News highlights on health security threats and countermeasures curated by Global Biodefense
This week’s selections include pandemic preparedness in the FY2023 Omnibus; the struggle to effectively utilize Paxlovid; the DoD’s new Enhanced Medical Countermeasures Approach; and a hopeful end to Uganda’s Ebola emergency.
POLICY + GOVERNMENT
Should the ASPR Lead the National Response to a Public Health Emergency?
Going forward, ASPR, now a stand-alone agency (phased in over the next two years), is to be deemed commensurable with other HHS agencies, such as the CDC, FDA, or the Centers for Medicare & Medicaid Services. The decision to reclassify ASPR doubtlessly reflects the ongoing efforts of HHS to address its widely publicized operational shortcomings during the COVID-19 pandemic. HHS Secretary Becerra expressed his conviction that the reclassification of ASPR will strengthen the “long-term preparedness posture” of HHS by “better positioning the division to continue coordinating health-related emergency response in collaboration with our various HHS teams.” This article considers the backdrop to the elevation of ASPR and the implications to the national response to future public health emergencies. JAMA Health Forum
Pandemic Preparedness Measures Passed as Part of FY 2023 Omnibus
President Joe Biden signed the Consolidated Appropriations Act, 2023 (H.R. 2617) into law on Dec. 29, 2022, a year-end government funding package that includes substantial policies to address pandemic preparedness. Key elements in package include: a new requirement for Senate confirmation of the CDC director beginning in 2025; provisions to address undue foreign influence in research, including a requirement for the HHS to develop a risk framework for the conduct of federally funded research involving human genomic information that considers any associated national security risks; policies to modernize and strengthen the Strategic National Stockpile and pandemic response supply chain; establishment of an advisory committee to the CDC director; and passage of the Tracking Pathogens Act (S. 3534), to expand activities related to detection and sequencing of pathogens. AAMC
Future Planning for the Public Health Emergency Preparedness Enterprise
“We have witnessed the greatest political and public health failure in our nation’s history.” Activities that were specifically called out include: legacy under resourcing of health departments; poor communication of the evidence base to support guidance; lack of adequate rural health care systems; lack of behavior research into the structural drivers of vaccine hesitancy; pandemic response by polling and magical thinking; and inability of CDC to support program implementation. Currently, only about half of the U.S. population is served by a comprehensive public health system; and only 28 percent of hospitals, on average, earned a top-quality safety grade in states. Since FY 2003, PHEP has been cut in half, when accounting for inflation, and the hospital preparedness program has been reduced by two-thirds. These are not the actions of a prepared nation. National Academies
The Treaties That Make the World Safer are Struggling
There was a stretch in December’s late-stage negotiations that seemed pretty bleak. Russia was mad, mostly that no one would entertain its made-up claims of a US-funded bioweapons program in Ukraine. Iran was mad, apparently about sanctions. And everyone was haggling over language in the final review document for the Biological and Toxin Weapons Convention (BWC), the nearly 50-year-old international treaty that prohibits states from developing or deploying biological weapons. Diplomats, delegations, and experts feared this is where the review conference (or “RevCon,” as it’s known) might stall out. But after three weeks of discussions that ended about a week before Christmas, the BWC RevCon ended up a modest success. Vox
Pandemic Response Gets a Permanent New Home at the White House
Next year’s government funding package includes a brand-new White House Office of Pandemic Preparedness and Response Policy that would have a director appointed by the president and up to 25 staff members. Some of the responsibilities of the new office seem like they overlap quite a bit with the existing NSC Directorate for Global Health Security and Biodefense. It’s also unclear from the legislative text whether the office would have its own budget. STAT
U.S. COVID-19 Testing Policy for Travelers from China Misguided
The U.S. government’s new policy of requiring pre-flight COVID-19 testing for all travelers from China will likely have limited impact on transmission and will not provide the necessary data to fully assess the increasing number of cases globally. In addition, the policy could unintentionally fuel anti-Asian bias and xenophobia. The U.S. must consider broader measures to mitigate Covid-19 transmission including supporting people staying home when ill, masking when appropriate, and getting all vaccinations and boosters. Infectious Diseases Society of America (IDSA)
MEDICAL COUNTERMEASURES
New Worldwide Threats Prompt Pentagon to Overhaul Chem-Bio Defenses
Officials are launching a new plan, “the Chemical and Biological Defense Program’s Enhanced Medical Countermeasures Approach,” to develop medical treatments, vaccines and personal protective equipment that can adapt to a range of evolving biological and chemical threats, said Ian Watson, DoD’s deputy assistant secretary for chemical and biological defense. It’s no longer just the special operations forces fighting terrorists who might be exposed to chemical or biological weapons deployed by regional actors such as Iran or Syria, Watson said. Now, the problem has evolved to threaten the entire force. “It’s a different scale,” he added, “and it’s a different environment in which our soldiers are going to be asked to potentially find it.” Politico
COVID Drug Paxlovid Was Hailed as a Game-Changer. What Happened?
