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COVID-19: Testing still vital even as vaccines roll out

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A healthcare worker at a testing facility collects samples for the coronavirus at Mimar Sinan State Hospital, Buyukcekmece district in Istanbul, Turkey. © UNDP Turkey/Levent Kulu

Testing will still be a critical tool against COVID-19, even as vaccines are deployed against the disease, the head of the World Health Organization (WHO) said on Friday during his regular briefing on the crisis. 

WHO chief Tedros Adhanom Gheybreyesus emphasized how testing has been common among countries which have worked to control the virus. 

“As vaccines are rolled out, testing will continue to play a vital role”, he said

“Initially, health workers, older people and other at-risk groups will be prioritised for vaccination. That will still leave the virus with a lot of room to move, and testing will remain a vital tool for controlling the pandemic.” 

However, Tedros stressed that though vital, testing is only part of the strategy against COVID-19

“Testing is the spotlight that shows where the virus is. Investments in testing must be matched by investments in isolation facilities, clinical care, protecting health workers, contact tracing, cluster investigation and supported quarantine”, he stated. 

More evaluation needed 

Meanwhile, WHO said more information is needed concerning the vaccine developed by the pharmaceutical company AstraZeneca and Oxford University. 

The partners announced this week that clinical trials showed a regimen consisting of one half-dose of the vaccine, followed by a full dose a month later, was more effective than two full doses. 

Dr. Katherine O’Brien, Director of Immunization, Vaccines and Biologicals at WHO, underlined the need for further evaluation as the data were reported in a press release. 

“I think what we can emphasize, though, is that from what we understand about the press release, there is certainly something interesting that has been observed. But there are many reasons that could underlie the differences that were observed,” she said. 

WHO’s Chief Scientist, Dr. Soumya Swaminatha, pointed out that less than 3,000 people were given the lower-dose regimen, according to the press release, all of whom were 55 years old or younger.  

She added that the other group consisted of more than 8,000 people of varying ages, thus making it very hard to compare the two, while overall, their numbers were too small to come to any definitive conclusions. 

“It would be speculation at this point,” Dr. Swaminathan told reporters. 

She said AstraZeneca has informed WHO that it intends to run a full trial of the lower-dose regimen. 

Lessons from Ebola 

Global experience with storage and distribution of the Ebola vaccine could inform delivery of any potential inoculation against COVID-19 once developed, according to WHO. 

“There is demonstrated experience of delivering ultra-cold chain vaccines, even in some of the most difficult and remote areas,” said Dr. O’Brien.  “But that has also taken enormous resources to do that.” 

The WHO official was responding to a journalist’s question concerning the experimental vaccine developed by pharmaceutical companies Pfizer and BioNTech, which was recently submitted to authorities in the United States for emergency approval. 

The vaccine, which has shown a more than 90 per cent efficacy rate, requires very cold storage of -70 degrees Celsius or below, prompting concerns about potential distribution in African countries. 

No one vaccine is enough 

“We do have experience in a number of countries, specifically in Africa, being able to deploy a vaccine with that ultra-cold chain requirement”, said Dr. O’Brien, referring to the Merck Ebola vaccine used in outbreaks in the Democratic Republic of the Congo. 

“So, as we anticipate the use of the Pfizer vaccine, the intention is certainly to be able to use it along with other vaccines because no one vaccine is going to have adequate supply, nor will any one vaccine necessarily have suitable operational characteristics to meet all of the needs.” 

Dr. O’Brien added that Pfizer has developed a special “shipper” which can maintain the vaccine’s temperature for up to 10 to 15 days. 

Furthermore, the vaccine can be stored at refrigerated temperatures for five days, she continued, while portable freezers that do not run on electricity, and even dry ice, also can be used. 

Innovate for delivery 

As ultra-cold chain logistics are not in place everywhere, including in high-income nations, Dr. O’Brien suggested that countries will have to “innovate” around systems for delivering COVID-19 vaccines that have this requirement.   

