Countries trying to strike a landmark global agreement on handling future pandemics began discussing how to keep the process alive as they ran out of time to seal a deal Friday.
With the chances fading of concluding an agreement by the end of the day, negotiations turned to what the next steps might be.
Shaken by the failures exposed by Covid-19 -- which killed millions, shredded economies and crippled health systems -- countries have spent two years drafting an international accord on pandemic prevention, preparedness and response.
Despite a common desire for binding commitments aimed at preventing another such disaster, big differences quickly emerged between country blocs on how to go about it.
And though progress has been made on bridging the differences, the clock was always against them.
The World Health Organization's 194 member states were meant to finish the process in March so the agreement could be formally adopted at their annual assembly, which starts on May 27.
This additional fortnight of talks was crammed in amid hopes of achieving a breakthrough. Countries did finally begin thrashing out text wording but could not get everything completed in time.
The talks are being held behind closed doors at the WHO headquarters in Geneva.
WHO chief Tedros Adhanom Ghebreyesus was attending the talks in person, along with the UN health agency's emergencies director Michael Ryan.
WHO spokeswoman Margaret Harris told a media briefing Friday that the overtime round of talks "will end later today".
Fuelled by trolleys full of coffee, bananas, biscuits and sandwiches, negotiators have been pulling 12-hour days since April 29 to try and find a way through.
Several diplomats were already leaving the building with their suitcases on Friday as the talks neared the end.
"During the past two weeks, negotiators have held extensive discussions on multiple aspects of the proposed agreement, meeting often into the early hours of the morning," Harris said.
"Next steps on the way forward will... be discussed today and they will be announced later."
Non-governmental organisations that were deemed to be relevant stakeholders can follow the process outside the room and are briefed daily by the talks' co-chairs.
"Member states are discussing what the next steps will be," Medicines Law and Policy director Ellen 't Hoen told reporters.
"It's fair to say there's progress made. If you look at the outline of the agreement, all the important themes are there.
"But there remain a significant number of thorny issues that simply need more time. No country as far as we can tell has tried to pull the plug."
James Love, the director of Knowledge Ecology International, added: "There is some room for negotiating right now. I don't think we're really there yet.
"I don't think it's the worst outcome if they take more time. I also don't think they're going to quit."
The main disputes revolve around access and equity: access to pathogens detected within countries and to pandemic-fighting products such as vaccines produced from that knowledge; and equitable distribution of not only counter-pandemic tests, treatments and jabs, but also the means to produce them.
Each of the draft agreement's 37 articles has been individually thrashed out, with country negotiators breaking off into working groups to try to figure out a consensus.
While general agreement has been found on some articles -- without formally signing them off -- the core aspects have proved the hardest to negotiate.
rjm/vog/rlp
TOPSHOT - A memorial for Dr Li Wenliang, who was the whistleblower of the Coronavirus, Covid-19, ... [+] that originated in Wuhan, China and caused the doctors death in that city, is pictured outside the UCLA campus in Westwood, California, on February 15, 2020. - The death toll from the new coronavirus outbreak surpassed 1,600 in China on Sunday, with the first fatality reported outside Asia fuelling global concerns. (Photo by Mark RALSTON / AFP) (Photo by MARK RALSTON/AFP via Getty Images)
China abandoned its zero-COVID program in December 2022. Travel restrictions were lifted. Quarantines ended. The government stopped testing, stopped even collecting data related to COVID, and declared victory.
Many Western experts, taking it at face value, expected an economic boom. Typical was a February 2023 article in The Economist entitled What Pandemic? Chinas Ultra-Fast Economic Recovery. China, so they said, was back with a vengeance. The authors claimed to discern evidence of a surprisingly rapid consumer revival in the worlds second-biggest economy a trend so strong that the countrys reopening will boost global growth, perhaps uncomfortably.
True, the concrete indicia were sketchy. The Economist cited record attendance at a mausoleum (ambiguous?), and long lines waiting to catch cable cars at a popular tourist site. (Not typical metrics of economic performance.) Optimism rested in large part on the unusually liquid status of Chinese households, with savings greater than 100% of the countrys GDP, purportedly ready to drive a spending boom. The gung-ho account described the frenetic pace of revenge spending; a spree; and a splurge that will make a welcome contribution to global growth.
Paeans to the Great Chinese Growth Engine flooded the media. Released from the zero-COVID cage, the Chinese economy would roar back to business as usual. Even the sober folks at the Federal Reserve bought into it.
BusinessWeeks contribution was titled Welcome Back: China Rejoins the Party. It would be good news for the rest of us, too the easing of COVID restrictions may be the boost the flagging world economy needs.
[A passing comment a buildup of savings is often not seen as a sign of economic health, as economists since Keynes have realized. See Martin Wolfs commentary in The Financial Times from March 5 of this year Chinas Excess Savings Are A Danger.]
In any case, within months it was becoming clear that the projected recovery was not taking place.
The end of zero-COVID was not the end of COVID. Infections in China exploded, affecting more than a billion people in just a few weeks. No other country has experienced so many COVID cases in such a short period of time. The healthcare system was completely overwhelmed. And as a June 2023 report in Nature magazine warned
Assessing the full medical, social, and economic impact of the pandemic in China starts with understanding the true toll on the Chinese population. Massive outbreaks in other places (e.g., New Zealand, Singapore, and Hong Kong) following the end of zero-COVID policies offer analogies for what China is experiencing, but the surge there is much larger and more intense.
How much larger? It is hard to say. Chinese government statistics on COVID are useless (The Economists assessment), for reasons described in the previous column. But other types of government data can be used to estimate the true death toll, at least to a reasonable order of magnitude.
How many Chinese have died? Official and unofficial accounts diverge.
Beijings message has been triumphalist.
On the other hand
Chinas active suppression of COVID data makes it impossible to answer this question directly. Incidental data sources (such as the sudden and acute shortages of pharmaceutical products, or satellite images of clogged roadways and parking lots near funeral homes and crematoriums in Chinese cities) suggest the scale of the problem. But they do not easily translate into hard number estimates.
