summer, likely portend that COVID-19 will become a seasonal threat, with both summer and winter waves. Dr. Katelyn Jetelina, who publishes the newsletter Your Local Epidemiologist, predicts that about 10-15% of Americans will be infected this summer if trends follow the previous 3 warm seasons.
In winter, more people socialize indoors (known to increase the risk of virus transmission), while in summer, more people travel and socialize in general. Adding to that, the recent heat wave in many parts of the US has driven more people indoors to air-conditioned, but not necessarily well-ventilated, spaces, increasing the risk of disease spread. Another factor behind the recent increase in indicators is that a year or more has passed since most people received a COVID-19 vaccination, meaning vaccine-induced immunity has waned over the past 6-9 months, leaving many susceptible to infection.
Based on discussions among public health officials, updated booster doses expected to be available later this year likely will target the XBB subvariant of the Omicron SARS-CoV-2 variant. Pfizer recently announced the company expects to receive US FDA authorization for its updated vaccine in August, although US CDC Director Dr. Many Cohen this week told NPR that the shots will be available to the public "probably in the early October time frame." The US House Select Subcommittee on the Coronavirus Pandemic has requested Dr. Cohen answer questions regarding fall vaccination plans as well as any plan for recommending annual COVID-19 vaccines, like those for flu. Also, the subcommittee's chair, Rep. Brad Wenstrup, this week opened an investigation into federal COVID-19 vaccination mandates and policies at several US agencies.
The lack of clarity surrounding when the updated shots will be available has left many wondering whether they should get a booster now. Though that decision rests with individuals, those who have weakened immune systems, are older, will be traveling, or are around crowds in social situations might consider getting a booster now, especially if it has been more than 3 months since their last dose. Additionally, availability of vaccines for flu and RSV is increasing, with several major pharmacy chains offering or planning to offer the shots soon.
US HHS announces formation of Office of Long COVID Research and Practice to coordinate federal response; NIH launches long-awaited series of clinical trials to test long COVID treatments
The US HHS this week announced the formation of the Office of Long COVID Research and Practice to lead and coordinate the federal government’s response to long COVID, a debilitating condition characterized by COVID-19 symptoms that last months beyond initial infection. Between 7.7 million and 23 million Americans are estimated to have long COVID. Additionally, the US NIH launched several phase 2 clinical trials to assess treatments for long COVID—from an intravenous immune drug to light therapy and a dietary supplement—part of a planned series of trials to test even more treatments in the months ahead.
The trials are part of the US$1.15 billion RECOVER initiative, first funded by the US Congress in December 2020. The studies were slated to begin last fall but were delayed 3 separate times. Long COVID patients, their advocates, and some researchers have criticized NIH for moving too slowly to find treatments for lingering COVID-19 symptoms and expressed frustration that early efforts have not yielded desired outcomes, recruited too few patients, or advocated interventions that could be harmful to patients. Several researchers said the trials—which will enroll about 100-300 patients each and examine treatments for symptoms such as brain fog and disturbed sleep—are a crucial step but only concrete progress will help to assure those affected that US health officials are taking their concerns seriously.
In related news, a growing number of long COVID patients who are denied disability benefits despite being unable to work are filing lawsuits seeking resolution of disability insurance claims. The Social Security Administration said about 1% of all new applications are associated with COVID-19. Experts say documentation of test results and medical care can assist patients seeking legal resolutions.
US State Department launches Bureau of Global Health Security and Diplomacy to prevent, detect, control, and respond to infectious diseases, including HIV/AIDS
The US Department of State this week launched the Bureau of Global Health Security and Diplomacy, with a mission to fortify the nation's global health security architecture to effectively prevent, detect, control, and respond to infectious diseases, including HIV/AIDS. According to a statement, the COVID-19 pandemic highlighted the need for US leadership in global health.
Ambassador-at-Large Dr. John N. Nkengasong will lead the bureau, serving as Ambassador-at-Large, US Global AIDS Coordinator, and Senior Bureau Official for Global Health Security and Diplomacy, reporting directly to the Secretary of State. Dr. Nkengasong was appointed last year to lead the US President’s Emergency Plan for AIDS Relief (PEPFAR), the bipartisan-supported program that is estimated to have saved 25 million lives over the past 20 years. During the launch, Dr. Nkengasong described PEPFAR as the US government's most successful global health program, underlining the importance of the "all-of-government response" that will be central to the new bureau. Meanwhile, PEPFAR, which is due for reauthorization by the US Congress by September 30, is embroiled in political battles over abortion.