One approach could be to use them for immunizing certain segments of the population.   

She cited health professionals as an example, because they work in facilities where immunization would take place and where it would be easier to install the ultra-cold chain freezers. 

Move your body 

Although the pandemic has imposed many restrictions on our lives, there is no excuse to sit on the couch, WHO affirmed on Friday, announcing new guidelines on physical activity and sedentary behaviour, published this week. 

Exercise is essential for physical and mental health throughout life, the agency said, but one in four adults, and four in five adolescents, do not move enough. 

The guidelines recommend between 150 and 300 minutes of moderate to vigorous activity per week for adults, and an average of 60 minutes per day for children and adolescents.

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Health & Wellness

Guterres warns against self-defeating ‘vaccinationalism’

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With more than two million lives now lost worlwide to COVID-19, the UN Secretary-General appealed on Friday for countries to work together and help each other to end the pandemic and save lives. In a video statement, Secretary-General António Guterres noted that the absence of a global coordinated effort has worsened the pandemic’s deadly impact.

“Behind this staggering number are names and faces: the smile now only a memory, the seat forever empty at the dinner table, the room that echoes with the silence of a loved one”, Mr. Guterres said.

Solidarity, to save more souls

 “In the memory of those two million souls, the world must act with far greater solidarity,” he added.

Since its discovery at the end of December 2019, COVID-19 has now spread to all corners of the world, with cases in 191 countries and regions. Deaths due to the disease reached the grim milestone of one million only in September.

 In addition, the socio-economic impact of the pandemic has been massive, with countless jobs and livelihoods lost globally, and millions pushed into poverty and hunger.

 A ‘vaccine vacuum’

 Mr. Guterres went on to note that though safe and effective COVID-19 vaccines are being rolled out, disparity continue between nations.

 “Vaccines are reaching high income countries quickly, while the world’s poorest have none at all,” he said, adding that “some countries are pursuing side deals, even procuring beyond need.”

 The UN chief went on to note that while governments have a responsibility to protect their populations, “‘vaccinationalism’ is self-defeating and will delay a global recovery.”

 “COVID-19 cannot be beaten one country at a time,” he stressed. Mr. Guterres called on countries to commit now to sharing any excess doses of vaccines, to help urgently vaccinate health workers around the world and prevent health systems from collapsing.

He also reiterated the need to ensure full funding for the Access to COVID-19 Tools Accelerator (ACT Accelerator) and its COVAX facility, to make vaccines available and affordable to all.

Proven steps

At the same time, people must remember and practice “simple and proven” steps to keep each other safe: wearing masks, physically distancing, avoiding crowds, and hand hygiene.

 “Our world can only get ahead of this virus one way – together. Global solidarity will save lives, protect people and help defeat this vicious virus”, added Mr. Guterres.

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Health experts arrive in Wuhan to investigate COVID-19 origins

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Members of an international team studying the origins of the virus that causes COVID-19 arrived in Wuhan, China, on Thursday, the head of the World Health Organization (WHO) announced during an expert meeting on the disease. 

Tedros Adhanom Ghebreyesus, the WHO Director-General, was addressing the latest session of the Emergency Committee on COVID-19 established under the International Health Regulations (IHR), a treaty that guides global response to public health risks. 

The new coronavirus that sparked the pandemic first emerged in Wuhan in December 2019.  Tedros reported that most of the 15 members of the delayed mission are now in the city, although two people are still in Singapore awaiting COVID-19 test results. 

“All members of the team had multiple negative PCR and antibody tests in their homes countries prior to traveling”, he said. 

“The team members who have arrived in Wuhan will be in quarantine for the next two weeks, and will begin working remotely with counterparts in China. They will then continue their work on the ground for a further two weeks.” 

Focus now on vaccine equity, travel prospects 

Thursday marked the sixth meeting of the IHR Emergency Committee on COVID-19.   