When clinical trial data for the antiviral drug Paxlovid emerged in late 2021, physicians hailed its astonishing efficacy — a reduction of nearly 90% in the risk of severe COVID-19. But more than a year later, COVID-19 remains a leading cause of death in many countries. Physicians have prescribed the drug in only about 0.5% of new COVID-19 cases in the United Kingdom, and in about 13% in the United States. Sentiment against the drug has persisted even as regulators globally have rescinded authorizations for monoclonal antibodies against COVID-19, leaving Paxlovid as one of the only tools to prevent death in high-risk individuals. Nature
Preparing U.S. Clinical Trials Infrastructure for Emergencies: A White House Virtual Roundtable Discussion and RFI
To advance innovation and enhance the responsiveness of our clinical trials infrastructure, OSTP is soliciting stakeholder input through an active Request for Information (RFI) entitled Clinical Research Infrastructure and Emergency Clinical Trials which is open for responses through 27 January 2023. A virtual multi-sector roundtable to hear from expert panelists on how we can strengthen the U.S. clinical trials infrastructure will be held on 12 January and is open to the public. WhiteHouse.gov
BioNtech Ready to Ship First mRNA Vaccine Factory Kit to Africa
Germany’s BioNTech said on 21 Dec it has completed construction of its first vaccine factory made from shipping containers called ‘BioNtrainer’ being sent to Africa. The logistics package is expected to arrive in Kigali, Rwanda in the first quarter of 2023. Reuters
Programmable Antivirals and Just-in-Time Vaccines: Biosecurity Implications of Viral RNA Secondary Structure Targeting
There is a novel approach to antiviral drugs that has great promise as a countermeasure against RNA viruses, many of which have pandemic potential. Drugs designed to bind and disrupt essential and conserved RNA structures have a high barrier to resistance. These drugs are based on locked nucleic acids (LNAs), which can be designed to bind to specific regions of viral RNA. LNAs have a longer half-life, and are more shelf-stable, than other nucleic acids like mRNA. They can persist in the body after a single dose, making them a convenient drug to administer. Health Security
A High-Throughput Single-Particle Imaging Platform for Antibody Characterization and a Novel Competition Assay for Therapeutic Antibodies
Monoclonal antibodies (mAbs) play an important role in diagnostics and therapy of infectious diseases. Here we utilize a single-particle interferometric reflectance imaging sensor (SP-IRIS) for screening 30 mAbs against Ebola, Sudan, and Lassa viruses (EBOV, SUDV, and LASV) to find out the ideal capture antibodies for whole virus detection using recombinant vesicular stomatitis virus (rVSV) models expressing surface glycoproteins (GPs) of EBOV, SUDV, and LASV. We also make use of the binding properties on SP-IRIS to develop a model for mapping the antibody epitopes on the GP structure. Scientific Reports
A Broadly Neutralizing Monoclonal Antibody Overcomes the Mutational Landscape of Emerging SARS-Cov-2 Variants of Concern
Here researchers isolated a highly potent and broadly neutralizing murine monoclonal antibody having broad neutralizing efficacy against SARS-CoV-2 and its variants of concern. The comparison of P4A2 with other known broadly neutralizing antibodies identified P4A2 as the only one that forms multiple interactions with its cognate epitope on spike-RBD which is composed of residues that are critical for interaction with ACE2. PLOS Pathogens
BIOSECURITY + BIOPREPAREDNESS
A Scoping Review of the Essential Components of Emergency Medical Response Systems for Mass Casualty Incidents
Emergency medical response systems require extensive coordination, particularly during mass casualty incidents. The recognition of preparedness gaps and contextual priorities to mass casualty incident response capacity in low- and middle-income countries (LMICs) can be better understood through the components of emergency medical response systems. This study aims to delineate essential components and provide a framework for effective emergency medical response to mass casualty incidents. Disaster Medicine and Public Health Preparedness
New Report: Ebola Biosafety and Infectious Disease Response Worker Training Program
After the 2014 Ebola outbreak, the NIEHS Worker Training Program implemented infectious disease response training for workers who could be exposed to infectious diseases on the job. This report provides an overview of accomplishments for the Ebola Biosafety and Infectious Disease Response Worker Training Program. Through the program, NIEHS built federal capacity for occupational health and safety training and outreach in biosecurity, biopreparedness, and rapid response for emerging infectious diseases. Grantees delivered evidence-based infection control and hazard recognition training to over 40,000 individuals across the U.S. National Institute of Environmental Health Sciences (NIEHS)