MORE HEADLINES
US members of Congress call for reforms to PAHPA reauthorization, commission to study pandemic-related lessons
Rep. Chip Roy: Rep. Chip Roy calls on Speaker McCarthy to reform pandemic response legislation
Devex: US Congressman wants 9/11-style commission to examine pandemic lessons
Equity at center of pandemic negotiations but questions remain over how future responses can achieve goal
Health Policy Watch: Are The Three Pandemic Negotiations Bringing a Safer World Closer?
Policy Options: Future pandemics demand a response that’s better focused on inequities
NIH names University of Alabama at Birmingham infectious disease expert Jeanne Marrazzo to succeed Anthony Fauci as NIAID Director
Washington Post: NIH taps Jeanne Marrazzo to succeed Fauci as infectious-disease chief
STAT: Infectious disease expert Jeanne Marrazzo assumes Fauci role at NIH
AP: Alabama researcher will succeed Fauci in infectious disease post
See also: Science, Axios, and The Hill
US CDC director outlines vision for agency, how to rebuild public trust
NPR: The new CDC director outlines 3 steps to rebuild trust with the public
NPR: New CDC director Dr. Mandy Cohen on her vision for the agency
UK National Risk Register highlights key vulnerabilities, threats, including pandemic disease, extreme weather, AI
Politico EU: AI, nuclear ‘catastrophe’ and Putin: UK spells out deadly threats to Brits
BBC: Future pandemic and extreme weather among key threats to UK
The Telegraph: One in four chance of a ‘catastrophic’ pandemic in five years
Center for Health Security senior scholar makes predictions for upcoming flu season; studies, compendium address severe flu outcomes, immunity, surveillance
Force of Infection: Winter flu season outlook
CIDRAP: Risk of severe flu outcomes 7-fold higher in poorer nations, analysis finds
News Medical: Does the anti-influenza vaccination protect against SARS-CoV-2 infection?
Nature Reviews Microbiology: Co-evolution of immunity and seasonal influenza viruses
MedPage Today: Universal Flu Vaccine Candidate Shows Promise in Mid-Stage Trial
WHO: End-to-end integration of SARS-CoV-2 and influenza sentinel surveillance: compendium of country approaches
COVID-19 pandemic has lasting impact on educational systems, learning
World Bank Blogs: Rebuilding education systems after COVID-19: How the pandemic has impacted schooling and learning
The 74: Pandemic Emergency May Be Officially Over, but Education’s Long COVID Continues
See also: CBS: How did schools spend COVID-19 emergency funds?
Pfizer predicts update COVID-19 vaccine boosters authorized by end of month, considers cutting costs as demand for vaccine, treatment fall
NBC: Updated Covid boosters could be authorized by end of month, Pfizer says
The Hill: Pfizer sees revenue for COVID products fall, expects new booster authorized this month
Reuters: Pfizer considers cost cuts as demand for COVID products falls
Studies in JAMA Pediatrics examine COVID-19 vaccine effectiveness, risks of ICU stay, death, MIS-C
CIDRAP: Overall risk of pediatric ICU stay, death in COVID-19, MIS-C low, study shows
CIDRAP: Three vaccine doses most protective for children during Omicron in Brazil
See also: Lancet Digital Health: Effect of COVID-19 vaccination and booster on maternal–fetal outcomes: a retrospective cohort study
Older adults have slightly lower risk of several adverse events after receiving Moderna COVID-19 vaccine than after Pfizer-BioNTech shot, study shows
CIDRAP: Older people at slightly lower risk of adverse events after Moderna than Pfizer COVID vaccine
JAMA Network Open: Comparative Risks of Potential Adverse Events Following COVID-19 mRNA Vaccination Among Older US Adults
See also: Reuters: Moderna sees up to $8 bln in 2023 COVID vaccine sales on private market hopes
Staffing shortages strained nursing homes during COVID-19 pandemic, but pandemic loans temporarily boosted staff hours, studies suggest
News Medical: Study suggests staffing shortages during the COVID-19 pandemic placed strain on nursing homes
The 19th: Nursing home staffing hours were temporarily boosted by pandemic loans, study shows
Interventions to promote mental health should focus on decreasing stress, enhancing resilience among healthcare workers in pandemics; many leaving profession because of moral distress, injury
Scientific Reports: Depression in healthcare workers during COVID-19 pandemic: results from Czech arm of HEROES Study
NPR: Doctors have their own diagnosis: 'Moral distress' from an inhumane health system (commentary)
Healthcare workers who nose pick more at higher risk of COVID-19, study shows
The Guardian: Nose-picking healthcare workers more likely to catch Covid, data suggests
Washington Post: Nose picking linked to higher risk of covid, study shows
One Health framework utilized in South-East Asia risk assessment; using culture-centered communication approach under One Health model should improve acceptance, study suggests
WHO: Strengthening joint risk assessment using the One Health approach in South-East Asia
World Medical & Health Policy: BSL-4 laboratories, combatting conspiracies, and using a culture-centered approach to improve risk and crisis communication in a One Health framework (commentary)
Florida reports increasing incidence of Hansen disease (leprosy), with cases lacking traditional risk factors
New York Times: Leprosy May Be Endemic in Central Florida, Scientists Report
CNN: Central Florida is a hotspot for leprosy, report says
CBS News: Leprosy could be endemic in Central Florida, researchers say. What to know about the disease.
