COVID-19 levels have been lower than usual, but a new set of variants could make summer unpredictable when it comes to the novel coronavirus.
The Centers for Disease Control and Prevention reports that KP.2 has overtaken JN.1 and is now the dominant variant circulating in the U.S. As of the most recent update, which is the two weeks ending May 11, KP.2 accounts for 28.2% of the COVID-19 cases circulating.
KP.2 is one of the variants in a group called FLiRT, which Johns Hopkins University explains are named after the technical names for their mutations. FLiRT refers to a whole group of variants, including any that start with KP or JN, which appear to have independently picked up the same set of mutations, called convergent evolution. They are the children and grandchildren of the JN.1 variant that has been dominant recently.
The prevalence of these variants comes at a critical time, when experts are deciding how to formulate the fall COVID vaccine, the university notes. The article adds that the COVID-19 virus mutates often to keep the bodys antibodies from recognizing it, but that makes it harder for the virus to infect cells. Then it mutates again to improve its ability to bind in a cycle that happens over and over. The fact that these different variants are picking up the same mutations tells virologists that this combination of mutations is helping the virus accomplish these goals most efficiently.
Johns Hopkins reports that a recent JN.1 infection should provide pretty strong protection against all the FLiRT variants. Infection from a variant older than JN.1 probably isnt very protective, it added.
Will the virus surge in summer? Guesses are varied. Johns Hopkins deems it certainly possible. According to virologist Andy Pekosz, a professor in molecular biology and immunology at Johns Hopkins, The FLiRT variants would be high on my list of viruses that could cause another wave of infection in the U.S. That said, our definition of a wave has changed. While we still see case rates rise and fall throughout the year, we see much lower numbers of cases of hospitalization or deaths than we saw in the first couple years of the pandemic, he said.
In the good news category, he added that Paxlovid is as effective against FLiRT variants as against previous variants of COVID-19.
The New York Times, though, offers some bad news. Dr. David Ho, a virologist at Columbia University, told the Times that his early lab tests suggest that slight differences in KP.2s spike protein might make it better at evading our immune defenses and slightly more infectious that JN.1.
However, Dr. Ziyad Al-Aly, the chief of research and development at the Veterans Affairs St. Louis Healthcare System, told the Times that at this time, Im not seeing any major indications of anything ominous.
As virus experts try to predict surges, Today notes that the seasonality of COVID-19 is something scientists are still trying to understand. But one thing is obvious: This virus is now integrating itself into our population and our way of life, as Dr. William Schaffner, professor of infectious disease at Vanderbilt University Medical Center, put it in the article.
The proportion of cases caused by KP.2 is increasing while the proportion caused by other variants is decreasing, which suggests KP.2 has features that give it an advantage, the experts note, Today reported. The article added that low vaccination rates and immunity that is lagging over time could make the population vulnerable and allow the variant to surge.
COVID-19 infection itself is no longer the terror that it was early on. Now, the threat of long COVID-19 is what looms large. Dr. Grace McComsey, who is the main investigator of the Long COVID RECOVER study at University Hospitals Health System in Cleveland, told WebMD that long COVID is the bigger issue. Per the article, Research released from The Lancet Infectious Diseases recently showed that many of those who end up with long COVID a chronic illness marked by fatigue, brain fog, and heart and lung problems didnt necessarily have a severe bout with the infection.
The Global Center for Health Security at the University of Nebraska Medical Center has four predictions for COVID-19 this summer and beyond:
In 2020, Zhang was appointed leader of Shanghais clinical expert team for Covid-19, becoming a household name and central figure in the countrys fight against the virus.
He has published hundreds of papers in the field of public health and infectious diseases. But now he is embarking on a new initiative to address the intersection between two growing threats: climate change and infectious diseases.
Research examining this relationship will become a growing focus globally, he said.
As the planets climate changes, including the expansion of the tropics, the way pathogens evolve and mutate is also changing.
A study published in the peer-reviewed Journal of Geophysical Research: Atmospheres in 2020 found that ocean surface warming in subtropical regions was expanding the width of the tropics.
02:27
Mosquito scientist leading fight against the worst dengue outbreak ever in Bangladesh
Mosquito scientist leading fight against the worst dengue outbreak ever in Bangladesh
It has been expanding from near the south the more tropical areas towards the north, and now it has also begun to expand to the Yangtze River Basin. So we can now also detect dengue fever in the Yangtze River Basin, Zhang said.
The World Health Organization (WHO) has said that in future decades climate change will affect the spread of vector-borne diseases like malaria due to changes in global temperature and precipitation patterns.
There is a hypothesis that the Covid-19 pandemic spread to humans from bats, whose habitats are also expanding.
So the work we are doing now is actually for the next pandemic.
But countries will need more data if they are to work together to create global disease management agreements and strategies to respond quickly to another global pathogen.
As director of the Shanghai Sci-Tech Inno Centre, Zhang signed a memorandum of understanding with the University of Hong Kong (HKU) to work towards that goal at the annual Pujiang Innovation Forum in Hong Kong in late April.
As part of the project, experts in climate change, public health, infectious disease control and public policy will be brought together for research at HKUs Centre on Contemporary China and the World (CCCW).
Resident and non-resident experts will pursue original research, establish regular monitoring systems and provide public policy discourse platforms, according to the CCCW.