Analysts have used three main approaches to assess the true impact of COVID in China.
This is the most straightforward approach, and arguably the most convincing. It relies entirely on official Chinese government figures.
Death rates are generally very stable. In most countries today, the crude death rate from all causes rises gently as the population ages. Excess mortality is defined as a significant upward deviation from the long-term trend.
Beginning in 2019, China experienced a sudden and significant inflection in the crude death rate. The multi-year average rate of annual increase jumps by a factor of five and remains elevated.
Crude Death Rates in China 2009-2023
The total over four years from 2019-2022 amounts to about 1.6 million excess deaths. (2023 added another 800,000 excess deaths above the pre-COVID baseline.)
Surplus Deaths in China 2019-2022
The Economist magazine has modeled excess mortality extensively and with technical sophistication. As of July 2023, their model produced estimates of between 560,000 and 3.7 million excess deaths in China, with a central best estimate of just under 2 million deaths (roughly in line with my simple estimate provided above).
Excess Mortality in China 2020-2023, As Modeled By The Economist Magazine
The most recent assessment of excess mortality comes from an article published in the Journal of the American Medical Association on August 24, 2023.
In summary, it is clear that COVID-19 struck China hard, starting in 2019, and persisting over the past four years. The crude death rate skyrocketed, reflecting millions of excess deaths above the normal long-term trend.
This approach relies on observed ratios for infection and mortality in other countries (comparables) where COVID data is more complete and of higher quality. These ratios are then applied to the Chinese population to derive an estimate of the likely impact there.
Strong comparables would combine: (1) similar cultural and ethnic background; (2) similar economic systems; (3) similar zero-COVID regimes; and (4) more reliable data.
Hong Kong is the best case for comparison. The city maintained a zero-COVID regime (albeit less stringent than that on the mainland) until February 2022, when it was overwhelmed by Omicron. In March 2022, the British Medical Journal wrote:
In the 12 months following the breakdown of Hong Kongs zero-COVID regime, the cumulative COVID death count in Hong Kong increased by over 6000 percentfrom 213 to 13,370. (The increase in the U.S. over the same period was 22 percent.) This is evidence for the catastrophic impact of the Omicron variant on a poorly prepared population, It underscores the point that the return-to-zero in Chinas reported daily death rate after March 2023 is epidemiologically impossible. Applying Hong Kongs mortality rate of 184 COVID deaths per 100,000 population to Chinas population of roughly 1.4 billion people would yield an estimate of about 2.5 million deaths, which is in line with the excess mortality figures cited above.
A Stanford University study modeled Chinas death count based on Hong Kong and Korean experiences resulted in lower estimates: 987,455 and 619,549 maximal COVID-19 deaths, respectively, assuming the entire China population was infected. Leaked official Chinese reports indicate that infection rates for the Chinese population reached 80 percent to 90 percent within a few weeks after the lifting of zero-COVID in December 2022.
There are important differences, however, between China and even the closest comparables, which point to a more severe impact for China. These aggravating factors include:
Ultimately, estimates based on the comparables approach are roughly in line with estimates based on excess mortality, and are five to 30 times higher than the official COVID death count published by the Chinese government.
COVID rates for China can also be estimated from various public data sources that partially and/or indirectly correlate COVID mortality. In February 2023, The New York Times reported on the results of a number of different modeling approaches, which converged in an estimate of 1 million to 1.5 million Chinese deaths through the end of 2022, and before the real impact of the lifting of zero-COVID (again in line with the excess mortality calculations described in the previous section.) A Chinese-led study extrapolated from the Shanghai outbreak in Spring 2022 and estimated 1.6 million deaths by mid-2023.
Airfinity, a health data analytics group, modeled 600,000 deaths in the first month after the lifting of zero-COVID10 times Chinas official figure during the same time periodand 1.7 million deaths by April 2023. The Seattle-based Institute for Health Metrics and Evaluation forecast about 300,000 deaths in China from the end of zero-COVID through the first quarter of 2023. (This model has been widely criticized as prone to significant underestimates for many countries, and updating was paused at the end of 2022. Even so, its final forecast was 100 percent higher than the official Chinese figures.)
And as noted earlier, The Economists figure for COVID deaths is about 2 million (central estimate) as of July 2023 1500 percent higher than the official death tolls.
Chinas zero-COVID policy effectively meant zero reporting of COVID. The suppression of data began early and instinctively, and became the fixed official policy in April 2020. It did not really change even after zero-COVID was lifted in December 2022. Zero reporting continues to this day. The most basic data are apparently no longer even being collected.
Consideration of anomalies in the raw mortality figures, infection rates, and case-fatality rates all show impossibly low figures for China compared to other countries with similar demographic and policy profiles. Hong Kongs infection rate is 143 times higher than the infection rate reported for the Chinese Mainland, and the mortality rate is 30 times higher than the mainlands reported rate.
In particular, the extremely low reported Case-Fatality Rate (CFR) reported by China (described in the previous column) 33 times lower than the CFR of Hong Kong is medically inconceivable. The fate of an infected person in Mainland China cannot have been very different from that of a COVID victim in Hong Kong or anywhere else. In fact, the institutional deficits in Chinas healthcare system would imply less effective treatment of COVID patients compared to Hong Kong or Korea.
The number of Chinese killed by COVID was likely between 1.5 and 2 million through mid-2023, with estimates ranging up to 3.5 million at the high end. The number who became seriously ill would have been in the tens of millions, stressing the healthcare system, diverting resources from productive uses, and hobbling the economy. Because of Beijings active suppression of the key data, it may never be possible to completely isolate and quantify the effects of this factor, but it must be accounted one of the major contributors to Chinas current slowdown.
