Regular life may have resumed for most people, but the pandemic rumbles on as researchers keep a watch on new variants and increase efforts to better identify patients at risk.

By  VITTORIA D’ALESSIO

Everyone, it seems, is more than ready to move on from Covid-19, but virus experts say it’s still too early for us to lower our guard.

That’s because the pandemic, they insist, is far from over. Indeed, in a typical week, 180 000 new cases are still being reported across Europe. So, while regular life has resumed for most of us – and the World Health Organization has dropped the status of Covid-19 as a ‘global emergency’ (the highest level of alert) – scientists remain vigilant.

‘We might have good control over the pandemic – and the vaccine has played a major role in achieving this – but the virus continues to persist, and the situation is still very dynamic,’ said Professor Giuseppe Pantaleo, head of Immunology and Allergy at the Swiss Vaccine Research Institute.

The virus causing Covid-19 is an artful opportunist, endlessly evolving to evade our defences – and with each significant mutation comes the threat of a new wave of infection. According to Pantaleo, a time is likely to come when our current defences – whether built up through infection or acquired by vaccination – will no longer effectively counter the virus. Complacency could be a costly mistake.

‘It’s critical for us to keep monitoring populations for new variants,’ said Pantaleo. ‘We need to know the impact each mutation has on the effectiveness of vaccines and treatments so we can be prepared for what is coming next and put in place new measures to control the spread.’

Active surveillance

Pantaleo coordinates CoVICIS, a three-year Covid-19 surveillance programme due to end next year and funded by the EU to the tune of €10 million.

CoVICIS involves researchers in Switzerland, Italy, France, Germany, South Africa and Ethiopia. African involvement is essential for the project to fulfil its ambition of evolving into a surveillance platform with a global reach.

Most countries on the African continent lack the infrastructure to monitor infections within their borders. Moreover, much of Africa’s population remains unvaccinated, said Pantaleo, meaning the virus has more opportunity to spread and mutate (a fact that probably explains why several variants, including Omicron, first emerged in Africa).

For good reason then, monitoring the evolution of Covid-19 in Africa is a pressing concern. However, Pantaleo hopes the programme will set the stage for collaborations with an even wider reach.

‘This pandemic has taught us that when it comes to dangerous pathogens we are all connected. We need to establish a new type of research infrastructure so, when it’s time to deal with a new virus, we can quickly mobilise the world’s scientific community and work as one,’ he said.

Identifying risk

Since the earliest days of the pandemic, scientists have been looking for new means to predict how any given person is likely to respond to a Covid-19 infection. The way some experience the virus as a mild cold while others die can seem almost random. Though there’s no doubt that having a comorbidity or an underlying non-diagnosed condition puts a person at higher risk, little is known about why some healthy individuals develop severe Covid-19.

There are two types of at-risk patients the researchers hope to identify: those who are hit hard during the acute phase of illness and those who are saddled with the debilitating symptoms of long-Covid.

‘What we must remember is that for many people, the virus causing Covid does not simply infect the lung cells, cause a few pulmonary problems and then go away,’ said Dr Yvan Devaux, leader of the Cardiovascular Research Unit at the Luxembourg Institute of Health. ‘For a substantial number of people, an infection leads to problems that affect the entire body and persist long-term.’

What has become clear from the work by Devaux and others is that Covid-19 can be bad for your heart.

One study of 160 000 unvaccinated people found that infected patients in the acute phase of their illness are four times more likely than uninfected individuals to develop a major cardiovascular disease – and 40% more likely in the 18 months that follow.

Taken to heart

This is true regardless of age, sex, race or pre-Covid-19 health status and whether an infection is mild or severe. However, the worst cardiovascular outcomes are experienced by Covid-19 patients who end up in intensive care and people with pre-existing cardiovascular conditions.

In other words, serious infections increase the likelihood of developing heart conditions and pre-existing heart conditions increase the likelihood of dying from Covid-19.

The problem is, cardiovascular disorders have an uncanny ability to remain hidden: a heart attack is often the first sign of an underlying problem. For this reason, finding reliable ways to expose cardiac problems before they become critical has long been a research priority within the EU.

Devaux and his collaborators have been trying to find new tests to diagnose cardiovascular conditions for many years. The pandemic simply spurred them on.

New tests to pre-empt complications

In March 2020 – the same month the World Health Organization declared Covid-19 a pandemic – the team decided to find a way to identify Covid-19 patients who were most likely to develop heart complications after an initial infection.