In the New Year, Resolve to Learn From the Past to Advance Pandemic Response in the Future
As COVID-19 sweeps across China after an abrupt U-turn on its pandemic control policies, it is a grave reminder that the impact of the ongoing pandemic is far from over. The early missteps of the global COVID-19 response have spurred calls to expand regional manufacturing for health commodities, rethink intellectual property rights, and redraw the architecture of global health governance. The data support calls for dismantling power imbalances that too often dominate donor-driven development and aid efforts. Governments and international actors must embrace governance structures that promote regional and country-level health autonomy and security. PLOS Speaking of Medicine and Health
Exposure to a Virtual Reality Mass-Casualty Simulation Elicits a Differential Sympathetic Response in Medical Trainees and Attending Physicians
High-risk occupations have, for decades, trained under artificial conditions that elicit similar stress responses to learn to compensate for these deleterious physiologic changes and complete the required tasks. Demonstrating that virtual mass casualty scenarios can elicit the same desired stress response achieved in live-action exercises is a first step in showing non-inferiority. This study measured changes in sympathetic nervous system response in subjects participating in a virtual reality scenario. Prehospital and Disaster Medicine
Can Pandemic Preparedness and HIV Programming Be Mutually Reinforcing?
The U.S. government’s President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest bilateral, disease-specific foreign assistance program in the world and the cornerstone of the U.S. global health portfolio. PEPFAR was created nearly 20 years ago in response to the global HIV/AIDS pandemic. The program is credited with supporting at least 20 million people on antiretroviral treatment, saving 25 million lives, and further galvanizing the broader global HIV/AIDS response that exists today, ultimately helping to change the trajectory of the HIV/AIDS pandemic. While there was considerable concern over the potential for the Covid-19 pandemic to be especially disruptive in countries with a high HIV burden, PEPFAR-supported initiatives have proven to be uniquely positioned to respond to Covid-19. Center for Strategic and International Studies (CSIS)
SELECT AGENTS + PRIORITY PATHOGENS
Sequencing Tests Confirm Polio Transmission In Indonesia
Following the November identification of vaccine-derived poliovirus type 2 in an Indonesian boy in the Aceh province who developed acute flaccid paralysis, investigators also found the virus in three healthy children, the World Health Organization confirmed on 19 Dec. These results are evidence of transmission of the virus and meets the criteria to be classified as circulating VDPV2 (cVDPV2). Aceh province has very low polio vaccination coverage in the routine immunization program; however, coverage is also low in several other provinces in Indonesia, including three provinces nearby Aceh (North Sumatera, West Sumatera and Riau). In 2021, in Aceh province, bivalent oral polio vaccine (OPV3) coverage was 50.9%, and IPV 28.2%. and for Pidie district the coverage was 17.7% for OPV3 and 0.5% for IPV. There is low population immunity against all polioviruses but primarily type 2 in children born after the switch from the trivalent to bivalent OPV in April 2016. CIDRAP
Humoral and Cellular Immune Responses to Lassa Fever Virus
Researchers describe cellular and antibody immune responses present in survivors of Lassa Fever (N = 370) and their exposed contacts (N = 170) in a LASV endemic region in Nigeria. Interestingly, data showed comparable T cell and binding antibody responses from both survivors and their contacts, while neutralizing antibody responses were primarily seen in the LF survivors and not their contacts. Neutralizing antibody responses were found to be cross-reactive against all five lineages of LASV with a strong bias to Lineage II, the prevalent strain in southern Nigeria. They identified the regions of the LASV glycoprotein and nucleoprotein that induced the broadest peptide-specific T cell responses. This data informs immunological readouts and potential benchmarks for clinical trials evaluating LASV vaccine candidates. Scientific Reports
Uganda is Set to Declare an End to Its Latest Deadly Ebola Outbreak
