June 23, 2022: Johns Hopkins COVID 19 Situation Report

COVID-19 Situation Report

Editor: Alyson Browett, MPH

Contributors: Clint Haines, MS; Noelle Huhn, MSPH; Natasha Kaushal, MSPH; Amanda Kobokovich, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; Marc Trotochaud, MSPH; and, Rachel A. Vahey, MHS.

CALL FOR PAPERS There is an opportunity to integrate Global Catastrophic Biological Risks (GCBRs) into pandemic preparedness policy and practice. In 2023, Health Security will devote a supplement to GCBRs. We encourage submissions of original research articles, case studies, and commentaries that discuss lessons learned from the COVID-19 pandemic response and/or key policy and technology advances that could prevent or better prepare for a future, potentially more severe, globally catastrophic infectious disease pandemic. The deadline is October 3, 2022. For more information: https://www.centerforhealthsecurity.org/our-work/journal/call-for-papers/index.html

MONKEYPOX OUTBREAKS UPDATE Read our latest update from June 15 on the monkeypox outbreaks and visit our monkeypox resource page. We will continue to analyze the situation and provide updates, as needed. If you would like to receive these updates, please sign up here.

EPI UPDATE The WHO COVID-19 Dashboard reports 538 million cumulative cases and 6.32 million deaths worldwide as of June 22.* The global weekly incidence remained relatively stable (-0.68%) from the previous week, when incidence was up nearly 8% after 3 weeks of decline. Global weekly mortality decreased as well, down 11% from the previous week. At the regional level, Europe (+17%), Southeast Asia (+46%), and the Eastern Mediterranean (+52%) experienced increases, while the other 3 regions had decreasing trends.

*The WHO COVID-19 dashboard indicates that there is a delay in reporting for the African Region, so the current totals may not be complete.

UNITED STATES

The US CDC is reporting 86.4 million cumulative cases of COVID-19 and 1,009,444 deaths. The average daily incidence has plateaued over the past several weeks, holding relatively steady at approximately 100-110,000 new cases per day. The current 7-day average is 99,365 new cases per day. Likewise, the average daily mortality has held relatively steady at approximately 250-300 deaths per day since late May.* Notably, the current 7-day average is 248, the lowest level since July 13, 2021.

*Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

Both new hospital admissions (+1.5% over the past week) and current hospitalizations (+1.1%) continue to increase, although they appear to have stabilized over the past week. Considering the plateau in daily incidence, it is possible that hospitalizations could also remain elevated, rather than peaking and then declining.

Community transmission in the US continues to be driven by the BA.2.12.1 sublineage of Omicron (56%), but BA.5 (23.5%) and BA.4 (11.4%) are now outpacing BA.2 (9.1%). The prevalence of BA.4 and BA.5 now appears to be increasing more rapidly than BA.2.12.1. These 4 sublineages of the Omicron variant represent all new SARS-CoV-2 infections in the US.

PEDIATRIC VACCINES Taking the recommendation of its advisory committee, the US FDA on June 17 authorized pediatric formulations of both the Moderna and Pfizer-BioNTech SARS-CoV-2 vaccines for children as young as 6 months old. The following day, US CDC Director Dr. Rochelle Walensky endorsed the agency’s Advisory Committee on Immunization Protection (ACIP)’s recommendation that all children younger than age 5 get vaccinated against COVID-19. US President Joe Biden visited a vaccine clinic in Washington, DC, on June 21 to mark the rollout of the last major phase of vaccinations in the nation, with virtually all individuals now eligible to receive at least 1 of 3 authorized or approved SARS-CoV-2 vaccines. In his remarks, President Biden said the availability of vaccines for the youngest children marks a “monumental step forward” and provides “some peace of mind” for parents who have been waiting 18 months since the first vaccines were authorized for adults. There are about 19 million children aged 6 months to 5 years in the US.

The Biden administration has said 10 million doses are available for distribution to states and healthcare providers, but only 2.5 million doses of the Pfizer-BioNTech vaccine and 1.3 million doses of the Moderna vaccine have been ordered to date. While some parents have expressed excitement and relief at the vaccines’ availability, it remains unclear how many will vaccinate their young kids. Only 29% of 5-11 year-olds are fully vaccinated, while 59% of those aged 12-17 years are fully vaccinated. Some parents already are facing challenges securing an appointment to get their children vaccinated, despite a federal operational plan released and implemented earlier this month. While neighborhood pharmacies and pharmaceutical chains are included in this phase of the vaccination campaign, many are expecting families to go to primary care physicians and pediatricians because of trust, familiarity, and relationships that may not exist at the pharmacy. Additionally, some parents are weighing the differences between the 2-dose Moderna and 3-dose Pfizer-BioNTech vaccines for children.

The FDA also authorized Moderna’s vaccine for children and adolescents ages 6-17 last week. The CDC’s ACIP is meeting today to discuss clinical considerations and recommendations for the vaccine in that age group. The Pfizer-BioNTech vaccine is already available for adolescents and older children.

ANTIBODY ESCAPE A correspondence letter in the New England Journal of Medicine published June 22 by authors from the Beth Israel Deaconess Medical Center in Boston provides new evidence that Omicron subvariants, including BA.4 and BA.5, are showing substantial escape from neutralizing antibodies provided by vaccination or infection. The authors evaluated neutralizing antibody titers against against the original wildtype SARS-CoV-2 and Omicron subvariants BA.1, BA.2, BA.2.12.1, and BA.4 or BA.5 among 27 participants vaccinated with the Pfizer-BioNTech vaccine who had no indications of prior infection and 27 participants with recent infection with the BA.1 or BA.2 subvariants a median of 29 days earlier (range: 2-113 days), a majority of whom were vaccinated. Among vaccinated but never infected participants, neutralizing antibody titers compared to wild-type SARS-CoV-2 were lower by “a factor of 6.4 against BA.1, by a factor of 7.0 against BA.2, by a factor of 14.1 against BA.2.12.1, and by a factor of 21.0 against BA.4 or BA.5.” Participants with a prior history of infection with BA.1 or BA.2 showed similar trends with neutralizing antibody titers compared to wild-type SARS-CoV-2 lowered by “a factor of 6.4 against BA.1, by a factor of 5.8 against BA.2, by a factor of 9.6 against BA.2.12.1, and by a factor of 18.7 against BA.4 or BA.5.” The authors asserted that these findings indicate that the Omicron variants continue to feature further neutralization escape, which may lead to increased infection among populations with prior immunity against the virus. Findings in a recent Lancet Infectious Diseases correspondence provided similar evidence of substantial escape from neutralizing antibodies against Omicron variants among individuals vaccinated with the Sinopharm vaccine, with only partial recovery after a booster shot of the same vaccine.

SARS-COV-2 REINFECTION The newest Omicron subvariants of BA.4 and BA.5 are driving increases in new SARS-CoV-2 infections in several regions, with many people experiencing reinfections despite immunity from prior infection or vaccination (1+ shots). These subvariants appear to be able to evade antibodies more easily than their predecessors, possibly due to new and different spike proteins. Though global COVID-19-associated mortality appears to be decreasing, a new preprint study posted on Research Square cautions that reinfections pose an increased risk of hospitalization (HR 2.98), all-cause mortality (HR 2.14), and sequelae in pulmonary and other organ systems. The risk of these adverse outcomes—including those impacting the heart, blood, kidneys, lungs, and brain—were most pronounced in the acute phase of infection but persisted throughout the 6-month follow up. Additionally, for every reinfection (1, 2, 3+) there was a stepwise increase in risk for all sequelae evaluated, including hospitalization. Although not yet peer-reviewed, the study serves as a signal that the COVID-19 pandemic remains a threat to the health of the world’s population, and individuals must continue to take precautions to prevent infection.