Members first convened a year ago, when there were less than 560 cases of the new disease. Today, more than 90 million cases have been reported globally, and the death toll has almost reached two million. 

Tedros said although the rollout of COVID-19 vaccines represents “hope of light at the end of the tunnel”, focus is now on ensuring all countries can access them on an equitable basis. 

He also highlighted two urgent issues for the committee’s attention: the recent emergence of multiple new variants of the virus, and the potential use of vaccination and testing certificates for international travel. 

“One theme ties both issues together: solidarity”, said Tedros.  “We cannot afford to prioritize or punish certain groups or countries. We are all in this together, and we must all come out of it together.” 

Challenges in Africa 

Meanwhile, the UN agency has warned of the need to avert a “runaway surge” of infections in Africa, as cases there top three million and new variants of the virus emerge on the continent. 

COVID-19 cases have risen steadily since mid-September, with a steeper rise from late November, and could increase in the wake of the Christmas and New Year holidays due to travel and festive gatherings. 

Dr. Matshidiso Moeti, WHO Regional Director for Africa, said although virus mutations are not surprising, preliminary analysis reveals that a new variant circulating widely in South Africa, known as 501Y.V2, is more transmissible.  

“Even if the new variant is not more virulent, a virus that can spread more easily will put further strain on hospitals and health workers who are in many cases already overstretched”, she said.  

“This is a stark reminder that the virus is relentless, that it still presents a manifest threat, and that our war is far from won.” 

WHO is supporting African countries with reinforcing genome sequencing efforts, key to finding and understanding new COVID-19 variants. 

So far, 501Y.V2 has been identified in Botswana, the Gambia and Zambia, while Nigeria is further investigating another variant found in samples collected in August and November.   The virus variant circulating in the United Kingdom has not been reported on the continent.

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Health & Wellness

WHO: Step up surveillance of emerging coronavirus variants

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Efforts should be stepped up to quickly identify and study emerging variants of the COVID-19-causing SARS-CoV-2 virus, UN World Health Organization (WHO) scientists said on Tuesday. 

Alongside monitoring, virus and serum samples should be shared via globally agreed mechanisms so that critical research can be promptly initiated each time, according to the agency. 

“Our collective goal is to get ahead of the game and have a global mechanism to quickly identify and study variants of concern and understand their implications for disease control efforts,” said Ana Maria Henao Restrepo, Head of WHO’s R&D Blueprint

She was speaking at a virtual meeting of scientists from around the globe, convened by the UN health agency, attended by over 1,750 experts from 124 countries. 

Participants noted the importance of research to detect and understand early on the potential impact of emerging variants on diagnostics, treatments and vaccines, and highlighted the importance of integrating new SARS-CoV-2 variants research into the global research and innovation agenda, according to WHO. 

Normal for viruses to mutate 

It is normal for viruses to mutate, but the more the SARS-CoV-2 virus spreads, the more opportunities it has to change. High levels of transmission mean emergence of more variants should be expected, according to WHO.  

Of the significant variants reported so far, some are associated with increases in transmissibility but not disease severity. Research is ongoing to address whether the changes impact public health tools and measures. 

“So far an astounding 350,000 sequences have been publicly shared, but most come from just a handful of countries. Improving the geographic coverage of sequencing is critical for the world to have eyes and ears on changes to the virus,” said Maria Van Kerkhove, WHO Technical Lead on COVID-19

New variants of the coronavirus have been detected in the UK, South Africa and Japan, which appear to be more transmissible, although health officials have said that there is no evidence it is more deadly, or that it would not respond in the same way to the vaccines cleared for emergency use.

Information sharing critical 

Genomic sequencing has been critical in identifying and responding to new variants, and increasing sequencing capacity across the world is a priority research area for WHO. 

Better surveillance and laboratory capacity to monitor strains of concern needs to be accompanied by prompt sharing of virus and serum samples via globally agreed mechanisms so that critical research can be promptly initiated each time, the agency added. 

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