News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include preparing for the superbug pandemic; preprint publishing risks in the context of DURC oversight; health care worker deaths and vaccination rates globally; and more data on mix-and-match COVID-19 vaccination and boosters.
POLICY + INITIATIVES
In the Calm Before the Superbug Storm, the World Needs to Prepare
Drug-resistant “superbugs” sicken nearly 3 million Americans each year and kill 35,000. Some experts estimate the real toll is much higher, with up to 162,000 Americans dying each year from antimicrobial resistance. An influential report commissioned by the Prime Minister of the UK and the Wellcome Trust estimated this scourge could kill as many as 10 million people each year around the globe. “So it doesn’t make sense to me that the Biden administration recently released a pandemic preparedness plan that mentions the threat of antimicrobial resistance just once, and then only in passing.” STAT
Health and Care Worker Deaths During COVID-19
WHO estimates that between 80,000 and 180,000 health care workers died from COVID-19 in the period between January 2020 to May 2021. As of September 2021, available data from 119 countries suggest that two in five health care workers were fully vaccinated on average, with considerable difference across regions and economic groupings. Fewer than 1 in 10 have been fully vaccinated in the African and Western Pacific regions, while 22 mostly high income countries reported that above 80% of their personnel are fully vaccinated. World Health Organization
Rapid Proliferation of Pandemic Research: Implications for Dual-Use Risk
The risk of accidental or deliberate release of dangerous pathogens may be increased by large-scale collection and characterization of zoonotic viruses undertaken in an effort to understand what enables animal-to-human transmission. These concerns are exacerbated by the rise of preprint publishing that circumvents a late-stage opportunity for dual-use oversight. mBio
WHO’s 7 Policy Recommendations on Building Resilient Health Systems
WHO has released a position paper on building health systems resilience towards UHC and health security during COVID-19 and beyond to reinforce the urgent need for renewed and heightened national and global commitment to make countries better prepared and health systems resilient against all forms of public health threats. World Health Organization
Senate Appropriations Committee Releases FY 2022 State and Foreign Operations (SFOPs) and Labor Health and Human Services (Labor HHS) Appropriations Bills
Total global health funding at CDC and NIH through the Labor HHS bill is not yet known, as funding for some programs at NIH is determined at the agency level rather than specified by Congress in annual appropriations bills. Of the known amounts, the Senate bill totals $694 million, which is $17 million above the FY21 enacted level, but $100 million below the FY22 Request and $246 million below the FY22 House level. All of the increase at CDC compared to FY21 is for polio.
Funding provided to the State Department and USAID under the SFOPs bill and through the Global Health Programs (GHP) account, which represents the bulk of global health assistance, totals $10.4 billion in the bill, $1.2 billion above the FY21 enacted level, $303 million above the President’s FY22 request, but $288 million below the FY22 House level. Funding for global health security totals $1 billion in the bill, which is $810 million (426%) above the FY21 enacted level ($190 million), $87 million (10%) above the FY22 Request ($913 million), and matches the FY22 House level. KFF
The Biden Administration’s Proposal for an Advanced Research Projects Agency for Health
Advancing ambitious translational goals for health will doubtlessly require a distinctive culture and an organizational structure that is performance-based, milestone-driven, and timeline-sensitive. The vetting of potential innovative projects by ARPA-H will not be the domain of academic peer reviewers as is the custom at the NIH. Instead, funding decisions will be made by experienced term-limited ARPA-H program managers. JAMA Health Forum
MEDICAL COUNTERMEASURES
F.D.A. Authorizes Moderna and Johnson & Johnson Booster Shots
The FDA authorized booster shots on Wednesday for tens of millions of recipients of Moderna’s two-dose coronavirus vaccine and Johnson & Johnson’s single-dose shot. The agency also authorized medical providers to give people a booster shot of a different Covid-19 vaccine, a strategy known as “mix and match.” New York Times
Mix-and-Match COVID Vaccines Ace the Effectiveness Test
Study after study has shown that people who receive two different COVID-19 vaccines generate potent immune responses, with side effects no worse than those caused by standard regimens. But now, for the first time, researchers have shown that such ‘mix and match’ regimens are highly effective at preventing COVID-19 — roughly matching or even exceeding the performance of mRNA vaccines. Nature
COVID-19 Pregnancy Studies Detail Impacts from Second Vaccine Doses, Male Fetuses
After the first dose, pregnant and lactating persons had lower antibody titers and FcR-binding capacity, but by follow-up after the second dose, the gap was smaller. In another study, researchers found that pregnant women infected with COVID-19 and who were carrying male fetuses had lower COVID-specific IgG titers and lower COVID-specific placental antibody transfer. CIDRAP
Pfizer Says New Data Show Booster Shots of Its Vaccine are Highly Protective Against Covid.