MODERNA BIVALENT BOOSTER Moderna announced June 22 that it plans to seek regulatory approval for an updated booster vaccine, mRNA-1273.214, after new clinical data on the bivalent candidate showed success against newer Omicron variants. The announcement comes in anticipation of fall booster shots, with the company saying it could ship doses as early as August. Moderna found that mRNA-1273.214 increased neutralizing titers against BA.4 and BA.5 Omicron subvariants among all participants (95% CI: 5.0, 5.9). Neutralizing titers increased by 6.3-fold (95% CI: 5.7, 6.9) among specifically seronegative patients. However, the boost to neutralizing titers for BA.4 and BA.5 was not quite as high as the boost in neutralizing titers against the original Omicron variant, BA.1, or the Delta variant. Moderna noted that a peer-reviewed manuscript describing clinical trial data should be available soon.

Scientists are hopeful that this new booster, as well as others under investigation, will aid in improving protection against a potential surge in the fall. However, both Moderna and BioNTech leadership expressed concern that regulatory processes needed to update boosters could cause delays, hoping that future updates to the most recent strains can be done without clinical trials. In a separate announcement, Moderna said it will establish a new research and manufacturing center in the UK, allowing that country to gain access to mRNA platform-based vaccines.

COVID-19 REBOUND Following a US CDC health advisory issued last month warning about the potential for recurrence of COVID-19 or “COVID-19 rebound” following treatment with the antiviral Paxlovid, several new studies suggest potential causes of the occurrence and support initial studies’ findings that rebound happens in only a small proportion of patients. A study published June 20 in Clinical Infectious Diseases examined the experience of one patient with rebound following Paxlovid treatment. The researchers, from the University of California San Diego School of Medicine, isolated the SARS-CoV-2 BA.2 variant from the patient with symptom relapse and sampled their plasma to test for viral immunity. They found the isolate had not developed drug resistance, nor did the patient have impaired immunity, leading them to hypothesize the rebound likely was the result of insufficient exposure to the drug.

Another study (preprint), posted to medRxiv and conducted by US NIH researchers, examined clinical, virologic, and immune measurements of 7 patients with COVID-19 rebound, 6 who had taken Paxlovid and 1 without previous treatment. Again, the researchers found no evidence of drug resistance, viral mutation, or impaired immune response. Instead, they found the rebounds were associated with elevated SARS-CoV-2-specific antibody and cellular immune responses, possibly due to the body trying to clear residual viral antigens possibly shed from dying infected cells. Both studies were very small and may not be generalizable to all COVID-19 rebound cases; additional larger studies are needed to confirm their findings. On June 21, the US CDC’s Morbidity and Mortality Weekly Report (MMWR) published a study examining 5,287 Paxlovid-treated patients aged 12 years and older, finding less than 1% experienced COVID-19-related hospitalization or emergency room visits 5-15 days after treatment was dispensed.

PANDEMIC INEQUALITY The COVID-19 pandemic has drastically impacted people’s health, income, and various social risk factors, worsening existing inequalities and exposing others. Nature uses 6 graphs to explore the pandemic’s effects. The graphs express various data sets examining specific issues globally, in low- and middle-income countries, and in the US, UK, and Brazil. Notably, by the end of this year, 75 million more people will be pushed into poverty—living on less than US$1.90 per day—than was expected before the pandemic, derailing gains made prior to 2020 and highlighting the need for increased efforts to get the world back on track toward the UN Sustainable Development Goals.

US NATIONAL PUBLIC HEALTH SYSTEM A bipartisan commission of health leaders this week released a set of recommendations to overhaul public health in the US, with the aim of creating a “national public health system” to protect and improve health, advance health equity, and effectively respond to emergencies. The authors call for changes that could address current health challenges—including rising maternal mortality, overdoses, and diabetes—and avoid a repeat of what it called a “splintered” response to COVID-19 that led to widely disparate outcomes nationwide. The Commonwealth Fund Commission on a National Public Health System proposal outlines actions for the US Congress; the administration of US President Joe Biden; and state, local, tribal, and territorial governments to create a coordinated and collaborative national public health system.

ISW: June 15 Ukraine War

RUSSIAN OFFENSIVE CAMPAIGN ASSESSMENT, JUNE 15

Jun 15, 2022 - Press ISW

Download the PDF

Russian Offensive Campaign Assessment, June 15

Karolina Hird, Kateryna Stepanenko, Mason Clark, and Grace Mappes

June 15, 6pm ET

Click here to see ISW's interactive map of the Russian invasion of Ukraine. This map is updated daily alongside the static maps present in this report.

Western officials announced additional military aid for Ukraine on June 15. US President Joe Biden pledged $1 billion worth of military aid, including coastal defense weapons, advanced rocket systems, artillery, and ammunition to support Ukrainian operations.[1] NATO members additionally announced they will additionally continue to provide Ukraine with heavy weapons and long-range systems and plan to agree on a new assistance package after consultations with Ukraine’s Defense Ministry.[2] This newest round of military aid will be invaluable to support Ukrainian operations, especially in the face of increasingly protracted and artillery-heavy fighting against Russian forces in Eastern Ukraine, though Ukraine will require further sustained support.

Key Takeaways

• Russian forces launched ground assaults in Severodonetsk and settlements in its vicinity but have not taken full control over the city as of June 15.
• Russian forces launched largely unsuccessful offensive operations around the T1302 Bakhmut-Lysychansk highway in an effort to cut Ukrainian ground lines of communication (GLOCs) to Lysychansk.
• Russian forces continued efforts to advance along the E40 highway to Slovyansk and southeast of Izyum.
• Russian and Ukrainian forces continued to fight in northeastern settlements around Kharkiv City.
• Russian forces continued to fortify fallback positions in Zaporizhia and Kherson Oblasts, while undertaking defensive measures to strengthen Russian presence in the Black Sea.
• The Kremlin and proxy republics continue to pursue ad hoc annexation policies in occupied territories.

We do not report in detail on Russian war crimes because those activities are well-covered in Western media and do not directly affect the military operations we are assessing and forecasting. We will continue to evaluate and report on the effects of these criminal activities on the Ukrainian military and population and specifically on combat in Ukrainian urban areas. We utterly condemn these Russian violations of the laws of armed conflict, Geneva Conventions, and humanity even though we do not describe them in these reports.

• Main Effort—Eastern Ukraine (comprised of one subordinate and three supporting efforts);
• Subordinate Main Effort—Encirclement of Ukrainian troops in the cauldron between Izyum and Donetsk and Luhansk oblasts
• Supporting Effort 1—Kharkiv City;
• Supporting Effort 2—Southern Axis;
• Activities in Russian-occupied Areas

Main Effort—Eastern Ukraine

Subordinate Main Effort—Southern Kharkiv, Donetsk, Luhansk Oblasts (Russian objective: Encircle Ukrainian forces in Eastern Ukraine and capture the entirety of Donetsk and Luhansk oblasts, the claimed territory of Russia’s proxies in Donbas)

Russian forces continued ground assaults in and around Severodonetsk but have not yet captured the Azot industrial plant or taken full control of the city as of June 15.[3] Russian forces have largely isolated Ukrainian troops in Severodonetsk from their lines of communication and are attacking Severodonetsk from multiple directions.[4] Russian troops also conducted an unsuccessful assault in Toshkivka, likely to drive northwards towards Lysychansk instead of conducting an opposed river crossing after having destroyed bridge access to Lysychansk from Severodonetsk.[5] Russian forces continued to fire on settlements surrounding Severodonetsk to further isolate Ukrainian troops and complicate their withdrawal or re-supply efforts.[6]

Russian forces continued offensive operations towards Slovyansk from the southeast of Izyum and made incremental gains on June 15.[7] A Russian Telegram channel claimed that Russian forces captured Dolyna, about 20 kilometers northwest of Slovyansk along the E40 (also known as the M03) highway.[8] Russian forces additionally continued fighting in Dolyna in Krasnopillya and are likely using their positions around Bohorodychne to launch operations to the southeast along the E40 highway.[9]

Russian forces continued ground assaults east of Bakhmut and made marginal gains along the critical T1302 Bakhmut-Lysychansk highway on June 15. Russian forces reportedly broke through Ukrainian defenses in Vrubivka and are fighting for control of Mykolaivka, Yasylivka, Yakovlikva, and Berestove, all settlements within 10 kilometers of the T1302.[10] The Ukrainian General Staff additionally noted that Russian forces re-deployed one battalion tactical group (BTG) to the Bakhmut area from Kupyansk and deployed unspecified elements of the 8th Combined Arms Army to the Komyshuvakha-Popasna area.[11] This deployment to the Bakhmut area indicates that Russian forces are increasingly prioritizing their force grouping around Bakhmut in order to drive up the T1302 highway and complete the encirclement of Lysychansk and Severodonetsk.