Using this platform, infectious disease experts and microbiologists can work with environmental experts and climate experts to conduct in-depth research on climate change and infectious diseases together, Zhang said.
While Zhang and other experts from the mainland will begin their work alongside experts in Hong Kong, preparing for the next pandemic will need to be a group effort for researchers around the world.
It will require science from different angles and levels to provide as much evidence as possible for policy experts and governments to use when devising disease management strategies.
As part of the work with the CCCW, an information-sharing platform will be created so that we scientists have some systems that we can use to communicate, Zhang said.
The work scientists are doing today will be guided by the research that has been done in the past few years since the coronavirus pandemic.
Beyond preparing to manage the spread of future pathogens, scientists are also concerned with how climate change will affect treatments for infected patients.
Antimicrobial resistance when bacteria, parasites, viruses and fungi develop resistance to drugs meant to kill them is another growing challenge.
Zhang said that in 2019, 1.27 million people died directly as a result of antibiotic resistance around the world.
An issue that scientists all over the world agree on is that by 2050, annually, 10 million people will die of drug resistance, Zhang said. That is equal to the number of people who currently die of cancer each year.
In the past, research on drug resistance was separated into clinicians studying how to treat it and pharmacologists trying to make new antibiotics.
But we have now discovered that the emergence of drug resistance is faster than the emergence of antibiotics, Zhang said.
02:50
World Health Organization announces Covid-19 is no longer a global health emergency
World Health Organization announces Covid-19 is no longer a global health emergency
While research on how climate change and drug resistance may be linked was currently lacking, expanding on this field should be an important part of pandemic preparedness, he said.
One of the strategies that has been proposed is One Health, an initiative that the WHO describes as an integrated global approach mobilising different sectors of society to work together on issues like managing global health threats.
This includes researchers, doctors, government officials, world organisations and global communities.
Although the world officially came out of Covid-19 lockdowns last year, Zhang said that how the virus mutates and evolved is still of great concern.
We will also observe how coronavirus spreads from the natural reservoir to human society, he said. This is due to the expanding habitable areas for its vectors.
It will have important implications for the future.
Coronavirus
Data reveals pandemic accelerated decline in number of worshippers regularly attending C of E services
Mon 20 May 2024 02.00 EDT
The Covid pandemic accelerated a decline in the number of people who regularly attend Church of England services, according to data.
If there had been no pandemic during which churches were closed for several months the C of E estimates that about 747,000 people would have attended weekly services in 2023, continuing a declining trend.
Preliminary analysis of data gathered by the C of E shows 685,000 worshippers attended services in 2023 62,000 less than the projection or 1.2% of the population of England.
In the pre-pandemic year of 2019, weekly attendance was 854,000, or 1.5% of the population.
However, some recovery was seen in 2023, with weekly attendance figures rising by almost 5% overall, and nearly 6% for under-16s.
Justin Welby, the archbishop of Canterbury, welcomed the figures, saying he hoped they would encourage clergy and congregations who have shown such faith, hope and confidence over recent years to share the gospel with their communities.
He added: These are just one set of figures, but they show without doubt that people are coming to faith in Jesus Christ here and now and realising its the best decision they could ever make.
Stephen Cottrell, the archbishop of York, said: For the first time in a long time we have seen noticeable growth. Of course we dont yet know whether this growth is a trend but I take it as a great encouragement that our focus on reaching more people with the good news of Jesus, establishing new Christian communities, wherever they are, revitalising our parishes, and seeking to become a younger and more diverse church, making everyone feel welcome, is beginning to make a difference.
The C of E will publish full attendance data in the autumn.
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President Biden appeared to claim he was vice president during the coronavirus pandemic and that former President Barack Obama had dispatched him to Detroit to help with the response.
In comments first reported by the New York Post, Biden addressed an NAACP campaign event in Michigan Sunday night, where he repeatedly railed against his presumptive Republican opponent, former President Trump, while offering an aside about the contagion which began in 2019 while the latter was in office.
"When I was vice president, things were kind of bad during the pandemic," Biden said near the beginning of his remarks.
"And, what happened was Barack said to me: Go to Detroit help fix it."
BIDEN BIZARRELY ENDS CONNECTICUT SPEECH WITH GOD SAVE THE QUEEN, MAN
Going on to reference Detroit Democratic Mayor Mike Duggan, who was seated to Biden's right, the president continued, "Well, the poor mayor he's spent more time with me than he ever thought he's going to have to."
READ ON THE FOX NEWS APP
Duggan then rose and shook Biden's hand.
The pandemic, numbered COVID-19 due to global health officials having deemed it an outbreak in 2019, transpired in the latter years of Trump's term, not Obama's. Biden succeeded Trump during the denouement of the pandemic.
Elsewhere in the speech, Biden referenced working with civil rights activists in his youth, and quipped that Detroit helped "put food on" his family's table, as his father, Joseph Biden Sr., was in the automobile business.
BIDEN DROPS EMBARRASSING GAFFES DAYS AFTER LIBERAL MEDIA HYPES SOTU PERFORMANCE
Reserving much of his remarks to criticize Trump, Biden claimed at one juncture that "MAGA Republicans" want to engage in book-banning and other endeavors he described as extremist.
"All that progress is at risk. Trump is trying to make the country forget just how dark things were when he was president," Biden said.