According to the World Health Organization (WHO) and the Ugandan Ministry of Health, as of 3 January 2023, there have been 142 confirmed cases of SVD, of which 55 died (CFR: 39%), and 87 recovered. In addition, 22 deaths among probable cases have been reported in individuals who died before a sample was taken. At least 19 healthcare workers have been infected and seven of them died. If no new case is reported Tuesday, the health ministry said it would formally announce the end of the outbreak on Wednesday. ECDC, CBS News
Comprehensive Review of Emergence and Virology of Tickborne Bourbon Virus in the United States
Bourbon virus (BRBV) was first discovered in 2014 in Bourbon County, Kansas, USA. Since its initial discovery, several cases of BRBV infection in humans have been identified in Kansas, Oklahoma, and Missouri. Thus far, BRBV has remained limited to a small number of confirmed human cases. Many unanswered questions persist that are related to both virology and ecology of BRBV. Recent evidence suggests increasing potential for BRBV genetic evolution through recombination with related thogotoviruses. The recent discovery in Japan of Oz virus, which exhibits high sequence identity to BRBV, in Amblyomma sp. ticks, which share the same genus as the lone star tick, illustrates the necessity for further examination of thogotoviruses and their geographic distribution. Emerging Infectious Diseases
Isolation and Identification of Novel Highly Pathogenic Avian Influenza Virus (H5N8) Subclade 2.3.4.4b from Geese in Northeastern China
H5N8, a highly pathogenic avian influenza, not only has an impact on public health, but also has a huge negative impact on animal health, food safety, safety, and even on the local and international economy. The migratory wild birds play a vital role in the intercontinental transmission of H5N8 virus. It is urgent that we should strengthen the function of the global surveillance network for H5N8 virus and accelerate the pace of vaccine development to confront the current challenges posed by H5N8 virus of subclade 2.3.4.4. Applied and Environmental Microbiology
Massive Measles Outbreak Threatens India’s Goal to Eliminate Disease by 2023
As of November, India had recorded 12,773 cases of measles this year, according to the World Health Organization, making it the largest outbreak in 2022. Between 2019 and 2021, only 56% of children received the recommended two doses of the measles vaccine by the time they were 3 years old, according to the India’s National Family Health Survey. Nature
Listeria Outbreaks Cause Maternal and Perinatal Mortality and Morbidity: We Must Do Better
Clinically vulnerable individuals infected with listeriosis are at risk of severe illness, including meningitis and sepsis. This group includes adults older than 65 years; those with comorbidities, such as cancer, liver failure, or kidney failure; and immunosuppressed individuals. As pregnancy reduces cell-mediated immunity, maternal listeriosis can be asymptomatic; if undetected and untreated, infection could lead to miscarriage, stillbirth, preterm birth, or life-threatening neonatal infection presenting with sepsis or meningitis. The Lancet Microbe
CHEMICAL + RADIOLOGICAL THREATS
Accepting Applications: 2023 Radiation Workshop Travel Award
NACCHO, in collaboration with the CDC and other state and local partners, is hosting a full day pre-conference radiological/nuclear preparedness and response workshop on Sunday, April 23 in Atlanta in advance of the 2023 Preparedness Summit. NACCHO’s Radiation Team is offering up to 30 travel awards for emergency and public health planners with various radiological/nuclear preparedness and response experience. Applications are due by February 17. National Association of County and City Health Officials (NACCHO)
Protection against Chemical Warfare Agents and Biological Threats Using Metal–Organic Frameworks as Active Layers
Metal–organic frameworks (MOFs), which comprise a tunable class of crystalline porous materials built from inorganic nodes and organic linkers, have emerged as a class of heterogeneous catalysts capable of rapid detoxification of multiple classes of these harmful chemical or biological hazards. Here researchers describe the evolution of porous and reactive MOF/fiber composites and focus on key design challenges and considerations. Accounts of Materials Research
Modeling of a Plutonium-238 Inhalation Incident Treated at Los Alamos National Laboratory