Russian forces may be staging false flag attacks around Donetsk City to dissuade pro-Ukrainian sentiment. Local residents of Donetsk City and Makiivka reported heavy shelling of infrastructure within both cities.[12] Donetsk People’s Republic (DNR) authorities accused Ukrainian forces of conducting the artillery strikes, but social media users and the Ukrainian Center for Counteracting Disinformation denied these claims and stated that they were likely perpetrated by Russian troops in order to foster anti-Ukrainian sentiments or encourage mobilization into proxy forces.[13] These potential false flag attacks may be a response to statements made by Western officials on June 15 announcing increasing military aid for Ukraine.[14]

Supporting Effort #1—Kharkiv City (Russian objective: Withdraw forces to the north and defend ground lines of communication (GLOCs) to Izyum)

Russian forces continued ground assaults northeast of Kharkiv City to push Ukrainian troops away from occupied frontiers near the Russian border on June 15.[15] Russian forces are likely fighting in Rubizhne (in Kharkiv, not Luhansk Oblast), Tsupivka, Ternova, Staryi Saltiv, and Verkhnii Saltiv.[16] Russian troops continued to fire on settlements around Kharkiv City.[17]

Supporting Effort #2—Southern Axis (Objective: Defend Kherson and Zaporizhia Oblasts against Ukrainian counterattacks)

Russian forces continued to focus on defensive operations in preparation for potential Ukrainian counterattacks along the Southern Axis on June 15.[18] The Ukrainian General Staff stated that Russian forces are improving their engineering equipment around two settlements just southeast of Davydiv Brid, where Ukrainian forces are still conducting limited counterattacks.[19] Russian forces are additionally regrouping in Zaporizhia Oblast.[20] The Zaporizhia Regional Military Administration reported that Russian troops are fortifying positions in Dniprorudne (western Zaporizhia Oblast) with equipment from Crimea and regrouping around Vasylivka to support operations along the Vasylivka-Orikhiv-Huliapole line.[21] The Ukrainian General Staff stated that Russian forces additionally deployed an electronic warfare complex to Melitopol, likely to further support their defensive presence in Zaporizhia and counter ongoing partisan actions.[22]

Russian forces are likely attempting to strengthen their presence in the northwestern Black Sea. Satellite imagery from June 14 shows an increase in fortifications and military equipment on Snake Island.[23] The Russian-appointed Kherson occupation administration stated that the Kherson Commerical Sea Port has resumed operations and will begin cargo transport.[24] While Ukrainian forces still control the critical coastline location of Ochakiv, Mykolaiv Oblast, and can possibly interdict Russian shipping, Russian forces likely intend to strengthen control over port access in the Black Sea under the protection of a fortified naval presence on Snake Island.

Activity in Russian-occupied Areas (Russian objective: consolidate administrative control of occupied areas; set conditions for potential annexation into the Russian Federation or some other future political arrangement of Moscow’s choosing)

Head of the Donetsk People’s Republic (DNR) Denis Pushilin continued attempts to establish economic partnerships between occupied areas of Donetsk Oblast with Russian territories. Pushilin met with the governors of Chelyabinsk Oblast and the Yamalo-Nenets Autonomous Okrug in order to agree on a patronage framework for cooperation with occupied Volnovakha and Yasinuvata.[25] Pushilin additionally met with governor of St. Petersburg to arrange for the restoration of Mariupol.[26] Pushilin is likely seeking to arrange for infrastructure assistance to restore these cities, but his continuous pursuit of ad hoc arrangements with Russian territorial bodies indicates continued inconsistencies between annexation policies pursued by DNR authorities.

Russian authorities are continuing to face difficulties implementing their occupation agendas due to pro-Ukrainian pressure in occupied areas. The Ukrainian Resistance Center reported that unidentified Ukrainian partisans targeted employees of the Russian Emergency Ministry in Mariupol on June 9 and 11.[27] The Ukrainian Resistance Center additionally claimed that Russian occupation authorities are unable to open schools in occupied Berdyansk due to resistance from Ukrainian teachers, who are refusing to teach under Russian curricula.[28] Such pro-Ukrainian action will likely continue to disrupt Russian efforts to consolidate full-scale administrative control of occupied areas and Russian annexation agendas.

January 16, 2022: Johns Hopkins COVID 19 Situation Report

Editor: Alyson Browett, MPH

Contributors: Clint Haines, MS; Noelle Huhn, MSPH; Natasha Kaushal, MSPH; Amanda Kobokovich, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; Marc Trotochaud, MSPH; and, Rachel A. Vahey, MHS.

NOTICE We will not publish the COVID-19 Situation Report on Tuesday, June 21, in recognition of the US Juneteenth holiday. We will resume publication on Thursday, June 23.

MONKEYPOX OUTBREAKS UPDATE Read our latest update from June 1 on the monkeypox outbreaks and visit our monkeypox resource page. We will continue to analyze the situation and provide updates, as needed. If you would like to receive these updates, please sign up here.

EPI UPDATE The WHO COVID-19 Dashboard reports 534 million cumulative cases and 6.31 million deaths worldwide as of June 15*. The global weekly incidence increased 4.3% from the previous week, following 3 consecutive weeks of decline. Global weekly mortality increased as well—for the first time since early February**—up 7.1% from the previous week.

*The WHO COVID-19 dashboard indicates that there is a delay in reporting for the African Region, so the current totals may not be complete.

**With the exception of a 1-week spike the week of March 21, which appears to be the result of a reporting anomaly in the Americas and South-East Asia.

UNITED STATES

The US CDC is reporting 85.7 million cumulative cases of COVID-19 and 1,007,374 deaths. The average daily incidence has plateaued over the past several weeks, holding relatively steady at approximately 100-110,000 new cases per day. Despite the ongoing elevated daily incidence, we have not observed a corresponding increase in daily mortality. Daily mortality has held relatively steady at approximately 275-325 deaths per day since late April*. *Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

Despite the absence of a surge in COVID-19 mortality, both new hospital admissions (+6.5% over the past week) and current hospitalizations (+1.8%) continue to increase. Notably, both trends appear to be tapering off to some degree. Considering the plateau in daily incidence, it is possible that hospitalizations could also remain elevated, rather than peaking and then declining.

Community transmission in the US continues to be driven by the BA.2.12.1 sublineage of Omicron (64.2%), followed by BA.2 (14.2%), BA.5 (13.3%), and BA.4 (8.3%). The prevalence of BA.2.12.1 increased slightly from last week, but the prevalence of BA.4 and BA.5 are increasing more rapidly. These 4 sublineages of the Omicron variant represent essentially all new SARS-CoV-2 infections in the US.

PANDEMIC TREATY On June 14, the WHO published an annotated draft outline of the prospective pandemic prevention, preparedness, and response treaty. The treaty is currently being drafted by an intergovernmental negotiating body representing WHO Member States, with the aim of establishing a global system for building and maintaining resilience to pandemics and other large-scale disease threats. The draft outline does not contain much detail, but it presents a framework of priority topic areas to be included in the treaty. The outline is organized such that it addresses equity, systems and tools, governance and leadership, and financing for the 4 key phases of pandemic readiness: prevention, preparedness, response, and recovery. The draft includes some specific items under some sections as well as placeholders for sections on One Health, access and benefit sharing, scientific cooperation, health literacy, and broader governance issues. The stated goal is to finalize the text of the treaty in time for consideration at the 77th World Health Assembly in 2024, and considerable uncertainty remains regarding the treaty’s final structure and content.