"We will never forget him lying about how serious the pandemic was, telling Americans just inject bleach I think that's what he did. I think that's why he's so screwy."
In another jab, Biden warned against his predecessor potentially nominating more justices to the Supreme Court: "Do you think he'll put anybody [there] who has a brain?"
"It's clear when he lost in 2020, and I mean this sincerely: something snapped in Trump. He just can't accept he lost That's why Jan. 6 happened."
A mid-April Fox News Poll in Michigan found 46% of registered voters there support Biden, while 49% support Trump. Trump gained two percentage points in that survey over a similar one conducted in February. Two years prior, Biden led Trump by eight percentage points in the Great Lakes State.
Fox News Digital reached out to the White House for comment but did not receive a response by press time.
Original article source: Biden suggests he was vice president during COVID-19 pandemic: 'Barack said to me, go to Detroit'
About 40,000 pandemic relief checks totaling $19 million were issued to recipients but never cashed and are now being treated as unclaimed property by the state, the Mills administration announced Monday.
The unclaimed checks represent nearly 2% of the 2.3 million checks the administration sent to help deal with the pandemic and its aftermath, including inflation. Overall, the administration distributed nearly $1.3 billion worth of relief checks.
Officials said the funding is still available through the Maine Unclaimed Property program and they encouraged people to check to see if theyre entitled to a payment.
My administration worked with the Legislature to deliver multiple relief payments to Maine people to help them through the economic hardships caused by the pandemic, Gov. Janet Mills said in a written statement. Now, like then, we want to make sure that money goes directly back into the pockets of Maine people. I urge you to check the Maine Unclaimed Property program to make sure you are not owed a relief payment or other unclaimed property held by the state.
Lawmakers approved three rounds of direct payments to Maine residents, ranging from $285 to $850, to help people deal with the pandemic and its aftermath, including inflation and high energy costs.
The first round of checks went out in late 2021, with $285 checks being sent to nearly 525,000 people with adjusted gross income of less than $75,000.
The following spring, lawmakers approved a second round of checks and increased the income limits. That time, $850 checks were sent to 876,000 people earning up to $100,000.
The final round of payments was sent out early last year to help offset high energy prices. Checks of $450 were sent to about 877,000 people earning up to $100,000.
Over 98% of the funds made it directly into the hands of Maine people to help with rising costs, state Treasurer Henry Beck said in a written statement.Now we want to do everything we can to get the remaining payments to their rightful owners and will be doing that through our unclaimed property system.
With the addition of the uncashed relief checks, the state is now holding more than $346 million in unclaimed property.
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Using a novel assay, the Simoa detection platform, investigators found the presence of SARS-CoV-2 in patients plasma 14 months after their initial infections. The findings were published in The Lancet Infectious Diseases.
It was previously believed the virus cleared in a shorter period of time.
We believe that our findings are the most definitive to date regarding the persistence of the virus in some shape or form. This is a bit of a surprise to the field, which largely thought that the virus is cleared after the first couple of weeks, said senior author Jeffrey Martin, MD, MPH, professor, Epidemiology & Biostatistics, UCSF School of Medicine. The other coronaviruses that we know about in humanswere not believed to be persistent.
Study Parameters and Findings The investigators looked at the plasma of 2 cohorts: pandemic era and pre-pandemic era participants. The former group consisted of 171 adults who were evaluated at multiple times in the 14 months following confirmed diagnosis and the investigators referenced that most the participants in this cohort were studied before vaccination or reinfection. This latter cohort (pre-pandemic) included 250 adults and their plasma was collected before 2020.
The diagnostic used to examine the plasma was the Simoa (Quanterix) single molecule array detection platform utilized to measure SARS-CoV-2 spike, S1, and nucleocapsid antigens.
In the pandemic participant cohort, 25% of participants had detectable antigens in at least one time point and the S1 spike was the most prevalent. Additionally, individuals with severe COVID-19 who were hospitalized were found to have greater detection of antigens.
Compared with those not hospitalized, participants who required hospitalization for acute COVID-19 were nearly twice as likely to have SARS-CoV-2 antigens detected (prevalence ratio 197, 95% CI 111 to 348), an absolute difference of +184% (95% CI +03 to +365), the investigators wrote. Among participants not hospitalized, those with worse self-reported health during acute COVID-19 had greater post-acute antigen detection.
Are There Long COVID Implications? One of areas around the results of this research might be if there is anything involving Long COVID for individuals with remnants of the virus in the body long-term.
At a minimum, we have discovered that you can find you can find this virus in your body up to a year later in some patients, Martin said. These footprints of the virus may not be causing any harm, but they may and that represents the next frontier of researchjust what do the presence of these viral antigens mean in terms of causing people to feel ill with the symptoms of Long COVID?
Final Takeaways The investigators suggested that the severity of acute infection with a higher inoculum may have provided the environment for SARS-CoV-2 to remain behind and not clear the body.
Those individuals who are hospitalized had a more severe course likely had higher amounts of virus in their bodies, greater chance for virus to then take hold in other parts of the body, and essentially set up shop for persistence later on, Martin said. We also found that amongst individuals who were not hospitalized, but reported more symptoms (in other words, had a harder time with their COVID-19 infection), had a greater percentage of detectable antigen than individuals who had the mildest cases.