A delivery man walks past a mall at a business district in Beijing on May 16, 2022. - China's retail ... [+] sales slumped to its lowest in two years while factory output plunged, official data showed on May 16, capturing the dismal economic fallout from Beijing's zero-Covid policy. (Photo by AFP) (Photo by STR/AFP via Getty Images)
For more information, see Part 1 of this essay, here:
The COVID-19 pandemic shock was unparalleled in modern history. The strict containment measures, with broad economic consequences, called for a quick governmental response. European governments swiftly enacted policies to support businesses and households on a scale and magnitude never seen before. The discussion of support mechanisms and their intended and unintended macroeconomic effects has naturally found its place in economic literature.
Evidence based on data on French firms (Coeur 2021) suggested that the pandemic government support sharply reduced the number of insolvent or failing companies. Van der Wielen et al. (2021) analysed data from an EU-wide survey among firms and confirmed that the COVID-19 support successfully reached the firms that suffered the most in terms of pandemic-induced revenue reductions and it avoided a liquidity dry-out and freezing of the corporate ecosystem.
Bighelli et al. (2021) argued that the COVID-19 government support has not been as unproductively distributed as feared. The subsidies were distributed towards medium-productivity firms, and only marginally towards the undeserving zombies, in several euro area countries. Rodano et al. (2022) confirmed for Italy that zombie firms were less likely than healthy firms to access public support measures.
The Expert Group on Productivity, Innovation and Technological Change, which includes a team of experts from the European System of Central Banks (ESCB), conducted an analysis of the short- and long-term impacts of the pandemic, including the containment measures and policy support, on EU productivity trends. Their work (summarised in Lalinsky et al. 2024) relied on the analysis of aggregate, sector and a large micro-distributed dataset including data from 12 euro area countries.
In this column, we show a subset of results of the expert group focusing on the distribution of the pandemic policy support, and how it changed over time, across firms of different productivity levels. The reason to focus on this particular aspect is its potential implications for aggregate productivity growth: if policy support unintendedly helped the survival of low-productivity firms, and thereby contributed to resource misallocation, aggregate productivity would be negatively affected over the short and medium term.
We document declining efficiency of the allocation of employment subsidies to firms with respect to their productivity. The analysis starts with a description of the overall evolution of the support to corporates over time, continues with the distribution of the support to different productivity clusters, and finally investigates whether the probability to receive subsidies and their size changed over time.
Although, the spread of the COVID-19 virus and its impact differed across countries, European governments responded with support to firms on a colossal scale. The employment support, provided mostly on a monthly basis, on average followed the stringency of the policies to mitigate the impact of the pandemic on public health and society. As suggested by Figure 1 showing aggregate developments for our sample countries, both the size of support and number of supported firms peaked in the first wave of the pandemic, when the implementation of lockdowns, social distancing measures, and other measures to curb the spread of the virus resulted in significant drops in sales affecting a large share of businesses, including financially healthy and viable ones.
Although firm eligibility was not initially directly connected to the stringency of the policy measure to curb the virus, the employment support started to rise again in October 2020, shortly after the onset of the second wave of COVID-19. It peaked again in the first months of 2021. The support then gradually declined and was suspended for some time in the summer of 2021 in several countries. Further months with somewhat increased spread of the virus and stringency measures saw only mild increases in the employment subsidies, as the severity of the COVID-19 virus declined and the ability to deal with the health and economic consequences improved.
Figure 1 The scale of support and the impact of the COVID-19 pandemic
In what follows, we study the distribution of the wage subsidies one of the main instruments to support firms liquidity across firms of different productivity levels in three steps. First, we divide firms into quintiles based on their productivity relative to the productivity of the rest of firms operating in the same country, and analyse the aggregate values of subsidies allocated to each of the quintiles. Next, we analyse how the probability of receiving subsidies varied depending on firm characteristics, and in particular firm productivity (the extensive margin). Lastly, focusing on those firms which received support, we analyse the correlation between the amount of support granted to each firm and its productivity (the intensive margin). For details of our regressions, see Labinsky et al. (2024).
In 2020, almost one-third of wage subsidies were allocated to firms in the top 20% of the pre-pandemic productivity distribution. Firms with above-median productivity received about two-thirds of all subsidies, i.e. significantly more than their proportional share. Only a small share of subsidies went to non-productive firms, defined as firms in the lowest quintile of the productivity distribution.
The allocation of wage subsidies changed in 2021. The distribution of support shifted towards less productive firms, as shown in Figure 2. The share of subsidies allocated to high-productivity firms declined. To better understand the drivers of these developments, we apply regression analysis to disentangle the role of the extensive and intensive margins.
Figure 2 Share of support allocated to firm productivity quintiles, 2020 and 2021
Di Mauro et al. (2021) demonstrated a non-linear relationship between the likelihood of receiving support and firm productivity. They found that firms around the median of the productivity distribution had the highest probability of receiving support in 2020. Our research confirms this relationship for a broader group of countries which extend beyond the Central and Eastern Europe (CEE) region analysed in their work. Although the degree of non-linearity and the magnitude of marginal gains vary among individual countries, on average firms from the 6th decile of productivity had about a 15% greater chance of being supported than firms from the bottom 10% of the productivity distribution.
As illustrated in Figure 3, the correlation between the probability of receiving support and firm productivity weakened during the second year of the pandemic. The reason was that high-productivity firms exited the supporting schemes earlier and, therefore, the relative probability of low-productivity firms being supported increased. Note that these results are based on data for Croatia, Latvia, and Slovakia, the only three countries with available data for 2021 at the time of writing the report. However, given that results were very similar across all countries in 2020, and that results for 2021 are similar across the three countries with data, we think this development may have been similar in other euro area countries as well.
Figure 3 Firm probability of receiving support by productivity, 2020 and 2021
Turning to the intensive margin, as documented in Figure 4, in the first year of the COVID-19 pandemic the amount of support increased almost linearly with firm productivity. Specifically, firms in the highest productivity decile received wage subsidies that were approximately 40% larger than those awarded to firms in the lowest productivity decile.