Importantly, independent experts around the world are publishing their own recommendations regarding the scope and content of the treaty. In a letter published this week, Women in Global Health emphasize the importance of including explicit language to protect healthcare workers. They argue that a treaty that focuses solely on government responsibilities and actions, pharmaceutical and non-pharmaceutical supplies and products, and patients would be insufficient to ensure a safe and supportive environment to protect frontline healthcare workers, who are critical for pandemic response. Researchers from Georgetown University (US) emphasize that the treaty should be informed by current available evidence to identify appropriate policies, systems, and capabilities. They outline 12 key elements that should be included in an evidence-based treaty, which broadly address 4 key facets of pandemic resilience: “(1) reducing spillover risk, (2) reducing pandemic risk, (3) reducing pandemic impacts, and (4) ensuring recovery and resilience.” Their 12 key elements address the human/animal/environmental interface, strengthening public health and healthcare systems and capacities, medical countermeasure (MCM) research and development, selecting appropriate government response policies and actions, government transparency and accountability, legal issues, and equity and justice.

PEDIATRIC VACCINE In their June 15 meeting, members of the US FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted unanimously in favor of authorizing the Moderna and Pfizer-BioNTech SARS-CoV-2 vaccines for use in children aged 6 months to 5 years (21-0 for both vaccines). The 3-dose Pfizer-BioNTech vaccine series demonstrated an overall 80.3% efficacy against symptomatic COVID-19, and the 2-dose Moderna series demonstrated 50.6% efficacy among children aged 6-23 months and 36.8 among those aged 2-5 years. Notably, the top-line efficacy estimate for the Pfizer-BioNTech vaccine is based on only 10 total cases of COVID-19 (7 in the placebo group, 3 in the vaccine group), which contributes to the wide confidence interval, particularly for children aged 6-23 months. The US CDC’s Advisory Committee on Immunization Practices (ACIP) is scheduled to meet June 17-18, and it is expected to issue its recommendation regarding the 2 vaccines. The final FDA authorization and CDC guidance is still required, but it is possible that the first doses for this age group could be available by early next week.

Despite the long-anticipated decision for some parents, it is still unclear how many will choose to vaccinate their youngest children. As health experts have pointed out, infants and preschool-aged children already have a considerable number of recommended routine vaccinations, including several multi-dose series. Adding another 2- or 3-dose series could be a barrier for some parents due to the extra logistical hurdles of additional visits to the doctor’s office. Most states are still anticipating demand for the newest pediatric series and have already ordered millions of doses. Notably, Florida is the only state not to place a pre-order with the federal government. Still, as more evidence continues to surface on the severe illness faced by children hospitalized with COVID-19, many with no underlying health conditions, the scales may tip further in the direction of vaccination.

PAXLOVID CLINICAL TRIAL On June 14, Pfizer announced plans to halt enrollment in its current clinical trial for Paxlovid, a SARS-CoV-2 antiviral drug. This decision came after preliminary data did not show a reduction in hospitalization and death among “standard-risk” participants—ie, those who do not have underlying health conditions that put them at elevated risk for severe disease and death. The risk decreased by approximately 50%, but it was not a statistically significant benefit. The drug also failed to demonstrate benefit in terms of alleviating COVID-19 symptoms. Due to the lower risk of severe disease and death among these individuals—and therefore, low benefit from the drug—Pfizer elected to terminate the trial. The current Emergency Use Authorization (EUA) for Paxlovid only applies to high-risk patients. Pfizer indicated that it will include data from this clinical trial in its New Drug Application (NDA) for full US FDA approval for use in high-risk patients.

VARIANT-SPECIFIC VACCINE On June 15, Pfizer and BioNTech announced that the European Medicines Agency (EMA) has initiated a rolling review for their variant-specific candidate SARS-CoV-2 vaccine. Major SARS-CoV-2 vaccine manufacturers have been working to update their vaccine profiles as evidence shows diminishing protection against new variants, particularly against the now-dominant Omicron variant. The Pfizer-BioNTech candidate is among the first updated vaccines to begin a formal regulatory review process. With the rolling submission process, the EMA will be able to review data as they become available. The EMA stated that its review will initially focus on manufacturing quality assurance and safety, followed by clinical trial safety and efficacy data as they become available. The announcement also indicated that the companies intend to submit an application to the US FDA in the near future.

CANADA TRAVEL RESTRICTIONS The Canadian government announced that it will lift some SARS-CoV-2 vaccination requirements for domestic and international travel. Starting June 20, Canada will no longer require vaccination for domestic or outbound air, bus, or rail passengers nor for federally regulated transportation sector personnel. Despite these changes, international travelers may still be subject to vaccination requirements. Notably, Canadian citizens and permanent residents who are not fully vaccinated must provide documentation of a negative SARS-CoV-2 test prior to entering the country, and they are subject to testing and quarantine requirements after their arrival. Travelers who are not citizens nor residents are still required to be fully vaccinated to enter Canada, but vaccination is no longer required for international rail or flights departing Canada. Due to the high risk of transmission, vaccination requirements will remain in effect for cruise ships, and other risk mitigation measures will continue for domestic travel, including mandatory mask use. Canada also announced that it will temporarily suspend mandatory random testing at airports through June 30, in an effort to reduce traveler wait times. Starting July 1, all required testing will be moved off-site to reduce the burden on airports.

UNIVERSAL HEALTH CARE Researchers from several US universities, led by the Yale School of Public Health, published findings from their research on the projected benefit if the US had a universal healthcare system during the COVID-19 pandemic. The study, published in PNAS, found that the US could have prevented nearly 339,000 COVID-19 deaths and saved more than US$105 billion in just hospitalization costs under universal health care, based on excess hospitalizations and mortality attributable to the loss of employer-sponsored insurance and low insurance coverage during the pandemic. At the time the study was conducted, the cumulative COVID-19 mortality in the US was 973,459 deaths, so the projected total benefit of universal healthcare would have reduced US COVID-19 mortality by approximately one-third. In 2020 alone, the researchers estimate that universal health care could have prevented more than 200,000 total deaths, including from COVID-19 and non-COVID-19 causes. The absence of universal health care results in myriad barriers to accessing health services, including screening and testing critical to early diagnosis of COVID-19 and other health conditions as well as preventive services, such as vaccination. And the high cost of care can delay care-seeking behavior, which can result in more severe disease. The additional patient burden from COVID-19 also negatively impacted hospital capacity, which compounds increases in mortality. The researchers argue that the fragmented healthcare system and existing societal vulnerabilities left the US ill-prepared to combat the pandemic.

Russian Offensive Campaign Assessment, June 13

RUSSIAN OFFENSIVE CAMPAIGN ASSESSMENT, JUNE 13

Jun 13, 2022 - Press ISW

Download the PDF

Russian Offensive Campaign Assessment, June 13

Kateryna Stepanenko, Mason Clark, George Barros, and Grace Mappes

June 13, 7:30pm ET

Click here to see ISW's interactive map of the Russian invasion of Ukraine. This map is updated daily alongside the static maps present in this report.