Marin County public health officials have endorsed a federal recommendation for adults aged 65 years and older to receive an additional dose of the updated COVID-19 vaccine.
But its definitely not with the same fanfare as in the past, said Dr. Lisa Santora, Marin deputy public health officer.
The decision is complicated for anyone contemplating getting the booster now. That is because a four-month interval is required between inoculations.
The challenge right now, Santora said, is that you would have to wait at least four months to get your fall booster. Were already into May so you would have to wait until October.
Santora said the amount of virus circulating in the community currently is relatively low. It could be much higher by fall.
On Friday, the countys public health department said in its newsletter that wastewater samples indicate that local transmission is on the rise, with 27% of samples taken last month testing positive for KP.2, also referred to as the FLiRT variant.
The variant is replacing JN.1 strain nationally. FLiRT is not one specific strain. It is a nickname given to a series of mutations S:F456L and S:R346T culled from the letters in the technical mutation names.
While symptoms and severity seem to be about the same as previous COVID strains, the new FLiRT variants appear to be more transmissible, said infectious disease expert Dr. Robert Murphy.
A new, more contagious variant is out there, said Murphy, executive director of Northwestern Universitys Institute for Global Health and a professor of infectious diseases at the Feinberg School of Medicine. COVID-19 is still with us, and compared to flu and RSV, COVID-19 can cause significant problems off-season.
Marin residents 65 and older who are in good health might want to consult with their doctor before scheduling the booster, but Santora said those with health insurance who want the additional protection are able to request it.
In Marin County, more than 90% of local COVID-19 hospitalizations have occurred among seniors.
All of our COVID deaths in 2023 were in the population over 65 years old, Santora said.
About 59% of Marin residents 65 or older are up to date with their COVID-19 booster shots following their primary series of vaccinations. Just 31.7% of Marins total population is considered to be up to date.
Since October 2021, the U.S. Centers for Disease Control and Prevention has issued a number of vaccine booster recommendations that varied depending on age and health status. People 65 and older are considered up to date with their boosters if theyve received two updated 2023-2024 COVID-19 vaccine doses. People 5 through 64 years old require a single updated COVID-19 vaccine to be up to date.
The percentage of Marin residents who are up to date with their boosters appears to be waning. In September, 42.3% of the countys population was considered up to date, nearly 11 percentage points more than today.
At that time, 47.9% of White residents in Marin, 20.2% of Black residents and 20.6% of Latino residents were up to date. Today, 34.4% of the countys White residents, 13.5% of the Black residents and 10.2% of the Latino residents are up to date.
Santora said some of the variability between racial and ethnic groups might reflect the fact that younger residents are less motivated to get vaccinated.
One reason the drop in the number of people getting boosters isnt setting off alarm bells is that current variants appears to cause less severe illness.
Weve seen a significant reduction in hospitalizations and deaths, Santora said. This particular variant doesnt cause severe disease, except in very vulnerable populations, which is why for many folks over 65, having their fall booster may be adequate.
Santora said that so far the coronavirus seems to be following the pattern of other viruses, becoming more infectious and maximizing its spread by also becoming less virulent.
The CDCs Advisory Committee on Immunization Practices has not yet decided whether it will continue its practice of recommending semi-annual or even annual doses of the COVID-19 vaccine when it comes time for a booster in fall. The committee was scheduled to meet to discuss the issue this month but postponed the discussion until June.
Criticism of vaccines, particularly in some social media circles, remains energetic.
As we enter into another political cycle, it continues to be a thread of conversation, Santora said.
Santora said that while no new information has come to light suggesting the vaccines are inherently dangerous, unfortunately in the beginning of the pandemic, there was a minimization of the adverse effects from vaccinations at the national level.
Anytime you take any treatment, including a vaccination, there is a risk of adverse effects, Santora said. Its a very, very low percentage of individuals that have an adverse effect, but for the individual that experiences those adverse effects, its very traumatic.
The Los Angeles Daily News contributed to this report.
History books
Dali L Yangs critique of Chinas response in the early days of the Covid pandemic is thoroughgoing if academic, while poet Liao Yiwus account mixes fact and fiction to extraordinary effect
Sun 19 May 2024 08.00 EDT
Cast your mind back, if you will, to the beginning of the pandemic, before the World Health Organization had coined the term Covid-19. Back then, it was the Wuhan virus, a mysterious pathogen from a city that few people outside China had visited.
On 12 January 2020, Chinas Center for Disease Control and Prevention (CDC) published the viruss genome on an international database, permitting scientists anywhere in the world to see that it was a coronavirus closely related to Sars the pathogen that had caused a mini-pandemic in 2002-2004.
On 20 January, Dr Zhong Nanshan well known in China as the first person to have spoken out in 2003 about the threat posed by Sars appeared on China Central Television to break the news that the Wuhan virus or Sars-CoV-2 as it was now officially known was certainly transmissible from human to human.
Three days later, Chinas president, Xi Jinping, instructed officials in Wuhan to lock down the city, placing 11 million under an unprecedented three-month quarantine. The problem was clinicians had been warning of a new Sars-like illness since 27 December 2019 and by late January cases had already appeared in Thailand, Japan and Korea. The Wuhan virus had gone global.