However, this relationship significantly weakened in 2021. The difference in the size of support allocated to high- and low-productivity firms became negligible, and firms with medium productivity levels received only about 10% more support than the least productive ones. This suggests a significant shift in the distribution of support towards less productive firms.
Figure 4 Size of support by productivity, 2020 and 2021
The main findings of the micro-distributed analysis presented in this column confirm that the allocation of pandemic-related wage subsidies in 2020 was efficient. This means that more productive firms were more likely than less productive firms to receive support; and received more support in absolute terms. However, not only the total volume of support, but also the allocation across firms evolved over time. We find that the link between firm productivity and policy support weakened in the second year of the pandemic. The reason is that more productive firms recovered more rapidly and were, in consequence, quicker to leave the government support schemes, which increased the probability of low-productivity firms receiving support. Our research, based on data for euro area firms, confirms and complements earlier findings of Bahar et al. (2021) suggesting that the support initially protected productive firms in temporary need and contributed positively to aggregate productivity, but as the economy recovered, the supporting schemes became more distortive.
Authors note: The results presented in this column are the result of a close and unique cooperation among several country teams from the euro area National Central Banks and the ECB within the WGF Expert group on productivity, innovation and technological change. We namely thank Konstantins Benkovskis, Olegs Krasnopjorovs, Josip Raos and Domagoj elebaj for their contributions. Paloma Lopez-Garcia coordinated the WGF Expert group on productivity, innovation and technological change. Tibor Lalinsky coordinated the Workstream on COVID-19 and productivity and all micro-distributed exercises.
Bahar, E, J Hambur and D Andrews (2021), COVID-19, job retention schemes and productivity: From supportive to distortive, VoxEU.org, 30 September
di Mauro, F, T Bighelli and T Lalinsky (2021), "Covid-19 government support may have not been as unproductively distributed as feared", VoxEU.org, 19 August.
Coeur, B (2021), What 3.5 million French firms can tell us about the efficiency of Covid-19 support measures, VoxEU.org, 8 September.
Hale, T, N Angrist, R, Goldszmidt et al. (2021), A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker), Nature Human Behaviour 5: 529538.
Lalinsky, T, M Anastasatou, S Anyfantaki et al. (2024), The impact of the COVID-19 pandemic and policy support on productivity: a report by the ESCB expert group on productivity, innovation and technological change, ECB Occasional Paper Series No 341.
Rodano, G, E Sette and M Pelosi (2022), Zombie firms and the take-up of support measures during Covid-19, VoxEU.org, 4 May.
Van der Wielen, W, D Revoltella, L Maurin, R Pl and P Harasztosi (2021), Firm-level policy support during the Covid-19 crisis: So far so good, VoxEU.org, 18 November.
A new study has disentangled the risks to infants and birth parents from infection with SARS-CoV-2the virus that causes COVID-19 from risks related to broader societal changes during the pandemic period.
Led by Dr. Shelley Jung, a UC Berkeley School of Public Health researcher, and published today in JAMA Network Open, the article shows that COVID-19 infection was associated with increased risk of preterm birth, hypertension, and severe maternal morbiditywhich the CDC defines as unexpected outcomes of labor and delivery that result in significant short- or long-term consequences to a womans health. Interestingly, the pandemic period itself was associated with a lower risk of preterm birth, but a higher risk of hypertension and gestational diabetes.
This is the first study to separate the infant and birth parent risks linked to the pre-pandemic period, the societal changes of the pandemic period, and individual COVID-19 infection. As far as we know, ours is the first within one coherent set of data to pull these three groups apart, said Dr. Jennifer Ahern, a UC Berkeley epidemiology professor and the papers senior author.
The societal changes that may have affected health included differential access to care, economic strain, physical inactivity, and other stressors.
It was an extremely stressful time for people for a variety of reasons, said Ahern. There were the economic impacts, which were pretty substantial, people losing jobs and sources of income.
Jung noted that while COVID-19 infections had negative effects, the pandemic did also bring some positive impact.
Youve got maybe less commute stress, less physical stress during pregnancy, she said. Its just a very complex set of changes that all coincided. It was exciting to dig into the net effect of the period on the people of California. This study examined statewide California data, individually linking all birth and hospital discharge records for 2019 to 2020. We linked the birth records to the hospital records, Jung said. Then we looked nine months back at the birth parents pregnancy and looked at all the hospital visits during those nine months.
Ahern praised the state of California for coordinating data sources and making them available through a rigorous process that she said allows for valuable research while also protecting patient privacy.
The team will move on to look not just at the overall effect of the COVID pandemic period on the population, but how COVID may affect health disparities.
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Posted: May 11, 2024
This story is part of CBC Health's Second Opinion, a weeklyanalysis of health and medical science news emailed to subscribers on Saturday mornings. If you haven't subscribed yet, you can do that by clicking here .
While there's no sign a dangerous form of bird flu has gained the ability to transmit between humans, the steady spread of the virus to new species of mammals most recently, dairy cattle throughout the U.S. suggests H5N1 is closer to us than ever before.
Officials are quick to note that without a few key evolutionary leaps, this pathogen won't spark a human health crisis. Dr. Michael Ryan, executive director of the World Health Organization's (WHO) health emergencies program, said as much during remarks on Wednesday.
"Nobody is suggesting that H5N1 is the new, next pandemic. I don't believe anybody can predict that," he said.
"But it's certainly concerning when a virus like this begins to infect multiple mammalian species, which means the virus that is adapting to [animals] that are more like us than birds, and therefore there's a higher level of alert."
Given the risks, WHO officials say that behind-the-scenes processes are in place, including agreements with drugmakers, to produce "billions" of H5N1 vaccine doses within the first year of a pandemic,should this virus gain the ability to spread between humans.
Other scientists warn that's easier said than done, given the complexities involved in manufacturing and distributing a new set of vaccines.
"Even though we have a massive global infrastructure capable of producing flu vaccines we will never be ready for a pandemic," McMaster University immunologist and vaccine researcher Matthew Miller said.