Kremlin-sponsored outlet Izvestia published and quickly removed an appeal by the First Deputy Head of the Russian Presidential Administration Sergey Kirelenko for Russia to rebuild the Donbas on June 12 and blamed hackers for what they (likely falsely) claimed was a “fake publication.” Izvestia likely intended to save the article for a later date to set informational conditions for Russian annexation of Donbas. Kirelenko’s appeal stated that Russia will restore the Donbas regardless of high costs or if doing so lowers the standard of living in Russia.[1] Izvestia blamed unknown hackers for publishing a “fake article,” but it is possible that hackers instead released an article Izvestia had prepared to publish at a later date. The Kremlin previously published and removed an article prematurely celebrating a Russian victory over Ukraine in late February and discussing the capture of Ukraine in past tense in anticipation of Ukraine’s capitulation during the first Russian-Ukrainian negotiations in Belarus.[2] Unnamed Kremlin officials previously identified Kirelenko as the future head of a new Russian federal district, which would encompass Donbas, and occupied settlements in Kherson and Zaporizhia Oblasts.[3]

Russia continues to deploy insufficiently prepared volunteer and reserve forces to reinforce its ongoing operations. Kremlin-sponsored outlet Izvestia released footage showing Russian artillery reservists undergoing training with old D-20 howitzers reportedly within 10 days of their deployment to Ukraine.[4] The reservists focused on learning how to operate hand-held weapons, despite being reportedly only days away from deploying. Social media footage also showed Russian forces transporting Russian volunteer and reserve units with T-80BV tanks (a variant produced in 1985, as opposed to the modernized T-80 BVM operated by the 1st Guards Tank Army) and BMP-1 armored personnel carriers (which have largely been phased out in favor of the BMP-2) to Belgorod Oblast on June 9.[5] Additional social media footage showed Russian forces transporting T-80BV tanks removed from storage in Moscow Oblast on June 9.[6]

Key Takeaways

• Russian forces pushed Ukrainian defenders from the center of Severodonetsk and reportedly destroyed the remaining bridge from Severodonetsk to Lysychansk on June 13, but Ukrainian officials reported that Ukrainian forces are not encircled in the city.
• Russian forces carried out unsuccessful ground assaults in an attempt to sever Ukrainian ground lines of communications (GLOCs) near Popasna and Bakhmut.
• Russian forces launched unsuccessful offensive operations southeast of Izyum and north of Slovyansk, and are likely setting conditions for an assault on Siversk and northwestern Ukrainian GLOCs to Lysychansk.
• Russian forces are likely conducting a limited offensive directly northeast of Kharkiv City in a likely attempt to push Ukrainian forces out of artillery range of Russian rear areas and secured some successes.
• Russian and Ukrainian forces are engaging in ongoing fighting for Davydiv Brid in northwestern Kherson Oblast.
• Russian occupation authorities likely staged terrorist activity in Melitopol and Berdyansk for Russia Day on June 12.

We do not report in detail on Russian war crimes because those activities are well-covered in Western media and do not directly affect the military operations we are assessing and forecasting. We will continue to evaluate and report on the effects of these criminal activities on the Ukrainian military and population and specifically on combat in Ukrainian urban areas. We utterly condemn these Russian violations of the laws of armed conflict, Geneva Conventions, and humanity even though we do not describe them in these reports.

• Main Effort—Eastern Ukraine (comprised of one subordinate and three supporting efforts);
• Subordinate Main Effort—Encirclement of Ukrainian troops in the cauldron between Izyum and Donetsk and Luhansk oblasts
• Supporting Effort 1—Kharkiv City;
• Supporting Effort 2—Southern Axis;
• Activities in Russian-occupied Areas

Main Effort—Eastern Ukraine

Subordinate Main Effort—Southern Kharkiv, Donetsk, Luhansk Oblasts (Russian objective: Encircle Ukrainian forces in Eastern Ukraine and capture the entirety of Donetsk and Luhansk oblasts, the claimed territory of Russia’s proxies in Donbas)

Russian forces conducted offensive operations in Severodonetsk and pushed Ukrainian forces away from the city center on June 13 but did not fully capture the city. Ukrainian Defense Ministry Spokesperson Oleksandr Motuzyanyk noted that Russian forces did not entirely clear Severodonetsk of Ukrainian resistance due to Russia’s reluctance to commit its (likely understrength) infantry units and overreliance on artillery and assault aviation for offensive operations.[7] The Ukrainian General Staff added that fighting is still ongoing in Severodonetsk.[8] Luhansk Oblast Administration Head Serhiy Haidai reported that Russian forces destroyed the last remaining bridge from Severodonetsk to Lysychansk and retain a significant artillery advantage over Ukrainian forces.[9] Deputy Head of the Donetsk People’s Republic (DNR) Militia Eduard Basurin blamed Ukrainian forces for destroying the bridge (though it is highly unlikely Ukrainian forces would willingly destroy the bridge while any of their forces remained in Severodonetsk and this claim is likely false) and claimed that Russian forces are entirely encircling remaining Ukrainian troops in Severodonetsk.[10] Haidai denied Basurin’s claims of encirclement, noting that Ukrainian forces still have limited military channels for the evacuation of wounded troops and reinforcements despite the destruction of all three bridges.[11] Haidai specified that Ukrainian authorities could not conduct civilian evacuations and humanitarian efforts because Russian forces damaged the third bridge prior to its destruction on June 13. Geolocated footage showed that Ukrainian forces continued to hold defensive positions around the Azot Chemical Plant on June 12.[12] The Ukrainian General Staff reported that Russian forces also conducted unsuccessful offensive operations on Metolkino, approximately 4km east of Severodonetsk.[13]

Russian forces unsuccessfully attacked settlements adjacent to Ukrainian ground lines of communication (GLOCs) south of Lysyschansk. The Ukrainian General Staff reported that Ukrainian forces repulsed Russian assaults on Vrubivka, a settlement on a connecting road to the Lysychansk-Bakhmut T1302 highway.[14] Russian forces reportedly resumed ground assaults near Zolote, a settlement adjacent to the Ukrainian GLOCs along the T1303 highway to Lysychansk.[15] A Luhansk People’s Republic (LNR) Militia commander (under the pseudonym Chapai) claimed that Russian forces seized Toshkivka, approximately 4.5km east of the T1303, but the Ukrainian General Staff reported that Russian forces continued to shell Ukrainian positions in the settlement on June 13, indicating fighting likely remains ongoing.[16] Russian forces reportedly conducted unsuccessful assaults on Kodema and Novoluhanske - approximately 15 and 21km south of Bakhmut, respectively.[17] Pro-Russian Telegram Rybar claimed that elements of the Russian Wagner Group have been fighting in Pokrovske (12.5km east of Bakhmut) since June 11, but Ukrainian sources stated that Russian forces are carrying out aerial reconnaissance in the settlement.[18]

Russian forces launched unsuccessful offensive operations southeast of Izyum and in settlements north of Slovyansk but did not resume assaults in the Lyman area on June 13. The Ukrainian General Staff reported that Russian forces attacked Bohorodychne, approximately 25km southeast of Izyum, but only secured the northwestern outskirts of the settlement.[19] Russian forces also launched an unsuccessful assault on Dolyna, a settlement along the E40 highway to Slovyansk.[20] Ukrainian military journalist Andriy Tsaplienko reported that Ukrainian forces are conducting counteroffensives just west of Izyum and have liberated Zavody and Spivakivka, but Ukrainian officials did not confirm this report.[21] Russian forces are likely continuing their preparations to cut off Ukrainian GLOCs to Lysychansk from Siversk and the northwest. Russian forces reportedly shelled Maiaky (just five kilometers northeast of Siversk) and transferred up to 80 units of military and artillery equipment to Kreminna and Starobilsk.[22] LNR Ambassador to Russia Rodion Miroshnik claimed that Russian forces will likely simultaneously attack Lysychansk and Siversk to block Ukrainian forces from retreating to Slovyansk.[23] Russian forces likely seek to set conditions for direct assaults against Siversk and settlements northwest of Lysychansk in the next two weeks.