‘We had good reason to believe there would be a strong link between Covid infection and coronary heart conditions,’ said Devaux, ‘and we wanted to be part of the international effort to save lives.’

The EU-funded COVIRNA project is devising a test to predict who is most likely to develop cardiovascular complications.

The hope is that an affordable blood test will soon be ready to roll out to hospitalised Covid-19 patients. It will measure a specific type of free-floating RNA molecule that has been linked to cardiovascular disease.

The researchers have collated RNA data from 2 000 study participants and are currently using artificial intelligence to analyse this information and create a reliable tool to predict an individual’s risk.

High-risk patients will then receive personalised care to monitor their health and, if necessary, receive treatment to degrade the troublesome RNA molecules.

‘Patients would get the test a few days into the disease and doctors would then be able to tailor their care – for instance, by sending them for a heart MRI scan when they otherwise wouldn’t have one or by redirecting them to a cardiologist to be watched closely,’ said Devaux.

‘We might not be able to close the last page on Covid quite yet, but this test could be considered a good output of the pandemic.’

Research in this article was funded by the EU. This article was originally published in Horizon, the EU Research and Innovation Magazine. 

Experiencing trauma can cause significant harm to an individual’s wellness. It is crucial to find strategies for addressing and handling the emotions and symptoms of events such as severe accidents, physical assault, natural disasters, and mental and emotional traumas. Trauma recovery is a journey that looks different for every individual. However, some strategies can prove helpful in managing symptoms and moving toward healing. Here are six ways to treat trauma:

1.      Engage in Sensory Activities

Sensory activities can help to ground an individual in the present moment and ease symptoms of anxiety or panic associated with trauma. These activities involve engaging the senses through sight, smell, sound, taste, and touch exercises. For example, you can practice deep breathing while focusing on a calming image like a beach scene, listen to soothing music, or incorporate aromatherapy with a calming essential oil like lavender.

Additionally, tactile exercises can promote relaxation. For instance, squeezing a stress ball or kneading playdough can be excellent grounding techniques. Listening to music and engaging in activities involving sound drumming and playing an instrument can also help individuals connect with their bodies and emotions.

2.      Practice Self Compassion

To overcome trauma, be kind to yourself and practice self-compassion. Treating oneself with kindness, acknowledging and validating one’s emotions, and being as caring towards oneself as towards loved ones fosters self-acceptance and non-judgmental thoughts. Eventually, this helps build resilience and makes it easier to manage symptoms.

3.      Seek Professional Support

An experienced professional can help to identify, process, and manage the emotions associated with trauma. Your clinician might suggest different treatment approaches, like EMDR therapy, CBT, Hypnotherapy, or DBT. These techniques focus on relieving trauma symptoms and helping you cope with trauma aftermath. Additionally, therapy can provide a safe place for an individual to talk about their traumatic experiences and express difficult emotions without judgment.

4.      Join Support Groups

Joining a support group of others who have experienced trauma can be a beneficial tool for treatment. The members provide emotional support and help you process the experience. Such groups can also normalize feelings and help participants reframe their experiences more positively.

Online support communities are available for those who cannot attend in-person support groups. Online forums offer the same benefits as an in-person group but without having to leave one’s home. Support groups are a great way to build resilience and manage trauma symptoms. In a support group setting, you openly express your feelings and experiences to others going through similar struggles without fearing judgment.

5.      Medication

Your doctor may also recommend medications to help manage trauma symptoms. Depending on your condition, medications such as antidepressants, anxiety medicines, or sleeping pills may be prescribed. Medication can be especially helpful if you are having difficulty managing your emotions and daily life after trauma. However, it is important to note that medications should never replace therapy or coping strategies but rather act as a supplement.

6.      Develop Healthy Coping Mechanisms

To better manage trauma symptoms, it is important to cultivate healthy coping mechanisms. Avoid harmful coping mechanisms like substance abuse, unhealthy eating habits, and self-harm behavior. Instead, prioritize healthy habits like regular exercise, establishing healthy sleep patterns, surrounding yourself with supportive people, and setting goals.

In summary, there is no single solution for treating trauma. The most critical aspect of trauma recovery is finding coping techniques customized to your case and strengthening your resilience. Although it may seem challenging, always hold onto hope and don’t give up. Investing in treatment, practicing patience with oneself, and seeking support from loved ones will undoubtedly lead you toward healing and transformation.