What accounts for Chinas failure to prevent the pandemic? After all, unlike Sars, which was initially mistaken for bird flu, Sars-CoV-2 had been rapidly identified by several laboratories in China. And after Sars, China had overhauled its national disease reporting system to ensure it would not be caught flat-footed a second time. Wuhan also boasted some of the best hospitals in China and a world-class virology institute.
As Dali Yang, a professor of political science at the University of Chicago and an expert on Chinese bureaucracy, puts it in his new book, Wuhan: How the Covid-19 Outbreak in China Spiraled Out of Control, China began with a remarkably strong hand but quickly squandered its authoritarian advantage. Why? Was it medical myopia a refusal to recognise the monster at its door bureaucratic incompetence, or something more sinister?
Yang has little time for claims that the virus was a product of a lab leak from the Wuhan Institute of Virology (WIV), devoting just one paragraph to the theory. Instead, he focuses on the bureaucratic obfuscation and missteps that allowed the outbreak to spiral out of control.
Frontline physicians, he explains, were initially fearful of reporting their suspicions to Beijing in case they were accused of scaremongering. Officials at the municipal level were similarly reluctant to sully Wuhans reputation as a healthy city, giving the go-ahead for a mass gathering of provincial Communist party officials on 15 January. The result was that it was not until New Years Eve that the CDCs director, George Gao, dispatched a specialist emergency response team to Wuhan, after learning about the outbreak via social media.
The second mistake came when the team from the national health commission decided to cordon off the Huanan market in Wuhan, even though by early January clinicians were already seeing patients with no connection to the market. The third came when the Wuhan health commission issued guidelines on how to diagnose the disease, stipulating that in addition to the usual clinical symptoms, patients had to have had a link to, or been in proximity to, the market. This meant that cases with no apparent connection to the market were ignored, lulling authorities into a false sense of complacency as the virus spread stealthily under the radar.
The result was that rather than drawing on its post-Sars warning systems and its considerable epidemiological expertise, China prioritised dominance and control over transparency, censoring social media posts about the spreading contagion, disciplining medical whistleblowers and squandering its reserves of trust.
Citing a study that showed that if Wuhan had locked down five days earlier, Covid-19 cases in China would have been two-thirds lower, Yang describes the four-week period from 31 December to the lockdown of Wuhan on 23 January as among the most important weeks in the history of pandemics.
He concludes his book by arguing that if, rather than using its powers to silence whistleblowers and issue positive propaganda messages, Beijing had been open and honest with the citizens of Wuhan, it could have enlisted peoples memories of Sars and fear of infection to encourage the voluntary adoption of social distancing measures, thereby limiting or avoiding catastrophe.
I am not so sure. By backdating mutations in the virus, scientists estimate it most likely infected someone as early as November or late October 2019. In other words, long before patients began presenting with unusual pneumonias, the virus had probably already escaped Wuhan and was set to become a global problem.
Aimed principally at an academic audience, Yangs book is hard going at times I could have done without the bold subheadings, such as The Stability Maintenance Regime, that pepper each chapter. However, as a forensic account of the initial response to the outbreak and Chinas dysfunctional bureaucracy, I doubt it will be bettered.
For a more engaging, if episodic, take on those early, fear-filled weeks of the pandemic, readers should turn to Liao Yiwus Wuhan. A Chinese dissident best known for his poems about the Tiananmen Square massacre, Liao is an outspoken critic of the Chinese regime.
From exile in Italy, he has written an extraordinary documentary novel that draws on official Chinese websites plus social media posts and blogs by citizen-reporters, to create a ground-level view of the crisis that mixes fact and fiction. The main protagonist is Kcriss, a former Chinese state TV host who travels to Wuhan to shed light on the rumours and ends up taking a job at a funeral home.
It does not take Kcriss long to realise that Wuhans crematoriums are working overtime and that the official death figures are a lie. But nothing can be allowed to stand in the way of the party and its message: One Belt, One Road, do not look back.
Unlike Yang, Liao does not dodge the questions surrounding the Wuhan Institute of Virology. However, his account, which draws largely on secondary sources, is inconclusive and he is unable to say whether an evil was committed there. On the question of whether Wuhan could and should have been locked down sooner, however, he and Yang are in accord. Like a high-speed train rushing towards the edge of a deep abyss the city was closed too late.
According to Yang, this failure was down to a mixture of cognitive bias the expectation that the outbreak at the market would be self-limiting and Chinas multilayered party-state hierarchy, which followed its own institutional political logic, rather than that of the virus.
The tragedy is that Chinese authorities appear to have learned little from their mistakes. Last month, the Shanghai-based virologist Zhang Yongzhen was evicted from his lab at short notice, apparently as a punishment for sharing the genome of the coronavirus without permission.
On 5 January 2020, Zhang had been among the first to sequence the virus and, concluding it was spreading from person to person, urged the authorities to act. When they prevaricated, he decided to circumvent official channels and publish the genome on virological.org, where it was accessible to scientists anywhere in the world. A day later, the CDC followed suit.
In response to his eviction, Zhang camped outside his lab in protest. I wont leave, I wont quit, I am pursuing science and the truth! he announced in a Weibo post that has since been deleted. Last week, he and his team were allowed back into the lab for the time being. Unfortunately, in China bureaucrats have long memories and truth is determined by the party, not scientists.