Russian forces did not conduct any offensive operations east or west of Avdiivka on June 13 and continued to shell surrounding settlements.[24] Ukraine’s Joint Forces Task Force reported liberating three unnamed settlements and pushing back the line of contact by 15km in Donetsk Oblast, though ISW cannot independently verify this claim.[25]

Supporting Effort #1—Kharkiv City (Russian objective: Withdraw forces to the north and defend ground lines of communication (GLOCs) to Izyum)

Russian forces are likely conducting a limited offensive directly northeast of Kharkiv City in a likely attempt to push Ukrainian forces out of artillery range of Russian rear areas. Russian forces made incremental territorial gains in settlements along the Ukrainian-Russian border northeast of Kharkiv City on June 13. The Ukrainian General Staff reported that Russian forces launched partially successful ground assaults on the border settlements of Ternova and Izbutske, approximately 40km northeast of Kharkiv City, and secured the northern outskirts of Izbutske.[26] Pro-Russian Telegram channel Rybar claimed that Russian and Ukrainian forces are engaging in trench and artillery warfare in Tsupivka and Velyki Prokhody, just west and east of the Kharkiv City-Belgorod City highway.[27] Geolocated footage confirmed that Ukrainian forces continued to target Russian ammunition storages in Velyki Prokhody.[28] Kharkiv Oblast Head Oleg Synegubov reported that Russian forces launched MLRS strikes on residential areas of Kharkiv City overnight.[29]

Supporting Effort #2—Southern Axis (Objective: Defend Kherson and Zaporizhia Oblasts against Ukrainian counterattacks)

Ukrainian forces reportedly continued to gradually attack Russian positions on the eastern bank of Inhulets River in northwestern Kherson Oblast. The Ukrainian Southern Operational Command noted that Ukrainian and Russian forces engaged in heavy fighting in the Davydiv Brid area, an operationally significant settlement situated on the eastern Inhulets riverbank and on Russian ground lines of communication (GLOCs) along the T2207 highway.[30] The Ukrainian General Staff reported that Russian forces conducted aerial reconnaissance over Davydiv Brid, but the scope of Ukrainian advances in the settlement remains unclear.[31] Russian forces continued to fortify their positions and reportedly strengthened the grouping of troops in areas near the Dnipropetrovsk-Kherson Oblast border.[32]

Ukrainian artillery struck Russian fuel and ammunition depots in Polohy, approximately 60km west of Zaporizhia-Donetsk Oblast border.[33]

Activity in Russian-occupied Areas (Russian objective: consolidate administrative control of occupied areas; set conditions for potential annexation into the Russian Federation or some other future political arrangement of Moscow’s choosing)

Russian authorities may have staged false flag attacks in Melitopol and Berdyansk on June 12, likely to accuse Ukrainian partisans of targeting civilians. Self-proclaimed head of the Zaporizhia Oblast Military-Civilian Administration Vladimir Rogov made a preliminary announcement that “terrorists” staged three explosions in Berdyansk, before retracting his statements and identifying the situation as an accident at the electrical station.[34] Rogov falsely maintained that Berdyansk residents attribute any emergency in the city to Ukrainian efforts to disturb peaceful life in “liberated” (Russian-occupied) regions. Self-proclaimed deputy head of the Zaporizhia Oblast Internal Affairs Ministry Alexei Selivanov also claimed that unknown assailants planted an explosive device in Melitopol to disrupt Russia Day (the day of adoption of the declaration of Russian state sovereignty after the collapse of the Soviet Union).[35] Zaporizhia Oblast Military Administration Head Oleksandr Starukh noted that Ukrainian authorities warned that Russian forces could stage terrorist activity prior to Russia Day.[36]

Russian occupation authorities continue to face personnel shortages that impede their occupation measures. The Ukrainian Military Intelligence Directorate (GUR) reported that Russian forces in Mariupol were unable to recruit collaborators by promising individual applicants 10,000 rubles per month and switched to offering payments in food supplies, given the dire humanitarian situation in the city.[37] The GUR added that Russian occupation authorities are inviting any volunteers to clear out rubble and dead bodies in Mariupol. Mariupol Mayor’s Adviser Petro Andryushenko noted that the Russian occupation authorities are restricting access to humanitarian aid for individuals younger than 65 years of age.[38] Russian occupation authorities in Mariupol may be attempting to gain the support of elderly citizens and coerce younger residents to work with Russian forces in exchange for food. Russian occupation authorities additionally deployed Donetsk People’s Republic (DNR) police officers to patrol Kherson City.[39] The GUR also noted that Russian occupation authorities are recruiting teachers without pedagogical education and transporting educators from Crimea to replace Melitopol teachers that refused to teach Russian curriculums.[40] Russian occupation authorities are also attempting to bribe civilians by offering debt forgiveness of all loans taken from Ukrainian banks.[41]

Russian occupation authorities continue to introduce new titles for personnel that agreed to cooperate with the Kremlin and its proxies. The Donetsk People’s Republic Head (DNR) Denis Pushilin appointed previous Ukrainian Mayor of Sviatohirsk Vladimir Bandura as the new Sviatohirsk Administration Head after Bandura agreed to cooperate with Russian forces.[42] Russian occupation authorities have seemingly eliminated the position of mayor in occupied settlements, likely to fully institute their own governance structures rather than taking over existing structures.

Russian occupation authorities are continuing to exploit Ukrainian agrobusiness and have reportedly banned the export of crops to Ukrainian government-controlled territories from Russian occupied settlements.[43] The GUR also noted that Russian forces are coercing Kherson Oblast businessmen and farmers to hand over 70% of their harvest to Crimean buyers at low profit margins.

Above is available daily from:  https://www.understandingwar.org/backgrounder/russian-offensive-campaign-assessment-june-13?campaign_id=249&emc=edit_ruwb_20220614&instance_id=64035&nl=russia-ukraine-war-briefing&regi_id=53444314&segment_id=95116&te=1&user_id=8a776225d84f290294e4274317e366a5

June 14, 2022: Johns Hopkins COVID 19 Situation Report

COVID-19 Situation Report

Editor: Alyson Browett, MPH

Contributors: Clint Haines, MS; Noelle Huhn, MSPH; Natasha Kaushal, MSPH; Amanda Kobokovich, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; Marc Trotochaud, MSPH; and, Rachel A. Vahey, MHS.

MONKEYPOX OUTBREAKS UPDATE Read our latest update from June 1 on the monkeypox outbreaks and visit our monkeypox resource page. We will continue to analyze the situation and provide updates, as needed. If you would like to receive these updates, please sign up here.

SARS-CoV-2 ORIGINS On June 9, the WHO Scientific Advisory Group for the Origins of Novel Pathogens (SAGO) published the first preliminary report from its efforts to determine key analyses necessary to identify the origin of SARS-CoV-2 and future emerging and re-emerging pathogens. While SAGO was not explicitly tasked with identifying the original source of SARS-CoV-2, the report indicates that the available evidence remains insufficient to fully characterize the circumstances around the emergence of the virus. The experts indicate that the available evidence suggests that the closest ancestor of the virus likely circulated in wild bat populations before the spillover event into humans. The report indicates that it is not possible to rule out that the virus escaped from a research laboratory, but additional investigation is required to more fully characterize that scenario. Several SAGO members included a note in the report, however, to emphasize that they identified “no new scientific evidence” to support this theory and did not support continuing this line of investigation.

The report includes a series of recommendations regarding data and analyses that would further support efforts to identify the original source of the COVID-19 pandemic. SAGO recommends further analysis of environmental specimens from the Hunan seafood market and of potential animal and environmental sources to identify the route of SARS-CoV-2 introduction to the market. Additionally, analysis of human respiratory pathogen specimens (eg, influenza, enteroviruses) collected prior to the emergence of COVID-19 could help identify previously undetected SARS-CoV-2 infections. Genetic analysis of infections in wild and livestock animal populations could similarly help identify related coronaviruses or intermediate hosts that may have facilitated spillover into human populations. The SAGO report also highlights the need for these types of analyses regarding the emergence of new SARS-CoV-2 variants. Some independent experts continue to call attention to the lack of transparency by the Chinese government, including restrictions on access to specimens, facilities, and personnel necessary to conduct these investigations.

SAGO also outlines key components of a global framework to guide response activities and investigations into the emergence or re-emergence of future pathogens. This framework largely mirrors SAGO’s calls for additional data related to SARS-CoV-2. Specifically, the group notes the importance of investigating human and animal specimens; interactions between humans, animals, and the environment; genomics and phylogenetics; biosafety and biosecurity systems and processes; and research activities or other human interaction with related pathogens.