The spread of H5N1 throughout cattle herds across at least nine U.S. states is the latest curve ball froma virus that's proven adept at latching onto new hosts, raising questions over whether the world is prepared for more surprises.
U.S. farm workers in multiple states may now be in regular contact with infected cattle, as officials are monitoring at least 260 people for symptoms amid growing concerns that limited testing could be masking the true scale of the outbreak, both in cows and in humans. ( On Friday,the U.S. federal government did announce major funding to expand testing efforts, which includes paying up to $75 to farm workers who take part in studies.)
Early research, which hasn't yet been peer reviewed, also suggests the cells in cows' mammary glands can be infected by both avian and human influenza viruses. Scientists warn that scenario may provide a viral mixing vessel, fuelling the development of adaptations that hike the risk to human hosts.
None of these signals are a smoking gun that H5N1 will evolve to sustain transmission in a human population. Yet the possibility is always present, even if the virus's next moves remain somewhat unpredictable.
In response to questions from CBC News, WHO officials stressed that there are two H5N1 vaccine candidates already available that could be used in a pandemic scenario, along with options targeting other forms of avian influenza.
There's no need to begin manufacturing these shots now, the WHO's Ryan said. Scaling up to produce pandemic vaccines would also mean a trade-off where manufacturers are forced to hit pause on annual shots for other strains.
"You can't just press the button and begin producing pandemic [H5N1] vaccines," Ryan said. "You have to stop producing your seasonal vaccine, and all of you out there know how life-saving that vaccine is... so this requires very careful consideration."
Some countries have H5N1 vaccines already on hand, including the U.S., which has two types of shots that are well matched with the currently circulating strain in dairy cattle. Both candidate vaccines are available to manufacturers, according to the U.S. Centers for Disease Control and Prevention (CDC).
The CDC is also testing human blood samples from people previously vaccinated with H5N1-based vaccines to see how it reacts to virus samples taken from the recent human case in Texas. So far, their research suggests vaccination "will offer good cross-protection against cattle outbreak viruses."
Here in Canada where no cases have been reported yet in dairy cattle federal officials say they're not acquiring a fixed stockpile of shots, since any changes in the virus that would allow it to transmit between humans could "fundamentally influence the antigen required for a human vaccine."
Currently, there are two H5N1 vaccines authorized in Canada, based on strains from previous outbreaks. The Public Health Agency of Canada (PHAC) also has agreementswith several vaccine manufacturers, both domestic and international, the agency noted in a statement.
A GlaskoSmithKline facility in Quebec, for instance, produces seasonal flu shots each year, and one of its subsidiaries also developed one of the country's two authorized H5N1 shots. That vaccine is approved for use in children six months of age and older, and nospecial safety concerns were identified in clinical studies, according to Health Canada's regulatory decision on its use.
"Under these contracts, the vaccine production process would be triggered by a WHO pandemic influenza declaration or a decision by the Government of Canada that influenza vaccine manufacturers switch from seasonal to pandemic influenza vaccine production," PHAC's statement continued.
While those preparations paint a rosy picture of countries' ability to rapidly respond, Miller, from McMaster, stressesthat the process from testing to manufacturing to shipping is complex and lengthy, even in a best-case scenario.
He pointed to the COVID-19 pandemic, during which drugmakers raced to develop brand-new vaccines for a never-before-seen threat. The pace of those trials was astounding; shots began rolling out in some countries as early as December2020.
Yet, a year later, infections and deaths soared to new heights thanks to the highly contagious Omicron variant, even as vaccination campaigns kept rolling out through the population.
It wasn't because the shots weren't effective, Miller added, "but because the virus evolves, and that causes problems."
The explosive spread of H5N1 among dairy cattle in mere months also points to how fast this kind of situation can change. Miller agreesthat while it's a simple switch to start producing pandemic-based vaccines, manufacturing and distributing eight billion global doses can't possibly happen overnight.
And the challenges don't stop there. Jillian Kohler, a professor at the University of Toronto whose research focuses on global access to essential medicines, says nationalism and rampant misinformation would surely complicate vaccination efforts in the event of another pandemic.
"There are a lot of variables that could easily derail getting vaccines out. And it's not just getting vaccines out, it's getting people to accept the vaccines."
Vaccine equity, she says, also remains a major issue. During the COVID pandemic, wealthier countries Canada included had an oversupply of vaccines, while others went without. And in 2022, when mpox spread worldwide for the first time, vaccines rolled out in many higher-income countries, yet the hardest-hit regions of Africa didn't have any shots.
Without learning lessons from those prior crises, Kohler warned much of the world could be sidelined during vaccination campaigns if H5N1 ever makes its human-to-human leap.
She also questioned the role of private industry in preventing pandemics, including decisions over which shots and customers to prioritize at any given time.
"Why are we relying on drugmakers to make the policy decisions that should be in the hands of government?" Kohler asked.
"To put trust in the industry to make sure we get the vaccines out in a timely fashion is repeating a mistake that we had before."
Lauren Pelley Senior Health & Medical Reporter
Lauren Pelley covers health and medical science for CBC News, including the global spread of infectious diseases, Canadian health policy, pandemic preparedness, and the crucial intersection between human health and climate change. Two-time RNAO Media Award winner for in-depth health reporting in 2020 and 2022. Contact her at: lauren.pelley@cbc.ca
New South Wales health authorities are urging people to protect themselves against influenza, with the latest data indicating an early flu season is imminent.
Respiratory surveillance reports published by NSW Health indicate approximately 5,160 people across the state were diagnosed with influenza in April, an increase of more than 20 per cent from the same time last year.
Nearly 200 people have presented to hospital emergency departments with influenza-like illnesses every week in that time.
The Australian Influenza Surveillance Report shows influenza cases typically rise in May, leading to a peak circulation of the disease in July and August.
This year, NSW is experiencing a flu season more akin to what it experienced in 2019, when cases rose in April and peaked in June and July.