Accidental inhalation of plutonium at the workplace is a non-negligible risk, even when rigorous safety standards are in place, requiring medical countermeasures such as chelation treatment to be administered to the worker. The present work aimed to interpret the bioassay data of a worker involved in an inhalation incident due to a glovebox breach at Los Alamos National Laboratory’s plutonium facility. The worker was treated with intravenous injections of calcium salts of diethylenetriaminepentaacetic acid (DTPA) in an attempt to reduce the amount of plutonium from the body and therefore reduce the internal radiation dose. Health Physics
Deteriorative Effects of Radiation Injury Combined with Skin Wounding in a Mouse Model
Taken together, the results from this study demonstrated that the toxicity of radiation plays an important role in the induction of the inflammatory response systemically and at wounded areas, a delay of skin-wound healing, and increases in animal mortality in a radiation dose-dependent manner. Toxics
Retinal Injury Mouse Model and Pathophysiological Assessment of the Effect of Arsenical Vesicants
The eye is ten times more vulnerable to chemical warfare agents than other organs. Consistently, exposure to vesicant arsenical lewisite (LEW) manifests significant corneal damage leading to chronic inflammation, corneal opacity, vascularization, and edema, culminating in corneal cell death. Experimental Eye Research
Advancing Chemical Safety and Security Capacities in Asia
The Workshop, funded by the Republic of Korea, focused on promoting the peaceful uses of chemistry and developing the capacity of Asian OPCW Member States in chemical safety and security management. Korean experts were invited to talk about dual-use chemicals, critical infrastructure protection, consequence of human error, cyber security, counter terrorism, and process safety management audits. Organization for the Prohibition of Chemical Weapons
UNODC and Canada Hold First Criminal Investigation and Mock Trial on the International Convention for the Suppression of Acts of Nuclear Terrorism
Experts from international organizations including the IAEA, INTERPOL and the United Nations Interregional Crime and Justice Research Institute (UNICRI), as well as national experts, presented on areas related to nuclear and radioactive material and devices including illicit trafficking, management of recovered materials, chain of custody, forensics and investigations. UN Office on Drugs and Crime
New Mexico Could Pull Plug on WIPP Decades Sooner Than DOE Wants
The state of New Mexico said it could potentially seek closure of the DOE’s Waste Isolation Pilot Plant near Carlsbad a half-century before the feds might like. The DOE Office of Environmental Management has said it envisions running WIPP beyond 2050 and maybe into the 2080s. DOE also expects the facility to play a central role in disposing of transuranic waste resulting from planned plutonium pit production at Los Alamos as well as the Savannah River Site in South Carolina. Exchange Monitor
SURVEILLANCE + DETECTION
Efficiency of Field Laboratories for Ebola Virus Disease Outbreak During Chronic Insecurity, Eastern DRC, 2018–2020
During the 10th outbreak of Ebola virus disease in the Democratic Republic of the Congo, the Institut National de Recherche Biomédicale strategically positioned 13 decentralized field laboratories with dedicated equipment to quickly detect cases as the outbreak evolved. The laboratories were operated by national staff, who quickly handed over competencies and skills to local persons to successfully manage future outbreaks. Laboratories analyzed ≈230,000 Ebola diagnostic samples under stringent biosafety measures, documentation, and database management. Field laboratories diversified their activities (diagnosis, chemistry and hematology, survivor follow-up, and genomic sequencing) and shipped 127,993 samples from the field to a biorepository in Kinshasa under good conditions. Emerging Infectious Diseases
Benchmarking Bioinformatic Tools for Amplicon-Based Sequencing of Norovirus
Human noroviruses are the leading cause of acute gastroenteritis in humans. The objective of this study was to optimize and benchmark a bioinformatic pipeline and classifier for rapid investigation of foodborne outbreaks of norovirus. The complexity of foodborne outbreaks, from the matrix, sampling time and comparison to clinical ‘ground truth’ sequences, requires a high degree of standardization and accuracy across jurisdictions. This study provides recommendations for analysis and classification of norovirus amplicon high-throughput sequencing data and with wide applicability during outbreak investigations. Applied and Environmental Microbiology
Characterizing SARS-Cov-2 Transcription of Subgenomic and Genomic RNAs During Early Human Infection Using Multiplexed Droplet Digital PCR