Mark Honigsbaum is a lecturer at City University of London and the author of The Pandemic Century
Wuhan: How the Covid-19 Outbreak in China Spiraled Out of Control by Dali L Yang is published by Oxford University Press (26.99). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply
Wuhan: A Documentary Novel by Liao Yiwu is published by Polity (25). To support the Guardian and Observer order your copy at guardianbookshop.com. Delivery charges may apply
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If the effects don't fade too rapidly, new data suggests regular COVID-19 vaccinations could strengthen our immune systems against future variants and even related viruses. This is on top of the proven protection they already provide against current infections.
With thousands of people still being hospitalized each day, more and more of us battling long COVID, and new variants continuing to rapidly emerge, this is hopeful news.
"These data suggest that if these cross-reactive antibodies do not rapidly wane we would need to follow their levels over time to know for certain they may confer some or even substantial protection against a pandemic caused by a related coronavirus," explains Washington University immunologist Michael Diamond.
Other vaccinations, such as those for the flu, are not necessarily made more effective by booster shots. Initial vaccinations prompt our immune system to create antibodies to recognize and fight an invasive virus. The details of the antibody are carried by memory immune cells, which help keep watch for and sound the alarm if the virus reappears, quickly producing more of the specific antibodies to defend against it.
When it comes to the flu, these cells are then so good at their jobs, they overwhelm our attempts to introduce updated antibodies through subsequent vaccinations. This is problematic as it leaves little chance for our bodies to store the more updated antibodies' details in memory B cells, weakening our response to future viral variants.
There was some concern this would occur with COVID-19 vaccines, too. So, using a mouse model and human volunteers who had contracted SARS-CoV-2, Washington University immunologist Chieh-Yu Liang and colleagues examined the memory B cell antibodies after different combinations of vaccines.
Incredibly, the researchers found that across doses, the response of the immune system to variants of the virus grows stronger, which is a sign of positive imprinting. In both humans and mice, rather than seeing antibodies specific to any one variant, the researchers found the majority of the antibodies reacted to both tested COVID-19 strains the original and omicron.
Further tests in mice revealed not only could the antibody response deal with a panel of different SARS-CoV-2 strains, but it could also help subdue SARS-CoV-1 as well, which derives from the 2002 to 2003 epidemic.
"In principle, imprinting can be positive, negative or neutral," explains Diamond. "In this case, we see strong imprinting that is positive, because it's coupled to the development of cross-reactive neutralizing antibodies with remarkable breadth of activity."
Questions about the longevity of the antibodies in our system still remain, as the researchers only tested the immune response one month after the latest booster. What's more, the study only focused on mRNA vaccines, so the results may not be the same in other types of vaccines. Additionally, human studies were limited, so further work is required to see if these results hold true more broadly, particularly in children.
But since uncertainty around COVID-19 vaccines early on in the pandemic, these shots have saved at least tens of millions of lives. What's more, massive studies have decisively demonstrated that the severe risks from the vaccines are extremely rare, especially in comparison to the ongoing and accumulative risks from contracting the virus.
The new study suggests we now have even more reason to keep up those regular boosters.
"At the start of the COVID-19 pandemic, the world population was immunologically nave, which is part of the reason the virus was able to spread so fast and do so much damage," says Diamond. "We do not know for certain whether getting an updated COVID-19 vaccine every year would protect people against emerging coronaviruses, but it's plausible."
This research was published in Nature.
As former chief scientist of WHO, Dr Soumya Swaminathan was the public face of science and research during the pandemic, demystifying COVID-19. Now, as chairperson of the MS Swaminathan Research Foundation, she is closely working on the impact of climate change on every aspect of our lives, particularly health. Her biography, At The Wheel of Research, documents her journey to make science the pillar of our public health. She speaks at the Idea Exchange session, moderated by Rinku Ghosh, Senior Associate Editor:
Rinku Ghosh: There is collective anxiety over the safety of Covid vaccines, what with AstraZenecas submission in court that in rare cases, its vaccine resulted in blood clotting. Considering that the same vaccine was used as Covishield in India, what kind of risks are we looking at?
Im very worried that this is going to have a negative impact on people, their beliefs and confidence in vaccines. When a vaccine is developed, it is tested several times over for its efficacy and safety. If a vaccine or drug is new, regulatory agencies conduct a post-marketing surveillance or a phase IV study. This is to capture rare side effects which might have been missed in clinical trials. For example, clinical trials for Covid vaccines had 30,000 to 40,000 participants. But when you give it to millions of people, then there may be rare things which you can pick up. This is why pharmacovigilance or post-marketing surveillance is important. Vaccines began to be administered by December 2020 as Pfizer, Moderna and AstraZeneca were approved in different countries. By March 2021, we had already heard about these thrombotic events, or Thrombotic Thrombocytopenic Purpura (TTP). At WHO, we were looking very closely at the data, which was coming out of high-income countries with good pharmacovigilance systems. These very rare side effects were mentioned in different reports from different countries, maybe somewhere in the range of four to eight per million vaccines. Every regulatory agency, including the WHO, looked at the safety profile again, assessed the risk-benefit ratio and concluded that the benefits far outweighed the risks. If you vaccinated a million individuals, the number of lives that you would save because of Covid was much more than these side effects. That has remained the same. So there has been no major change in our knowledge about this side effect since.