However, Associate Professor of Health at the University of NSW Holly Seale said an early flu season itself was not a cause for deep concern.
"It has peaks and troughs that have changed over the years," she said.
"Prior to the COVID-19 pandemic, it was more common to have late seasons in which peak influenza activity was occurring in September and October as the weather was getting warmer.
"This year, we're seeing a repeat in trends from what the northern hemisphere has encountered in terms of having an earlier flu season."
While changes to the timing of flu season are not uncommon, the early start to the season in 2024 has seen politicians and health professionals encourage people to take earlier action than usual to protect themselves.
NSW Minister for Health Ryan Park has been advising the community to get vaccinated as soon as possible, emphasising that the flu was far more serious than the common cold that people often mistake it for.
"This is not an ordinary cold and flu," he said.
"We know that it can lead to hospitalisations and serious impacts on people's health, and unfortunately, this year, we're already seeing significant increases in cases compared to the same time last year."
The government's respiratory surveillance reports show 1,458 children under the age of 10 were diagnosed with influenza in April, making up 28 per cent of all diagnoses.
Chair of the Immunisation Coalition Rod Pearce told ABC Radio National that children under the age of five were especially susceptible to influenza, having not been exposed to the disease throughout the COVID-19 pandemic.
"A three- or four-year-old child hasn't seen influenza through natural protection," Dr Pearce said.
"They're being hit with a disease the body's not yet seen."
According to the Australian Immunisation Register, only one in 14 children under the age of five are currently vaccinated against influenza in NSW, despite vaccines being available for all children over six months old.
Dr Seale said the most effective way someone can protect themselves against infection is by getting a vaccination, but misconceptions about influenza and the effectiveness of the vaccine are complicating this process for many.
Vaccinations help the body develop immunity to influenza using deactivated or weakened versions of the virus.
Antigens in the vaccine stimulate the immune system to recognise the virus and develop antibodies that fight infection.
This process takes approximately two weeks to take effect, during which Dr Seale said the vaccinated person is still susceptible to contracting influenza.
"You may end up getting the flu in that period when you're still waiting for your vaccine to kick in," Dr Seale said.
"That's when you hear people say the flu vaccine didn't work for them or that they had the worst case of flu the year that they got vaccinated."
Because of this, she says there is no ideal time to wait for vaccination, and that members of the community are best protected by vaccinating themselves as early as they are able.
Beliefs about the severity of influenza and alternative forms of treatment also complicate the matter.
Dr Seale said a high number of people are attempting to obtain antibiotics as treatment, despite evidence that they don't remedy symptoms of influenza.
The frustration of having to get vaccinated annually also disincentives people from protecting themselves against infection, she said.
The Australian Immunisation Register indicates that, as of April 28, only one in 10 people had been vaccinated against influenza.
The beginning of the influenza season this year coincides with a breakthrough discovery that could change the need for an annual vaccination against influenza.
Currently, as new strains of influenza develop every year, new vaccines must be rolled out to match the risk posed by the virus, making an annual flu jab necessary.
Different vaccines are available for people of different ages and with different health conditions.
Two weeks ago,scientists from the Peter Doherty Institute for Infection and Immunity in Melbourne discovered nine viral fragments of influenza that have been present in all historical strains of the virus.
These nine fragments are key to activating killer T-cells, a type of cytotoxic T cell in the body that is crucial to fighting influenza.
It is their hope that this discovery can be used to develop a universal influenza vaccine.
Posted10h ago10 hours agoSun 12 May 2024 at 7:47pm, updated8h ago8 hours agoSun 12 May 2024 at 9:39pm
This has manifested in various ways but has almost always been accompanied by vilification of those raising the alarm and the monstering of those most affected.
Such behaviours are evident in the handling of the Post Office Horizon scandal, the victims of malpractice in gender medicine, women attacked for defending sex-based rights and the victims of Covid-19 vaccine injury.
While I have been on the receiving end of such attacks, I remain resolute in my position. This is not because I am pig-headed, a dinosaur or a conspiracy theorist, its because I draw on my professional experience and critical thinking skills to analyse, evaluateand interpret information in a logical and systematic manner.
No more clearly can this be demonstrated than by a recent attempt from an unnamed SNP source who contacted the Dundee Courier advising it that the questions I have been raising in Parliament on behalf of vaccine-injured constituents constituted apparent support for conspiracy theories.
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The sad reality is this was an ill-informed political smear rather than an accusation of substance, and when I represented the factual basis of my concerns to the journalist who initially seemed very eager to participate in the smear the story was dropped.
Investigating clinical injury is something I have done many times. Thankfully such injuries are often transient and a full recovery is achieved. In most cases they are down to human error as opposed to negligence but addressing concerns thoroughly and diligently is essential to reassure the injured party and minimise any repeated risk.
On rare occasions, the impact can be far more serious, with the consequences devastating or even fatal. In either case, the need to investigate without an agenda is paramount as there is nothing to be gained by trying to protect any individual, organisation, corporate or political interest for risk to be understood, managed and mitigated.
Since I started looking into vaccine injury, I have established that there are serious questions to be answered but to date there has been little political appetite to do so north or south of the Border.
Politicians, clinicians and industry each carry a duty of honesty and candour, and they must not dismiss emerging clinical evidence. Whether we like it or not, this issue must be addressed openly and urgently.
After decades of direct involvement in the management and delivery of numerous clinical trials, my starting point is a matter of unavoidable fact.
Any agent has the potential to cause harm or injury to the subject. The responsibility to identify, reportand address such risks are the foundation of good clinical practice and are central to any clinical trial protocol.
Good Clinical Practice (GCP) guidelines are the standards on which good science is based. GCP is not about having a nice bedside manner or knowing which treatment to prescribe it is a set of internationally recognised ethical and scientific quality requirements that must be followed when designing, conducting, recordingand reporting on clinical trials that involve people.
The rights, safetyand wellbeing of the trial subjects are the most important considerations and should prevail over interests of science and society, including commercial or political interests.