The African Union Commission (AUC) and the Vaccine Alliance (Gavi), in an effort to increase access and accelerate the uptake of life-saving vaccines across African Union member states towards supporting immunisation, providing technical and learning assistance and health systems strengthening, have signed a Memorandum of Understanding (MoU) mid-May 2023.

“Children of today are the leaders of tomorrow. Knowing they are prone to preventable life-threatening diseases, we – current leaders – must do all it takes to protect and secure their future.‎‎ I am well-pleased with the growth of the partnership between the AUC and Gavi, which I am certain will accelerate reducing the number of zero-dose children worldwide by 2030,” said H.E. Amb. Minata Samate Cessouma, Commissioner for Health, Humanitarian Affairs and Social Development.

“In September 2022, the African Union Commission and Africa CDC launched the New Public Health Order, which offers insights and a roadmap towards health security on the continent. The collaboration of the AUC and Gavi will further relate to Africa CDC-led initiatives for vaccine uptake in AU member states, as well as support investments in the goal to locally manufacture 60% of the vaccine doses required on the continent by 2040” underscored the Director General, Africa CDC, Dr. Jean Kaseya.

“As an Alliance of governments, partners, civil society, industry and others, Gavi has a longstanding commitment to support access to life-saving vaccines through sustainable immunization programmes, and to collaborate with countries to strengthen health systems across Africa. This MoU is the strengthening of our shared determination to protect more children against vaccine-preventable diseases and to help realise the AU’s vision for sustainable vaccine manufacturing and the New Public Health Order on the continent,” stated the  CEO of Gavi, Dr. Seth Berkley.

Through this MoU, AUC and Gavi Alliance commit to work together to:

1. Scale up and strengthen routine immunization, focusing on reaching “zero dose” children – children that have not received a single dose of a routine vaccine;

2. Build sustainable regional vaccine manufacturing in Africa;

3. Undertake joint advocacy to boost vaccine demand for routine vaccines;

4. Strengthen primary health care systems and bolster diagnostic and surveillance capacity for diseases such as yellow fever, cholera, and typhoid;

5. Communicate jointly on routine immunization, pandemic prevention, preparedness and response (PPR), vaccine access and delivery;

The AUC and Africa CDC, in April 2021, established the Partnerships for African Vaccine Manufacturing (PAVM) to steer a bold goal that will enable the African vaccine manufacturing industry to develop, produce, and sustainably increase supply, from less than 1 percent, currently. This goal can be reached through achieving sustainable and reliable economies of scale by launching mechanisms that create demand certainty for manufacturers while facilitating country procurement. 

The AU Bureau of Heads of State and Government further requested Gavi Alliance and other partners to procure a percentage of all vaccines produced by the continent. In December 2022, the Gavi Alliance Board approved a plan to support the development of a regionally diversified vaccine manufacturing ecosystem, based on three pillars: support for strategic antigen selection by manufacturers/countries, market shaping and demand creation.

The initiative, supported by the African Union, Africa CDC, G7 and other stakeholders also envisages the possibility of a fourth pillar, the design of a new financial instrument in the form of an Advance Market Commitment (AMC) for African vaccine manufacturing.

The global COVID-19 pandemic and climate change impact have jeopardised the health, security, and livelihoods of people across Africa and impeded the progress made over the years in reaching over 400 million children with vaccines and averting more than 9.9 million future deaths on the continent. 

The major focus of this new agreement is forging new and strengthened partnerships to reach the millions of “zero-dose” children, particularly in marginalised settings that still lack access to vaccines and other essential services in addition to providing a concrete framework for the AUC and Gavi Alliance to jointly address these challenges, identify gaps and monitor progress to achieve universal access to immunization and drive positive impacts on the continent.

According to reports, the MoU was signed on behalf of the African Union Commission Chairperson by the AU Commissioner for Health, Humanitarian Affairs & Social Development (HHS), H.E. Amb. Minata Samate Cessouma and Africa Centre for Disease Control and Prevention (Africa CDC) Director General, Dr. Jean Kaseya and Gavi Chief Executive Officer Dr. Seth Berkley. 

The partnership builds on the historic Addis Declaration on Immunization (ADI), which aims to ensure that everyone in Africa – regardless of who they are or where they live – receives the full benefits of immunization. It includes 10 commitments to increase political, financial and technical investments in immunization programs. The evolving direction of this partnership is bound to accelerate the attainment of health security as premised in the AU Agenda 2063 and the New Public Health Order (NPHO).