Second, Covid itself damages the lungs, the cardiovascular, brain and nervous systems and triggers clotting. All of us, who have suffered from Covid, now have a higher risk, may be by two to three times, of suffering health conditions related to these systems than ever before. If you have already had other risks say diabetes or hypertension then Covid is an add-on risk. The clotting due to Covid is many times, perhaps even a hundred times, more than the clotting due to the vaccine.
The third aspect is that the case revolves around the compensation thats being claimed by people who have had these severe side effects. At WHO, when we set up COVAX (COVID-19 Vaccines Global Access), we had already thought about setting up a no-fault compensation system globally. We took an insurance policy for hundreds of millions of people worldwide in low and middle-income countries, who would be receiving different vaccines. Till the time I was at WHO, there had been no claims. Im not sure if there has been any claim in the past year.
Besides, these side effects occur within a few weeks of taking the vaccine. So people whove taken the vaccine in 2021 or 2022 need not worry today about a clotting disorder. They will not get it because of the vaccine. They could get it because of Covid or an underlying condition that got exacerbated.
Rinku Ghosh: Is communicating science to the masses a big challenge because we lack scientific temperament?
Vaccine hesitancy or anti-science is not directly linked with the level of education. Countries with high vaccine hesitancy generally have high levels of education western Europe and US. Comparatively India has very small pockets of vaccine hesitancy but those were overcome by officials talking to the communities and so on.
Science is about doing experiments repeatedly because the truth could change when somebody finds something contradictory. Thats why theres a need for constant scrutiny. Usually, its a collective effort scientists around the world working in a particular discipline will have their own arguments. But during Covid, all of this was playing out in the public domain. So the layman saw scientists arguing and disagreeing, which is a normal scientific practice, but thought they couldnt make up their mind and deduced something was wrong. The anti-vax and anti-science groups took advantage of this gap in understanding. This is the first pandemic that weve had in the social media age. There will be more infodemics and we have to teach our children to sift facts. As public health people, we need to give, not hide information.
Nobody can deny that any drug or vaccine could have side effects. Even the polio vaccine has had side effects but that hasnt stopped the polio eradication programme. As scientists, we have to communicate in a way that makes information more acceptable. We have to be willing to constantly answer the same questions. Scientists cannot be patronising.
Rinku Ghosh: What are the big takeaways of COVID-19 and have we internalised them enough?
I can tell you the lessons from my perspective. How many governments and people have internalised them and are acting on them is a good question. We can see the push and pull in the negotiations of a global pandemic treaty to strengthen pandemic prevention, preparedness and response. This is a once-in-a-lifetime opportunity to actually put down on paper the lessons weve learnt and what needs to be done in the future.
First, a pandemic is a global issue and needs a global effort, solidarity and cooperation on surveillance, sharing data and R&D. Second is the issue of financing for which the World Bank has set up a fund. About $ 2 billion has come in as contribution and the bank has already finished one round of grants. We have to invest in science, be it to tackle climate change or for pathogen X. The third is investing in public health. Countries which had focussed more on public health infrastructure and primary healthcare actually did much better in terms of lowering deaths than first world countries. The US is a good example where the Centers for Disease Control and Prevention (CDC) public health budget had been cut year after year. So it couldnt do very simple things like contact tracing or scaling up surveillance. In contrast, poorer countries in Africa with a strong cadre of community health workers were able to do much better. Thailand is a prime example of a Southeast Asian country with excellent primary health care services. It was the first country outside China to locate the virus, put in place containment measures and use technology like South Korea did to test almost its entire population. The fourth is countering misinformation and the fifth is strengthening frontline workers. We need to pick up outbreaks quickly and you need an empowered team at the district level that immediately goes to the hotspot, investigates, reports, collects the data and acts on it. Decentralisation of data-based decision-making is the key.
Amitabh Sinha: How did the pandemic go away, what explains the negligible numbers now?
In a majority of countries, 60-70 per cent of the population has been vaccinated. Besides, people acquired immunity through natural infection. So a large part of the world today has cell-mediated as well as antibody-based immunity. And therefore, the virus is no longer able to extract the damage that it did in the early part. But the virus is still mutating and spreading. Were still getting infected but were not falling sick because our cell immunity kicks in and protects us. May be after four or five years that immunity will wane and we will all need boosters. Or a small infection may actually be boosting our immunity. We need regular studies on our levels of immunity.
Amitabh Sinha: Although we experienced the worst pandemic, none of the political parties has mentioned healthcare in manifestoes. Your take?
WHO Director-General Dr Tedros Ghebreyesus had predicted that we would go through this cycle of panic and neglect. We would panic in the middle of something terrible and ease away when we got a little comfortable. Im afraid thats happening all over the world. Other priorities have come up now, be it conflicts, trade wars, economic issues. There is no focus on health. I was happy that this time, during the World Bank-IMF Spring Meetings, the bank president, Ajay Banga, talked about a liveable planet, a sustainable lifestyle, health and nutrition. I think from the perspective of politicians, it is more rewarding to invest in a facility, which is very visible, because you can get credit from the local population.
Preventive healthcare is completely invisible. Its about making the right policies, laws and implementing them, dealing with lobbies and doing hard work behind the scenes. We have to implement the Rules on the Clinical Establishment Act. Thats why private hospitals continue to exploit the patient. And out-of-pocket expenditure in India though it has come down from 60 per cent to 45 per cent is still extremely high. I will again quote the example of Thailand, where the government actually invested in an organisation for health promotion and disease prevention. It is funded by taxes on tobacco, alcohol, sugar and unhealthy items.