ACUTE HEPATITIS & LONG COVID Researchers from Israel published findings from their study on instances of long-term COVID-19 liver manifestation among children. The study, published in the Journal of Pediatric Gastroenterology and Nutrition, involved a retrospective investigation of 5 patients hospitalized in an Israeli children’s hospital. Each of the patients had a confirmed SARS-CoV-2 infection and presented with long-term liver injury stemming from their infection. Two of the patients in the study, both under 6 months of age, presented with acute liver failure, the other 3 patients, ranging between ages 8 and 13 years, presented with acute hepatitis and cholestasis.

This review adds to the growing list of evidence tying post-acute sequelae of COVID-19 (PASC/Long COVID) to cases of acute hepatitis of unknown origin. Last month, multiple technical and news media publications documented an international cohort of children with severe hepatitis. Many experts have suggested that COVID-19 could be a potential source for this unexplained manifestation, considering the lack of apparent epidemiological explanations. The US CDC is examining a series of US cases of acute hepatitis as well, and a recent update indicates that adenovirus type 41 could be a possible causative agent as well. While much has been written about Long COVID, many questions remain, and advocates continue to call for expanded research efforts into explanations and treatments.

US PEDIATRIC VACCINATION Last week, the Biden Administration outlined its SARS-CoV-2 vaccination plans for children under 5 years of age. The current estimates suggest that up to 18 million children may become eligible for SARS-CoV-2 vaccination once the US FDA authorize existing vaccines for emergency use in younger children. The White House has allocated 10 million doses for states to distribute to dispensing sites. Notably, the White House estimates that 85% of the newly eligible pediatric population lives within 5 miles of one of these sites. The allotment of vaccines is approximately even between the Pfizer-BioNTech and Moderna vaccines. Despite a ready supply of vaccines and a plan to make them accessible to a large number of children in this age group, questions remain regarding the willingness of parents and caretakers to get the children vaccinated. In the age group of children from 5-11 years, only one-third of eligible children have received the vaccine.

US TRAVEL RESTRICTIONS On June 12, the US CDC lifted its testing requirement for travelers arriving in the US on flights originating in other countries. In the CDC’s announcement rescinding the policy, CDC Director Dr. Rochelle Walensky noted that the availability of vaccines, therapeutics, and alternative testing options (eg, rapid at-home test kits)—as well as the current prevalence of vaccination coverage in the US—largely render the testing restrictions obsolete, and she emphasized that the CDC continues to recommend full vaccination against SARS-CoV-2, including with the appropriate booster dose/s.

Previously, international air travelers with destinations in the US were required to obtain a negative PCR-based or antigen test within 1 day of departure—or provide documentation of recent recovery from SARS-CoV-2 infection—regardless of vaccination status. The policy was instituted in the final days of the Trump Administration and continued under President Joe Biden. Notably, the restrictions only applied to international air travel and did not cover individuals entering the US via land borders nor domestic air travel. The travel industry, particularly airlines, has long called for the testing requirement to be eliminated, arguing that it was originally instituted at a time when the vast majority of the US was unvaccinated. Additionally, some health officials and other experts have argued that the testing mandate provided little protection for travelers or benefit in terms of slowing domestic transmission or the introduction of new SARS-CoV-2 variants into the US.

US SEROPREVALENCE The US CDC COVID-19 Response Team published updated analysis of infection- and vaccine-induced SARS-CoV-2 seroprevalence in the US. The findings, published in JAMA, are based on more than 2.4 million blood donations collected from individuals aged 16 years and older across all 50 states; Washington, DC; and Puerto Rico from July 2020-December 2021. The research does not include individuals with active SARS-CoV-2 infection or who were suspected COVID-19 cases, and results were weighted by demographic factors, including age, sex, race, and ethnicity.

The researchers observed increases in both infection-induced seroprevalence and combined seroprevalence between May 2021 and December 2021, increasing from 20.2% to 28.8% and 83.3% to 94.7%, respectively. At the end of the timeframe for the study, researchers observed the highest level of infection-induced seroprevalence in multiple demographic groups—including individuals aged 16-29 years (40.0%), non-Hispanic Black individuals (32.5%), and Hispanic individuals (32.5%)—as well as the Midwest (31.7%) and South (33.5%) regions.

Notably, regions with higher vaccine coverage seroprevalence exhibited a significantly smaller increase in infection-induced seroprevalence. In regions with vaccine-induced seroprevalence less than 60%, infection-induced seroprevalence increased by 19.8% over the course of 2021, compared to only 10.6% in regions with vaccine seroprevalence greater than 80%. Despite widespread combined seroprevalence at the end of 2021, the Omicron variant was still able to drive a major surge in early 2022, and the researchers note that this illustrates the transmissibility and immune escape potential of new variants.

BA.4 & BA.5 SUBVARIANTS IN EUROPE The European CDC published an epidemiological update on the emergence and prevalence of the BA.4 and BA.5 sublineages of the SARS-CoV-2 Omicron variant of concern (VOC). The subvariants were first detected in Europe in March, and in May, Portugal was the first European country to report a COVID-19 surge associated with one of the subvariants (BA.5). Notably, Portugal’s daily incidence appeared to peak in late May/early June. While most European countries have reported relatively low prevalence of these subvariants, they represent an increasing proportion of new sequenced specimens in multiple countries over the past several weeks, including Austria, Belgium, Denmark, France, Germany, Ireland, Italy, Netherlands, Spain and Sweden. In particular, the BA.4 and BA.5 subvariants represent more than 25% of sequenced specimens in Belgium over the second half of May, and more than 10% in some communities in Spain. The increasing prevalence of BA.4/BA.5 corresponds to increasing COVID-19 daily incidence in most of those countries as well.

The ECDC projects that BA.4 and BA.5 will become the dominant variants across Europe “in the coming weeks” and that the continent can expect an associated COVID-19 surge like those in the countries noted above. The daily incidence in Europe has increased nearly 30% since June 6, with even larger increases in the UK. While there is “no evidence” these subvariants pose higher risk of severe disease, the ECDC notes that an overall increase in transmission can be associated with subsequent increases in hospitalizations and mortality.

WASTEWATER SURVEILLANCE Researchers from the University of Illinois and University of Florida published (preprint) findings from a study on the implementation of neighborhood-scale SARS-CoV-2 wastewater surveillance systems. The COVID-19 pandemic has popularized wastewater surveillance as a tool to provide early warning of impending outbreaks; however, most of these efforts have focused on large-scale sewer systems. Neighborhood-scale systems can provide more targeted early warning capacity, but as the catchment population decreases, the volume of fecal matter is less consistent, which can make it more difficult to analyze the concentration of SARS-CoV-2 and accurately detect emerging outbreaks.

This study covered 7 neighborhood-scale wastewater surveillance systems in Champaign County, Illinois, from January-November 2021, with catchment populations ranging from 853 to 2,402 individuals. In an effort to improve the system’s accuracy, the researchers developed a methodology to normalize the concentration of SARS-CoV-2 N gene fragments by the concentration of pepper mild mottle virus (PMMOV) detected in the system. The presence and concentration of PMMOV served as an analogue for the presence of fecal matter in the sample, which enabled the researchers to establish more accurate baseline metrics and better analyze the relative concentration of SARS-CoV-2. Based on the concentration of SARS-CoV-2 N gene fragments to PMMOV, the system output a binary risk assessment (ie, Low or High).

Over the 11 months of the study, the 7 neighborhoods experienced 26 total local COVID-19 outbreaks, and the surveillance system identified High COVID-19 risk corresponding to 19 of those time periods (73% sensitivity). The system identified 17 total High-risk time periods, and 12 of those corresponded to local COVID-19 outbreaks (71% specificity). The researchers also indicated that the surveillance system was capable of providing sufficiently accurate risk assessment for specific variants of SARS-CoV-2, which could provide early warning of the geographic spread of variants of concern. This study provides evidence that smaller-scale wastewater surveillance systems can provide indication of increased transmission risk among specific communities, particularly during periods of relatively low local incidence.