Here researchers develop a method for multiplexed droplet digital PCR (ddPCR) assay to quantify SCV-2 subgenomic RNAs (sgRNAs), which are only produced during active viral replication, and discriminate them from genomic RNAs (gRNAs). They applied the assay to specimens from 144 people with single nasopharyngeal samples and 27 people with >1 sample. Results were compared to qPCR and viral culture. sgRNA is concordant with culture results during the first week of infection but may be discordant with culture later in infection. More work is needed to understand why some cultures are negative despite presence of sgRNA. The Journal of Infectious Diseases
New Mpox Diagnostic EUA
On December 23, 2022, FDA issued an EUA for the VIASURE Monkeypox virus Real Time PCR Reagents for BD MAX System for the qualitative detection of DNA from monkeypox virus in human lesion swab specimens from individuals suspected of mpox by their health care provider. Emergency use of this test is limited to authorized laboratories. FDA
Validation of a Portable SARS-CoV-2 Multiplex PCR Panel for Five Major Variants of Concern
Here researchers have created a panel of four triplex RT-qPCR assays targeting 12 mutations to detect and differentiate all five variants of concern: Alpha, Beta, Gamma, Delta, and Omicron. They also developed an expanded pentaplex assay that can reliably distinguish among the major sublineages (BA.1–BA.5) of Omicron. In silico, analytical and clinical testing of the variant panel indicate that the assays exhibit high sensitivity and specificity. This panel can help fulfill the need for rapid identification of variants in samples, leading to quick decision making with respect to public health measures, as well as treatment options for individuals. Compared to sequencing, these genotyping PCR assays allow much faster turn-around time from sample to results—just a couple hours. Frontiers in Public Health
Rapid Digital Microfluidics-Powered Immunoassay for Assessing Measles and Rubella Infection During Outbreaks
The Democratic Republic of the Congo (DRC) has a high measles incidence despite elimination efforts and has yet to introduce rubella vaccine. Here researchers evaluated the performance of a prototype rapid digital microfluidics powered (DMF) enzyme-linked immunoassay (ELISA) assessing measles and rubella infection, by testing for immunoglobulin M (IgM), and immunity from natural infection or vaccine, by testing immunoglobulin G (IgG), in outbreak settings. PLOS One
Advancing Detection and Response Capacities for Emerging and Re-Emerging Pathogens in Africa
In sub-Saharan Africa, where 70% of zoonotic outbreaks occur, there remains the perennial risk of outbreaks of new or re-emerging pathogens for which no vaccines or treatments are available. As the Ebola virus disease, COVID-19, and mpox (formerly known as monkeypox) outbreaks highlight, a major paradigm shift is required to establish an effective infrastructure and common frameworks for preparedness and to prompt national and regional public health responses to mitigate the effects of future pandemics in Africa. The Lancet Infectious Diseases
HEALTH BEHAVIOR + RISK
Why Is Florida’s Governor Ramping Up His Anti-Vaccine Rhetoric?
On 13 December 2022, Florida Governor Ron DeSantis held what he ominously called a “Covid-19 mRNA vaccine accountability roundtable.” The event featured his surgeon general, Joseph Ladapo, and Martin Kulldorff and Jay Bhattacharya, authors of the Great Barrington Declaration and now senior scholars at the Brownstone Institute, a libertarian think tank. The roundtable was a high visibility opportunity for the governor to escalate his opposition to covid-19 vaccines. DeSantis ramped up the rhetoric even further at the roundtable, announcing the formation of a statewide grand jury investigation into alleged “crimes and wrongdoings” related to the vaccines, though he offered few details on what the jury would examine. The BMJ
Social Media During a Public Health Crisis
While misinformation is certainly rampant on social media, these platforms also provide a space for state and local health departments to promote safe health habits and combat misinformation. This article outlines strategies that worked for state and local level departments, including enlisting champions within impacted communities and distributing social media toolkits to help combat misinformation and help spread useful information. National Association of County and City Health Officials (NACCHO)
COVID-19 PANDEMIC
Stark Scenes from China Show the Pandemic is Far from Over
Repeated surges in infection and death are giving way to a constant thrum of loss, as well as debilitation caused by long COVID. A focus on COVID-19 has also affected the fights against AIDS, malaria and tuberculosis. As attention moves to preparations for ‘Disease X’ — the as-yet-unknown pathogen that could cause the next pandemic — COVID complacency is inflicting death by a thousand cuts on health-care systems reeling from the past three years. Nature