Harish Damodaran: The remit of public health has traditionally been confined to communicable diseases like TB, malaria and viral infection. Now we are seeing lifestyle or non-communicable diseases like diabetes and cardiovascular conditions affecting the poor and lower middle-classes alike. Can we bring these under the public health umbrella?
Yes, public health is not just about communicable diseases. The WHOs SDG (Sustainable Development Goal) target 3.4 aims to reduce by one third premature mortality from non-communicable diseases through prevention and treatment by 2030. These are increasing rapidly in developing countries because of unhealthy diets and air pollution. The National Institute of Nutrition (NIN) data has shown that only a small fraction of the population is actually consuming a healthy diet. Some of it can be attributed to behavioural change as a recent household expenditure survey showed that 10 per cent of household expenditure, both in urban and rural areas, is now being spent on processed and ready-to-eat foods. Thats huge. May be, it has to do with convenience but it has also got to do with believing misleading advertisements that tell you these are healthy when actually they are not. A lot of public education drives have to be done on nutrition. A lot of policy and regulatory work needs to be done. We need to focus on agriculture and ensure we produce more nutritious food rather than focus on just rice and wheat. Dietary diversity has to improve. Big changes cannot be done without government intervention, certainly with regard to air quality and pollution.
My interest today is in looking at these determinants of health. Covid taught me to look upstream. We need an inter-sectoral and a holistic view of health, not a narrow one. Its a joke now that the Ministry of Health should perhaps be called the Ministry of Sickness and Disease, because its current focus is on managing a sick population. But the Ministry of Health also needs to be a steward and an advocate for good health across other ministries.
Rinku Ghosh: Recently, there was a row on added sugars in baby food and contaminants in spices. What would you say are the challenges of regulating food in India?
The primary focus of regulators in India has to be on public health and safety. For example, ban advertisements which have misleading information. Make sure that there is front of pack labelling on food, which is a simple traffic light system and has been adopted by many countries. As soon as you pick up a packet and see a red star on it, youre alerted that the package has been classified as unhealthy because it has high fat, sugar and salt. You dont even have to be literate to understand the potential dangers. Studies have shown how such labelling has helped in significantly reducing serious health outcomes like heart attacks. Strict labelling also compels the food industry into making healthier products.
As for contamination, lead poisoning is a huge public health risk in India. One of the sources is adulterated turmeric, which contains lead chromate to give it a bright yellow colour. A recent study across 10 cities showed that the average lead levels in children were far higher than the WHO cut-off. There is lead in our environment, coming from recycling batteries and paint. This is affecting the cognitive development of children. The Economist, in fact, had an article saying that if you get rid of lead, then your IQ levels improve.
Regulation and advertising are going to be important in dealing with the private sector. This is why we talk about commercial determinants of health, which are now as important as the social and environmental ones.
Anuradha Mascarenhas: How prepared are we for dengue outbreaks today? What about tuberculosis?
Dengue is the fastest-growing infection globally as the vector has adapted itself extremely well to living in cities. Genetic manipulation with Wolbachia bacteria can manipulate mosquito populations and reduce disease transmission. This has been tried in some countries. You have to breed and release a lot of mosquitoes with the Wolbachia to control dengue. A small place like Singapore probably can do it but it may be very difficult to do it across India. May be some cities could.
Were very close to eliminating diseases like filariasis and kalazar. As regards TB, the national prevalence survey indicates wide variations between states. The biggest risk factor for TB is under-nutrition with almost 50 per cent of cases being attributed to it. We have to think out of the box, use more technology and data-driven approaches. Statewise approaches will be different. In terms of financial resources, its going to require a multi-disciplinary approach.
Ankita Upadhyay: Are we doing enough to tackle air pollution, which comes at an enormous health cost?
In large parts of the country, the AQI (air quality index) is way above the WHO cut-off and even way above the Indian cut-off for PM 2.5, which is 40 g/m3. The more we learn about the health effects of air pollution, the more frightening it is. Setting up inflammatory cascades, pollution is impacting our brain, triggering early dementia. Its impacting the heart and lungs. Data shows that women exposed to pollution, particularly in the first and third trimester, have premature babies.
We do not need more data, we now need multi-sectoral action. By moving to clean energy, we can achieve net zero goals while reducing air pollution. We need to reduce the number of vehicles on the road and use public transport, cycle or walk. The Chief Technology Officer of the Transport for London told me that obesity rates in the city are much lower than those in other districts because people use public transport. In London, people are incentivised not to own cars. So if you want an apartment in the heart of London, they now have what are called ultra-low emission zones, which means you cannot own a car. You have to make a commitment to public transport, then the government has to provide it. It works both ways. In India, were still incentivising cars. We want three car parks with each apartment. In Geneva, I didnt have a car. I had a bicycle, I used to walk, take the train or bus.
Rinku Ghosh: Are you playing the violin and which is your favourite Beatles song?
No, I am not playing and have to restart practice. I listen to Hindustani music, old songs and jazz. I am a hiker and trekker and recently visited Kashmir. And my favourite Beatles song is probably Michelle.