Much of the January 6 Congressional Report may have been known back in April 2021

International Committee of the Fourth International (ICFI)

Internal Pentagon document confirms military standdown during January 6 coup attempt

Jacob Crosseg = "http://www.w3.org/2000/svg" />11 April 2021

Over the weekend the Associated Press (AP) revealed the contents of an internal Pentagon report detailing a series of calls made between lawmakers and the Department of Defense during the attack on Congress on January 6. The report demonstrates that Trump-appointed officials within the Pentagon purposefully forestalled the deployment of military forces for hours even as lawmakers and Vice President Mike Pence pleaded for help while fascist-led mobs hunted and called for their deaths inside the Capitol.

The report states that at 4:08 p.m. on January 6, over two hours after windows at the Capitol were breached by members of the fascist Proud Boys, Pence called acting Secretary of Defense Christopher Miller and demanded he “clear the Capitol.”

The AP wrote that Pence’s phone call to Miller “lasted only a minute” and that Pence, who was still trapped in a “secure location,” asked for a deadline as to when the Capitol would be clear. The AP wrote that Pence was forced to make the call because the coup-plotter Trump was “not engaged” during the attack on Congress.

In this Jan. 6, 2021, file photo rioters try to break through a police barrier at the Capitol in Washington. (AP Photo/John Minchillo, File)

This meant that the authority to deploy the D.C. National Guard resided in the hands of acting Defense Secretary Miller, a former Special Forces commander and Trump loyalist.

In addition to Pence, the Pentagon report indicated that congressional leaders were also making desperate appeals to military officials seeking the deployment of the National Guard.

“We need help,” Senate Majority Leader Chuck Schumer told General Mark Milley, chairman of the Joint Chiefs of Staff, and other military and Pentagon officials more than an hour after the Senate chamber had been breached, the AP reported. By 3:19 p.m. both Schumer and House Speaker Nancy Pelosi were calling the Pentagon demanding the deployment of the National Guard to the Capitol.

Lawmakers were being ferried in underground tunnels away from the approaching mob of Trump supporters, far-right militia members and neo-Nazis, some were wielding clubs, bear mace and ropes. Apparently high-ranking Pentagon officials were more concerned with protecting themselves than any lawmakers.

The AP reported that by 3:37 p.m., “the Pentagon sent its own security forces to guard the homes of defense leaders. No troops had yet reached the Capitol.”

At 3:44 p.m. Schumer called the Pentagon again and told officials, “Tell POTUS to tweet everyone should leave.” At the same time, House Majority Leader Steny Hoyer inquired to Pentagon officials about deploying active duty troops to the Capitol.

Despite Pence making the call to Miller at 4:08 p.m., Miller’s approval to D.C. National Guard Commander William Walker to deploy the Guard would not come until an hour later, at 5:08 p.m. The call from Pence to Miller occurred roughly two hours and 19 minutes after Walker originally sought approval from Miller to deploy his soldiers to the Capitol to assist overrun police.

By roughly 4:30 p.m., about 13 minutes after Trump tweeted to his “special” followers to “go home and go in peace,” Miller gave his approval to Walker to send the National Guard to the Capitol. However, he would not be told that for nearly 40 minutes.

Despite the apparent approval given to Walker, by about 4:40 p.m. Pelosi and Schumer were again on a call with Gen. Milley and the rest of the military leadership, demanding that acting Secretary Miller “secure the perimeter.”

The timeline noted that during the 30-minute phone call, Pelosi and Schumer “accused the National Security apparatus of knowing that protestors planned to conduct an assault on the Capitol.”

This stunning revelation further demolishes claims from the intelligence agencies as well as D.C. Metropolitan and Capitol Police chiefs that there was “no intelligence” that the January 6 rally would turn violent and that Congress itself was the target.

Underscoring the need to subpoena the entire Pentagon civilian and military leadership and the heads of the various intelligence agencies to ascertain their involvement and knowledge in the attempted overthrow of the election, the report also revealed on January 3, Milley, Trump and his entire cabinet had all gathered to discuss deploying the National Guard in preparation for the planned rally. During the meeting, Trump approved the activation of the D.C. National Guard, telling Miller to “take whatever action [was] needed as events unfolded,” according to the AP.

Following the meeting, Miller and Secretary of the Army Ryan McCarthy issued two memos, which would severely limit the ability of the D.C. National Guard to play any effective security role on January 6.

A January 5 memo from McCarthy to Walker prohibited Walker from deploying a quick reaction force of soldiers without prior approval from McCarthy. A January 4 memo from Miller to McCarthy prohibited Walker from deploying D.C. Guardsmen with weapons, helmets, body armor or riot control agents without the approval of Miller and allowed McCarthy to deploy the aforementioned quick reaction force “only as a last resort.”

On March 3, Walker testified before the Senate Rules and Homeland Security committees that these memos were unlike anything else he had experienced in his military career in that “it required me to seek authorization from the secretary of the Army and the secretary of defense to essentially even protect my Guardsmen.”

Walker testified that the three-hour 19-minute delay left him “stunned and frustrated.” He also said that during the June 1 protests against police violence, Army Secretary McCarthy was “right by my side” ready to approve any request he had. But at the time of the January 6 assault, Walker testified that McCarthy was “unavailable” to approve his requests.

Miller was appointed as acting secretary of defense after Trump fired previous Secretary Mark Esper on November 9. Esper sealed his fate with Trump after he publicly opposed Trump’s June 1 threat to invoke the Insurrection Act and deploy active duty soldiers to major US cities to quash mounting protests against police violence. Esper’s position was shared by Milley, both of whom feared the use of troops would provoke massive resistance in the working class that would spiral out of their control.

Even though the entire cabinet, Gen. Milley and Trump were discussing the possibility of violence and the need for the National Guard at the Capitol three days before the attempted coup, none of the domestic intelligence agencies issued reports that would normally accompany such threats, deeply implicating them in the plot to halt the certification of the election.

In congressional testimony earlier last month, FBI Director Christopher Wray confirmed that the FBI did not issue a threat assessment for January 6. Melissa Smislova, a senior official with the Department of Homeland Security (DHS), confirmed at the same hearing that the DHS did not designate the January 6 joint session as a National Security Special Event, despite the numerous well-known threats.

The report is the latest damning piece of evidence demonstrating that the January 6 attack was not the result of a few excitable Trump zealots overwhelming a suspiciously underprepared Capitol Police force. Rather it was a coordinated operation between fascist militias, sections of the police, military, intelligence agencies and the Republican Party to overturn the results of the election and install Trump as president-dictator.

The release of the report reflects the still ongoing and unprecedented crisis within the capitalist state over three months after the attempted coup. According to the AP, the document was “obtained” by them, and its contents were “vetted by current and former government officials.”

Taking their cue from President Joe Biden and the Democratic Party, the mainstream press has largely ignored the damning report, with neither the Democratic-aligned Washington Post nor New York Times devoting an article to the stunning report more than 24 hours after its publication.

This continues the line advanced by Biden and the Democratic Party, who above all seek to foster “unity” with their “Republican colleagues” in order to chloroform the working class to the danger of fascism and continue their shared class agenda. To expose the involvement of the police and military in the attempted coup could trigger a massive social explosion from below against the state and both political parties.

In order to prevent this, Pelosi and former Homeland Security officials have rekindled discussions about a joint “9-11 style commission” into the events of January 6. The fact is the establishment of such a commission would be an effort to conceal rather than reveal the full extent of the “insider threat.”

More than three months after the attempted coup, the Democratic Party, despite controlling both houses of Congress and the executive branch, has yet to subpoena any high-ranking Pentagon officials to explain their seditious actions. This fact alone underscores the need for an independent investigation to be conducted outside the control of the Democratic Party, a party of Wall Street and the military.