Clinical trials should always be conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki, GCP and applicable regulatory requirements.
And this matters because there are allegations that the big pharmaceutical companies responsible for developing the mRNA-based Covid vaccines have deliberately hidden evidence of significant complications in their published trial data.
I spoke to one woman who was severely injured during the initial trials but who discovered all record of her case was removed from trial data. If substantiated, this is a breach of every principle of GCP and the Declaration of Helsinki.
What has been established clinically is that mRNA technology doesnt replicate at the site of administration as was originally suggested. It travels to distant tissue and replicates spike protein in all tissue and organs. This is problematic for a variety of reasons.
According to the esteemed University of London Professor of Oncology, and principal of the Institute for Cancer Vaccines and Immunotherapy, Professor Angus Dalgleish, this has precipitated serious and sometimes fatal consequences.
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He and other clinical academics have been arguing for some time that the vaccine has induced a coagulation condition called Thrombotic Thrombocytopenia Syndrome (TTS) which leads to both blood clot formation and a reduction in available platelet cells needed for normal blood clot formation.
This can lead to stroke, pulmonary emboli (lung clots) and heart attacks, all of which can be life-limiting or fatal. Another antibody that Dalgleish has linked to the spike protein exerts an effect on myelin and is associated with paralysing Guillain-Barre Syndrome (GBS) and Transverse Myelitis, a swelling of the spinal cord.
In a speech in the Commons last month, I cited multiple clinical studies and reviews raising further serious concerns about mRNA vaccines including their impact on cardiac inflammatory markers, cancer relapse, excess mortalityand the abandonment of ethical practice in the rush to find a vaccine during a once-in-a-century pandemic.
I have also uncovered that the Medicines and Healthcare products Regulatory Agency (MHRA) has received 489,004 Covid-19 vaccine suspected adverse drug reaction reports, 2734 of which are associated with a fatal outcome. The true number is unknown, due to limited public awareness, under-reporting and most worryingly a refusal from the Office of National Statistics (ONS) and UK Government to open Record Level Data (RLD) to clinical academic scrutiny.
The need for an urgent rethink has been given fresh impetuous following AstraZenecas admission that the AZ vaccine can, in very rare cases, cause TTS. This admission runs counter to previous comments in 2023 that AZ would not accept that TTS is caused by the vaccine and comes after a 100 million class action lawsuit was filed in the UK on behalf of 50 victims claiming the vaccine was responsible for severe injuries and deaths.
This is an important development for victims because the governments own Vaccine Damage Payment Scheme is totally inadequate.
I raised this specific point during the recent debate and I am pleased to see that Health Secretary Victoria Atkins (above) has since ordered a review of the scheme as Covid vaccine claims soar.
The bottom line is that dogma, hyperbole and adherence to false received wisdom wont cut it. We must investigate the impact of mRNA as a technology without agenda.
As I said at the start of this column, there is nothing to be gained by trying to protect any individual, organisation, corporate or political interest for risk is to be understood, managed and mitigated.
Questions being raised on this issue must be answered with full access to ONS record level data for clinical academics as a minimum. If we are to tackle the problem, we must first understand the extent of it.
None of these clinical experts are quacks or conspiracy theorists.
As the Government said so often during the pandemic, we must follow the science.
The first case, a man with underlying health conditions, went to hospital in early April after developing a cough, fever and body aches. He later died from the disease.
But two other men in the same hospital, both aged 60, have also tested positive for the coronavirus sparking a broad contact tracing effort from health officials, to detect further infections before it can spread further. Dozens of people have been tested.
Hospitals can either serve as a source of prevention or amplification of transmission, said Dr Saskia Popescu, an infectious disease epidemiologist at the University of Maryland School of Medicine.
Ive spent a lot of time studying Mers healthcare-transmission cases and using those lessons to strengthen healthcare bioprep and honestly, THIS is why we invest in infection prevention programs, she wrote on X, formerly Twitter.
Mers was first detected in 2012, when it jumped from camels to humans in Saudi Arabia, and it has since spread to 27 other countries. Globally, 2,204 cases and 860 deaths have been reported, according to the WHO the vast majority, more than 80 per cent, have been in Saudi Arabia.
Earlier this year, the country also reported a fatal case in Taif a city 500 miles west of Riyadh, by the Red Sea earlier this year.
There have been several large chains of transmission in healthcare facilities including the largest outbreak outside of the Middle East, in South Korea in 2015. The country confirmed 185 cases and 38 fatalities as the coronavirus swept through 24 hospitals.
While several Mers treatments and vaccines are in clinical development, unlike Covid-19 none have been carried through clinical trials and approved by regulators.
[This is] a good reminder that we dont have any proven antiviral treatments, vaccines or rapid diagnostics for Mers, said Dr Tom Fletcher, an infectious disease specialist at the Liverpool School of Tropical Medicine.
The WHO said the latest cases do not change the overall risk assessment, though it expects that additional cases of Mers-CoV infection will be reported from the Middle East and/or other countries where Mers-CoV is circulating in dromedaries.
The health analytic firm Airfinty, which monitors disease outbreaks globally, said there was a high threat for the city Riyadh.
Mers-CoV [is] still around and still a threat, Prof Peter Horby, director of the Pandemic Sciences Institute at the University of Oxford said on X. [Saudi Arabia] has great experience of detecting and controlling health-care associated MERS transmission other places are less aware and less prepared.
Prof David Heymann, Professor of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine, said there had been no change in epidemiology with these infections.
He added: The index case is not the first case but was likely infected from the first case they are looking for that case now.
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More than a third of COVID-19 cases in the U.S. are now estimated to be from a new, fast-growing member of a group of so-called "FLiRT" variants, nicknamed for their small but distinctive changes relative to the JN.1 strain. JN.1 was the variant behind this past winter wave of infections.
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More than a third of COVID-19 cases in the U.S. are now estimated to be from a new, fast-growing member of a group of so-called FLiRT variants, nicknamed for their small but distinctive changes relative to the JN.1 strain. JN.1 was the variant behind this past winter wave of infections.