A Very Hard Road Ahead’ for China as COVID-19 Cases Spiral
China’s unyielding “zero-COVID” approach, which aimed to isolate all infected people, bought it years to prepare for the disease. But an abrupt reopening, which was announced without warning on Dec. 7 in the wake of anti-lockdown protests, has caught the nation under-vaccinated and short on hospital capacity. While China counts 90% of its population vaccinated, only around 60% have received a booster. Older people are especially likely to have not had a booster vaccine. Over 9 million people older than 80 have not had the third vaccine, according to China’s official Xinhua News Agency. Associated Press
FDA Releases Important Information About Risk of COVID-19 Due to Certain Variants Not Neutralized by Evusheld
FDA is closely monitoring the emergence of the XBB.1.5 subvariant, a SARS-CoV-2 Omicron variant that is currently estimated to account for 28% of circulating variants in the U.S. Because of its similarity to variants that are not neutralized by Evusheld (e.g., XBB), FDA does not anticipate that Evusheld will neutralize XBB.1.5. This means that Evusheld may not provide protection against developing COVID-19 for individuals who have received Evusheld and are later exposed to XBB.1.5. FDA
Prevalence of SARS-CoV-2 and Influenza Coinfection Among Children Who Were Hospitalized or Died with Influenza
During the 2021–22 influenza season, 6% of hospitalized pediatric influenza patients had SARS-CoV-2 coinfection; a higher percentage of patients with coinfection required invasive or noninvasive respiratory support compared with those with influenza only. Among influenza-associated pediatric deaths, 16% had SARS-CoV-2 coinfection; only one coinfected decedent received influenza antivirals, and none had been fully vaccinated against influenza. MMWR
The XBB.1.5 Variant is on a Growth Spurt in the United States
Of all the variants in the current mix, XBB.1.5 has the most growth advantage vs. BA.5 with substantial dropdown for the others. Now that is playing out in New York and the Northeast regions of the United States. A recent paper established that the immune evasion for XBB.1 is more than BQ.1.1. Yunlong Cao just posted new data to show that XBB.1.5 is not more immune evasive than XBB (good) but it has tighter bind to its ACE2 receptor, which would explain its higher level of transmissibility. Ground Truths
Omicron BQ.1 and BQ.1.1 Escape Neutralisation by Omicron Subvariant Breakthrough Infection
These results suggest that BQ.1 and BQ.1.1 extensively, but incompletely, escape omicron subvariant breakthrough infection neutralisation, including the most recent BA.5.1.2, BA.2.76, and BF.7 infections. However, serum samples of BA.5.1.2 breakthrough infection were effectively neutralised by BQ.1 and BQ.1.1, suggesting that previous BA.5 breakthrough infection might prevent BQ.1 and BQ.1.1, and BQ.1 and BQ.1.1 might not completely replace BA.5. The Lancet Infectious Diseases
Pediatric Disease Modeling for Long COVID
In an MCMi Regulatory Science program extramural research project, Children’s Hospital Los Angeles and partners are studying how early inflammatory and tissue responses can predict long-term health consequences of COVID-19 in children. FDA
ALSO READING
Guide to Implementing the Biological Weapons Convention. UNODA
A Multiplex PCR and DNA-Sequencing Workflow on Serum for the Diagnosis and Species Identification for Invasive Aspergillosis and Mucormycosis. Journal of Clinical Microbiology
Lessons learned from the deadly combination of sepsis and Covid-19. STAT
Host Antiviral Factors Hijack Furin to Block SARS-CoV-2, Ebola Virus, and HIV-1 Glycoproteins Cleavage. Emerging Microbes and Infection
Improving the effectiveness of Field Epidemiology Training Programs: characteristics that facilitated effective response to the COVID-19 pandemic in Uganda. BMC Health Services Research
Household Transmission of SARS-CoV-2 from Humans to Pets, Washington and Idaho, USA. Emerging Infectious Diseases
A strategy for evaluating potential antiviral resistance to small molecule drugs and application to SARS-CoV-2. Scientific Reports
Sources of Mapping used in Humanitarian Emergencies: The Case of Ebola. Quaestiones Geographicae
Validation and establishment of the SARS-CoV-2 Lentivirus surrogate neutralization assay as a prescreening tool for the plaque reduction neutralization test. Microbiology Spectrum
Detection of hospital environmental contamination during SARS-CoV-2 Omicron predominance using a highly sensitive air sampling device. Frontiers in Public Health