Pandora Report: 4.30.2021

This is World Immunization Week! The US is donating up to 60 million doses of the Astra Zeneca COVID-19 vaccine to the global vaccine effort. This week also marks the first 100 days of the Biden administration, which has already seen 200 million COVID-19 doses administered in the US.

World Immunization Week

The last week of April is World Immunization Week! World Immunization Week promotes the use of vaccines to protect people of all ages from disease. Every year, vaccines save millions of lives as one of the most successful health interventions. Despite their efficacy, nearly 20 million children worldwide are not vaccinated, leaving them vulnerable. This year’s theme is “Vaccines bring us closer,” which urges “greater engagement around immunization globally to promote the importance of vaccination in bringing people together, and improving the health and wellbeing of everyone, everywhere throughout life.” The World Health Organization’s campaign aims to increase trust, confidence, and investments in vaccines.

In great news, a vaccine against malaria, a disease that kills over 400,000 people each year, has proven 77% effective in early trials. The trial included 450 children in Burkina Faso and the shot was found to be safe and showed “high-level efficacy” over one year of follow up.

Epidemics That Didn’t Happen

In this COVID-19 era, we are constantly reminded of gaps or failures in pandemic preparedness; however, a new resource is offering examples of effective preparedness by showcasing epidemics that never hit or that were largely tempered. The examples include Yellow Fever in Brazil, Ebola in Uganda, Anthrax in Kenya, Monkeypox in Nigeria, and COVID-19 in Mongolia and Senegal.

Though anthrax is often associated with bioterrorism, it is an ancient disease that is found naturally in soil. The anthrax bacterium can infect livestock and wildlife, which, in turn, infect humans when their contaminated meat is consumed. In 2019, a local herder and two students located in a town in Kenya became very ill after eating the meat from a dead cow. All three were diagnosed with anthrax. A volunteer who had been trained by the Kenya Red Cross Society’s Community-Based Surveillance system, immediately sent an SMS alert to the system. This alert notified local health and veterinary authorities, and quickly spurred action to contain the outbreak. Ultimately, there were four human cases and one death. This and the other case studies highlight that outbreaks can be contained and epidemics can be prevented with strong preparedness and response measures, protocols, and activities.

Spillover or Endemic? Reconsidering the Origins of Ebola Virus Disease Outbreaks by Revisiting Local Accounts in Light of New Evidence from Guinea

New research published in the BMJ Global Health journal finds that the 2021 outbreak of Ebola virus disease (EVD) in Guinea originated in viral resurgence from a persistently infected survivor from the major 2013–2016 epidemic 5–7 years ago, prompting an urgent need to re-evaluate whether past EVD epidemics hitherto considered as independent zoonotic spillovers may have had similar origins. In the article, researchers reconsider local accounts from the West African epidemic that trace its origins to people, dismissed until now as implausible. The authors reinterpret existing scientific accounts of other alleged spillovers, finding that several past outbreaks probably originated in persistent infections over even longer latency. By recalibrating the balance between “spillover” and “flare-up,” they suggest that EVD manifests less as a series of discrete epidemics and more as an endemic disease in humans over long timescales and wide areas, helping to account for the increasing frequency of episodes. The authors recommend that more collaborative, respectful approaches with local communities are needed to understand the origins of outbreaks, to address them and to support rather than stigmatize sufferers and survivors. Read the article here.

India’s COVID-19 Crisis Prompts Global Response

India is currently experiencing a severe surge in COVID-19 cases, the worst in the pandemic. In fact, India broke the global daily record for the number of COVID-19 cases for a fifth straight day, with more than 350,000 new infections reported. Hospitals are facing critical shortages of oxygen and remdesivir, an antiviral used to treat hospitalized COVID-19 patients. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, said, “the situation in India is beyond heartbreaking.” President Biden spoke with Indian Prime Minister Narendra Modi about sending raw materials for its Covishield vaccine to help quell the crisis.

How COVID-19 Prepared the Military for Future Biological Warfare

Although the COVID-19 pandemic shut down much of society or transitioned it into a remote format, the vast majority of the military’s missions continued. These missions include activities ranging from air transportation to basic training. Since most of these activities cannot be conducted over Zoom, the military was forced to improvise and adapt operations to keep forces healthy, and were largely successful. According to Lt. Gen. Brian Robinson, deputy commander of Air Mobility Command, the pandemic is one of the few, if not only, times in which the military has “faced a true challenge to how it commands and controls its forces on a global scale.” The COVID-19 outbreak on the aircraft carrier Theodore Roosevelt provided important lessons about how to respond in a biological attack. The disease spread rapidly on the ship and led to the ship’s skipper pleading with Navy leadership for help, a plea that was leaked to the media. Lt. Cmdr. Brian Pike stated that the ship’s outbreak reveals the need to consider deploying technical experts in the detection and surveillance of biological threats on Navy ships to contain infectious diseases. Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, asserts that improving detection capabilities on a vessel should entail monitoring the health of the crew and preparing for a situation in which the first sign of an attack is the presentation of symptoms. To do so, the Navy may need to add personnel that are skilled in disease surveillance or specially train existing personnel.  

Navalny’s Novichok Poisoning Was Putin Sending the World A Message, Experts Say

In August 2020, Alexei Navalny, an Russian opposition leader, was poisoned with a Novichok, an agent banned by the Chemical Weapons Convention. After being hospitalized in Germany, Navalny returned to Russia and was imprisoned. In response to rising international pressure, Putin gave a “fiery state of the nation speech” that warned other nations to not attempt to cross the unspecified “red lines” in regard to Navalny. Navalny’s recent court appearance saw him at the end of a three-week hunger strike, and there are fears he may be close to death. He is not the first to be poisoned with a Novichok; Sergei and Yulia Skripal were poisoned in 2018. According to Dr. Gregory Koblentz, Director of the Biodefense Graduate Program, prior to the Skripals, the Novichok was not thought to be a weapon of assassination. Further, at that time, only about a dozen laboratories in the world were equipped to detect it. This means that the number of other enemies of the Kremlin that have been victims of a Novichok is unknown. As a clear and odorless agent, it is among the most lethal nerve agents known. Some experts are interpreting the Novichok poisonings as warnings to those who oppose Putin, but also as a message to NATO nations that “Russia is using a forbidden chemical weapon that Russia says it doesn’t have — that it can harm not only its own citizens but citizens in any city, any country outside of Russia.”

Harris to Tell UN Body It’s Time to Prep for Next Pandemic

On Monday, Vice President Kamala Harris will address the United Nations in a virtual speech to make the case that “now is the time for global leaders to begin putting the serious work into how they will respond to the next global pandemic.” This speech will come near the 100-day mark of the Biden-Harris administration. According to excerpts, Harris will provide an overview of what the administration wants to focus on: improving accessibility to healthcare; investing in science, healthcare workers, and the well-being of women; and boosting capacity for personal protective equipment (PPE) and vaccine and diagnostic test manufacturing.

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