The largest among them, called KP.2 by scientists, has quickly multiplied in recent weeks to become the now-dominant new COVID-19 strain.
According to the Centers for Disease Control and Preventions every-other-week variant estimates, KP.2 and another strain with the same FLiRT mutations, called KP.1.1, together make up a projected 35.3% of infections this week. This is up from 7.1% a month ago.
That means that while KP.2 is proportionally the most predominant variant, it is not causing an increase in infections as transmission of SARS-CoV-2 is low, a CDC spokesperson told CBS News in a statement.
The strain also does not have large amounts of worrying changes, unlike some previously highly-mutated variants that have raised alarm in years past.
However, the swift change in circulating variants has resulted in the Food and Drug Administration this week delaying a key step in its process for picking out the strain to target with this falls COVID-19 vaccines, citing the need for more up-to-date data.
While federal requirements for hospitals to report COVID-19 data to authorities lapsed this month, the CDC says it still has reliable figures from sources like wastewater testing and emergency rooms to continue tracking activity from the virus.
Heres the latest of what we know about COVID-19 variants in the U.S.
According to the latest projections published by the CDC, around 28.2% of COVID-19 cases nationwide are now being caused by a sublineage of the virus called the KP.2 variant.
The next largest variant on the rise is another JN.1 descendant called JN.1.16. That strain has not grown as quickly, only inching up to an estimated 10% of cases this week.
That projection is based on genetic sequences of the virus reported by mostly public health labs, which have dropped significantly in recent weeks alongside the slowdown in cases overall. Other CDC data from wastewater and traveler testing still does not separate out KP.2 from its JN.1 parent.
KP.2 is a closely related descendant of the JN.1 variant from this past winter, which turned out not to be significantly more severe than the variants that were dominant before it, despite its large number of mutations.
So its one that we are watching. Its one that we are monitoring. And again, reiterate the need for continued surveillance of SARS-CoV-2 in people around the world, so that we can monitor this evolution, the World Health Organizations Maria Van Kerkhove told reporters Wednesday.
The nickname FLiRT comes from two distinctive mutations seen in several descendants of the JN.1 variant that have sprung up around the world after its sweep over the winter. Some of the largest strains with FLiRT mutations in the U.S. right now are KP.2 and KP.1.1.
It is essentially just making a word out of the specific amino acid changes in the spike protein F456L + R346T, or phenylalanine (F) to leucine (L) at position 456 and arginine [R] to threonine [T] at position 346, Canadian biologist Ryan Gregory, a professor at the University of Guelph, told CBS News in an email.
Gregory coined this nickname in March, and it gained traction among the variant trackers who have spotted and nicknamed many distinctive changes to the virus during the pandemic. Though unofficial, these nicknames have become commonly used names for a number of variants.
FLiRT won out over another nickname tiLT variants which had been coined by Australian consultant Mike Honey. FLiRT refers to a collection of faster-growing JN.1 offshoots the trackers are keeping an eye on, KP.2 among them.
Basically, pretty much everything right now is a descendant of BA.2.86.1.1 (JN.1) and things are evolving rapidly, so it makes more sense to focus on mutations of interest rather than individual variants for the time being, wrote Gregory.
Unlike some previous highly mutated variants that had raised concerns over potential changes to symptoms in recent years, the JN.1 variant many Americans already likely caught over the winter is closely related to the KP.2 strain now on the rise.
Based on current data there are no indicators that KP.2 would cause more severe illness than other strains, a CDC spokesperson told CBS News.
KP.2s two distinctive so-called FLiRT mutations have also been seen before, in XBB.1.5 variants that were circulating throughout 2023, the spokesperson said.
A draft study from scientists in Japan, released as a preprint that has yet to be peer-reviewed, found that the variant did appear to dodge antibodies better than the JN.1 variant. This increased immune resistance likely explains its rise, the scientists said.
In general, health authorities and experts have downplayed claims that variants were causing different symptoms. Changes to a persons immunity from vaccines and prior infections often play a role in different symptoms, rather than specific mutations.
Mutations happen frequently, but only sometimes change the characteristics of the virus, the CDC says.
The CDC has not made any changes to its current vaccine recommendations, which were last updated in April. But the emergence of these new JN.1 variant descendants like KP.2 might affect what vaccine the FDA picks out for this coming fall and winter.
Most Americans remain eligible to get at least one dose of this past seasons updated COVID-19 vaccine, which CDC data so far suggests was up to 51% effective against emergency room or urgent care visits during a time when JN.1 was on the rise.
CDC will continue to monitor community transmission of the virus and how vaccines perform against this strain, the agency said of KP.2.
Last month, the World Health Organizations experts recommended that vaccine manufacturers produce shots targeted at the JN.1 variant for next season. A panel of the FDAs own vaccine experts were scheduled to weigh that approach for the American vaccine market next week.
However, the agency recently announced it had decided to delay the meeting until June in hopes of buying more time to ensure it picks out a vaccine target that is most appropriate to be used for the strain(s) anticipated to be circulating in the fall.
The FDA, along with its public health partners, carefully monitors trends in the circulating strains of SARS-CoV-2. As has happened since the emergence of COVID-19, we have recently observed shifts in the dominant circulating strains of SARS-CoV-2, an FDA spokesperson told CBS News in a statement.
Pfizer has generated data from research of its vaccines against KP.2, but a company spokesperson said they were currently unable to share the results. A Moderna spokesperson did not respond to a request for comment.
A Novavax spokesperson said they had data showing their vaccine candidate for the fall aimed at JN.1 has good cross-reactivity for KP.2. While Novavaxs vaccine takes longer to make than the mRNA shots from Pfizer and Moderna, the spokesperson said FDAs delay to the meeting will not affect their ability to deliver a shot this fall.
We have manufactured JN.1 consistent with the recommendations and are on track to deliver an updated vaccine this fall, the Novavax spokesperson said.