“Leprosy has likely been endemic in Florida for several years if not longer as it is home to armadillos, which carry the bacteria,” – Dr. Amesh Adalja, Senior Scholar at the Johns Hopkins University Center for Health Security, in Healthline
Climate change fueling cholera outbreaks, catching areas off guard, unprepared
AP: As climate change leads to more and wetter storms, cholera cases are on the rise
Undark: The World Is Not Prepared for Another Cholera Wave
Afghanistan, Pakistan edge closer to polio eradication, but workers continue to be attacked; several African nations launch polio vaccination campaigns
VOA: WHO: Afghanistan, Pakistan Close to Eradicating Polio
AP: Gunmen open fire on police officers during anti-polio drive in southwest Pakistan, killing 2
Precision Vaccinations: Polio Vaccines Deployed to Stop Outbreaks
Experts concerned over growing risk of H5N1 endemicity in North America; new bird outbreaks in Russia, China; Finland culls farmed minks, foxes; S. Korea recalls possibly contaminated cat food
The Atlantic: This Bird Flu Is Here to Stay
CIDRAP: Russia and China report new H5N1 avian flu outbreaks in birds
Reuters: Finland orders cull of 50,000 mink and foxes due to bird flu
Yonhap News Agency: S. Korea detects avian influenza virus in cat food
Strain of H1N1 virus jumped from humans to swine approximately 370 times since 2009, leading to new variants that crossed back to humans
SciTechDaily: Viral Ping-Pong: "Swine Flu" Strain Has Passed From Humans to Pigs Nearly 400 Times Since H1N1 Pandemic
PLOS Pathogens: Reverse-zoonoses of 2009 H1N1 pandemic influenza A viruses and evolution in United States swine results in viruses with zoonotic potential
Vietnam approves world's first commercial vaccines against African swine fever; several European countries fight outbreak, request assistance
Reuters: Vietnam approves commercial use of first African swine fever vaccines
Reuters: Serbia, Bosnia, Croatia fight African swine fever, ask for help
See also: NC State University: Is the U.S. Ready for an African Swine Fever Outbreak?
Emergent BioSolutions awarded up to US$704M from BARDA to develop Ebola treatment; pediatric patients now eligible for Merck's Ebola vaccine under FDA-approved expanded indication
CIDRAP: Emergent BioSolutions receives BARDA contract for Ebola treatment
Contagion Live: Indication for Ebola Vaccine Expanded to Pediatric Patients
China experiencing increase in mpox cases; authorities issue guidance, open vaccination centers
MIT Technical Review: China is suddenly dealing with another public health crisis: mpox
MIT Technical Review: Decoding the data of the Chinese mpox outbreak
ABC News: First was COVID. Now China is facing an mpox crisis as cases spike
South China Morning Post: 'No need to panic': Hong Kong mpox vaccination centre opens for high-risk groups, amid call for calm from experts, NGOs
See also: CIDRAP: Study shows proctitis as predictor of mpox among symptomatic men
Growing susceptibility of US, UK adults to measles causing concern among experts
STAT: Measles was once seen as a childhood disease. Increasingly, adults are susceptible, too
The Independent: Scientists fear 'tinder box effect' could spread measles in under-vaccinated London
The Conversation: Measles: it’s not just London that’s at risk of an outbreak – it’s all of the UK (opinion)
Related upcoming event: The International Vaccine Access Center is hosting a webinar and Q&A session on August 8, 9:30–10:30 AM EDT, on the dangerous rise in measles cases, attributable in part to missed routine immunizations during the pandemic and a growing mistrust in vaccines. Register here.