The company said that out of more than 5,000 Pfizer-BioNTech vaccine recipients enrolled in its study who received a booster shot, only five later developed symptomatic disease, compared with 109 people among a similar group that received a placebo instead of a booster dose. New York Times
Historic Yet Imperfect: Malaria Vaccine Brings Hope But the Fight is Far From Over
The newly approved RTS,S malaria vaccine takes four doses per child, most of which can be worked into existing infant immunization schedules. The fourth shot is an important booster timed for later in the toddler years, adding some complexity to deployment in under-resourced regions. Countries must continue using existing malaria interventions such as artemisinin combination treatments, insecticide-treated bed nets, and preventive treatments for pregnant women and children because RTS,S is no silver bullet. STAT
Gates Foundation Commits up to $120 Million to Accelerate Access to COVID-19 Antiviral Drug Molnupiravir for Lower-Income Countries
The Bill and Melinda Gates Foundation announced on Wednesday that it would attempt to expedite the timetable for getting the drug, the antiviral molnupiravir, to low-income countries. It pledged an initial investment of up to $120 million to prompt eight generic drugmakers that have signed licensing agreements with the drug’s developer Merck to start producing the medicine now, a sort of insurance policy gambling that it will be approved by regulatory bodies. Drug production experts say there are still critical challenges, such as the supply of raw materials and regulatory approval. Gates Foundation, NY Times
SELECT AGENTS + CBRNE THREATS
The Navalny poisoning: Moscow Evades Accountability and Mocks the Chemical Weapons Convention
Russia recently rejected a Western proposal to use the Chemical Weapons Convention’s (CWC) consultation and clarification procedures to resolve allegations that it is responsible for the poisoning of Alexei Navalny. In doing so, Moscow has slammed shut the door to the least confrontational solution to the dispute. The international community will now have to weigh next steps carefully, balancing the need to clarify the nerve agent attack on the Russian opposition leader with the risk of further alienating Moscow and its allies from the chemical weapons prohibition regime. Bulletin of the Atomic Scientists
In Aftermath of Navalny Poisoning, Chemical-Weapons Group Tiptoes Toward Unprecedented Step
One of the most important tools available under the 1997 Chemical Weapons Convention is something called a Challenge Inspection. Essentially, this allows for a country to demand that a team of OPCW inspectors be dispatched to another country to verify whether that country is producing chemical weapons. It has never been done before. RFERL
Irradiating the Mail: The Anthrax Attacks of 2001
The Armed Forces Radiobiology Research Institute (AFRRI) was already studying how to render anthrax spores harmless through irradiation prior to the mail attacks of 2001. AFRRI’s testing confirmed that two forms of ionizing radiation could be used to sanitize the mail: electron beams and X-rays. X-rays have a deeper penetration, which allows them to treat parcels and boxes, but the X-ray machines of 2001 could process only one-tenth as much mail as the e-beam machines could. Plus, X-rays required safety shielding and monitoring to protect workers. Scaling up e-beam and X-ray machines to process all that mail proved a huge logistical challenge. IEEE Spectrum
SURVEILLANCE + DETECTION
BARDA Seeks Applications for Developing At-Home COVID-19 Diagnostics and Technologies
BARDA’s Divisions of Research, Innovation, and Ventures (DRIVe) and Detection, Diagnostics, and Devices Infrastructure (DDDI) opened a new area of interest (AOI) under the EZ Broad Agency Announcement (EZ-BAA) solicitation to develop rapid and affordable home-based diagnostics to detect SARS-CoV-2 acute infection and supportive technologies which help enable more widespread, decentralized testing. MedicalCountermeasures.gov
Three New Ebola Cases Confirmed in Eastern Congo
Three new Ebola cases have been confirmed in eastern Democratic Republic of Congo, bringing the total to five in the last 10 days, the World Health Organization said on Monday. Reuters
Covid PCR Tests: At Least 43,000 in UK May Have Had False Negatives
NHS test and trace has suspended testing operations by Immensa Health Clinic at its laboratory in Wolverhampton. The move comes after an investigation into reports of people receiving negative PCR test results after they had previously tested positive on a lateral flow device. About 400,000 samples had been processed through the lab, the vast majority of which will have been negative results, but an estimated 43,000 people may have been given incorrect negative PCR test results between 8 September and 12 October, mostly in south-west England. The Guardian
Breakthrough SARS-CoV-2 Infections in 620,000 U.S. Veterans, February-August 2021
Study using large-scale, national VA data, covering 2.7% of the U.S. population and collected in real time. “Patterns of breakthrough SARS-CoV-2 infection among vaccinated Veterans show a worrisome temporal trend, overlapping with the emergence of Delta as the dominant variant in July 2021. Increasing risk of infection was not explained by age or comorbidity, implicating increased infectivity of the Delta variant vs. waning immunity as the primary determinant of infection.” medRxiv pre-print
EPIFORGE 2020 Guidelines: Recommended Reporting Items for Epidemic Forecasting and Prediction
The importance of infectious disease epidemic forecasting and prediction research is underscored by decades of communicable disease outbreaks, including COVID-19. Unlike other fields of medical research, such as clinical trials and systematic reviews, no reporting guidelines exist for reporting epidemic forecasting and prediction research despite their utility. We therefore developed the EPIFORGE checklist, a guideline for standardized reporting of epidemic forecasting research. PLOS Medicine
PUBLIC HEALTH
House-to-House Polio Vaccination to Resume in Afghanistan
Suspicions that vaccinators were helping the U.S. government target drone strikes led to a years-long ban by the Taliban on house-to-house vaccination in the southern part of Afghanistan. Organizations including the Global Polio Eradication Initiative (GPEI) stepped up negotiation efforts to move on polio eradication with the new governing body and were given the green light for house-to-house polio vaccination to resume across the entire country on 8 November. Science
SPECIAL INTEREST
NASEM Call for Nominations: Use of Race, Ethnicity, and Ancestry as Population Descriptors in Genomics Research
Volunteer experts are sought for an anticipated ad hoc committee to review existing methodologies and produce a report on best practices on the use of race, ethnicity, and genetic ancestry and other population descriptors in genetics and genomics research. National Academies