This week, the global death toll from COVID-19, the deadly virus caused by SARS-CoV-2, topped 3 million, and global cases topped 140 million, data compiled by Johns Hopkins University shows. As if that wasn’t bad enough, the Johnson & Johnson and Oxford/AstraZeneca COVID-19 vaccines sunk deeper into possible regulatory purgatory as the US and several EU countries restricted, paused or completely stopped their use altogether.
This oversized blog post is an evidence-based curation of key global news headlines on the coronavirus, burgeoning global COVID-19 vaccine “apartheid”, emerging deadly virus variants and mutations, increasing prevalence of vaccine “blood clots” and side-effects, vaccination pauses and restrictions, and the racist global politics around the distribution of life-saving COVID-19 vaccines for the week ending April 17, 2021, that we believe you will find informative and empowering in this moment of our collective vulnerability in this age of the global COVID-19 pandemic.
The Johnson & Johnson and AstraZeneca vaccines are two of the 13 “leading” COVID-19 vaccines either “approved for full use” (8) or currently being deployed for “limited use” (5) against the deadly virus around the world, according to The New York Times’ Coronavirus Vaccine Tracker. At least 89 COVID-19 vaccines are in various stages of development around the world.
Since effective vaccines hit the market late last year, the Johnson & Johnson and AstraZeneca COVID-19 vaccines have had a bumpy journey underlined by pauses and restricted use in several countries.
In February, South Africa stopped using the AstraZeneca COVID-19 vaccine after it had failed to protect people against the deadly B.1.351 variant of COVID-19, which has since been detected or become predominant in at least 47 other countries. Shortly afterwards, several countries, including Canada, the United States and several EU member states, condemned the vaccine to either limited use or outright pause in use.
This week, two US health agencies, the US Centers for Disease Control and Prevention (CDC) and US Food and Drug Administration (FDA), jointly recommended that the United Stated pause the use of Johnson & Johnson’s COVID-19 vaccine following reports of “cases of a rare and severe type of blood clot” in six women who had received the vaccine.
Rob Reddick, The Conversation’s commissioning editor for science and health, recently highlighted some of the inevitable global impacts of COVID-19 vaccine pauses and restrictions:
The decisions of these western nations’ regulators are having a knock-on effect elsewhere. The withholding of AstraZeneca and Johnson & Johnson vaccines in Europe and the US has dented both official and public confidence in these jabs, in some instances in countries where there are currently no alternatives… In other African countries still offering the AstraZeneca jab, public fear is mounting and doses are going unused. Considering how efforts to deliver vaccines to lower-income countries are already faltering, declining faith in the few doses that have been provided is worrying – this compounds the issue that coverage in low- and middle-income countries was already likely to be low for the foreseeable future.
Indeed, following US health agencies’ recommended pause in the use of the J&J COVID-19 vaccine, South Africa immediately temporarily paused its rollout of the vaccine, Reuters reports. Zweli Mkhize, the African country’s health minister, told reporters:
I held urgent consultations with our scientists, who have advised that we cannot take the decision by the FDA lightly. We have determined to voluntarily suspend our rollout until the causal relationship between the development of clots and the Johnson & Johnson vaccine is sufficiently interrogated.
Meanwhile, the ongoing global rollout of life-saving vaccines no longer guarantees victory over COVID-19 as new “variants of concern” have emerged and are spreading worldwide, “putting current pandemic control efforts, including vaccination, at risk of being derailed,” a group of leading health experts from around the world argued in a recent joint op-ed published in The Guardian.
These stubborn “variants” which, (1) spread faster (2) are more deadly and (3) are more resistant to current COVID-19 vaccines, now threaten the “progress” the world has made against COVID-19 since effective and safe vaccines were developed. They are wreaking havoc around the world.
This week, Canada “passed a grim milestone, with more new Covid-19 cases per capita than the U.S.,” according to Bloomberg. The fast-spreading COVID-19 variants are past of the equation. They have already forced Ontario, Canada’s most populous province, into another lockdown. The province began a 28-day “emergency brake” shutdown on April 3.
Several other countries are also experiencing “third waves” of COVID-19 that are directly linked to these deadly variants. According to The Guardian, the fast-spreading B.1.1.7 variant, first detected in the United Kingdom, is “currently the main driver of the spread” and burgeoning “third wave” of COVID-19 in several EU countries, where it also “increasingly being detected in children and young people.”
As of the end of March, the B.1.1.7 variant was also “quickly on its way to becoming the dominant variant of the virus in the United States,” a recent study by scientists at Scripps Research and the COVID-19 test maker Helix found.
Brazil’s P.1. COVID-19 variant, which is wreaking havoc in at least 20 countries, including Brazil and Canada, “can re-infect” a person who has previously recovered from COVID-19.
At the moment, researchers and health experts unanimously agree that current COVID-19 vaccines, including those that have an efficacy rate of over 90%, such as the Pfizer/BioNTech vaccine and Moderna vaccine, are not as effective against these variants as they are with the original virus. That’s because the vaccines were developed to fight the original COVID-19 virus, and not its variants or mutations.
Then there is burgeoning COVID-19 vaccine “apartheid”. And COVID-19 “vaccine nationalism”. A paper published by the Lancet in May 2020, warned about the “real” spectre of rich countries using their deep pockets to monopolize the global supply of future COVID-19 vaccines. Also in May 2020, Jane Halton, a former World Health Organization (WHO) board and the Australian chairperson of the Coalition for Epidemic Preparedness Innovations, warned that the development of an effective coronavirus vaccine could trigger a form of “vaccine nationalism” – a situation where “one country looks after itself first” and prioritizes its citizens’ survival “at the expense of the rest of the world”.
When we talk about “COVID-19 vaccine apartheid”, we’re talking about a situation where the global distribution of life-saving COVID-19 vaccines has the characteristics of apartheid as it was implemented in South Africa during the racist era of apartheid. As you will recall, apartheid in South Africa was all about depriving the Black majority of access to land, economic opportunities, decent housing, healthcare, basic human rights, essential freedoms, and basic human dignity. It was about prioritizing the minority white population while deliberately oppressing and depriving the Black majority.
In an opinion piece published in STAT in March, Jonathan Shaffer, a cofounder of Right to Health Action and Ph.D. candidate in sociology at Boston University, wrote:
Vaccine apartheid is an apt description of the injustice built into the current and persistent inequalities in vaccine access. The map of current Covid-19 vaccine access overlays neatly onto much older maps of colonial conquest.
Canada and several rich countries joined COVAX, formally called COVID-19 Vaccines Global Access, when it was created in early 2020. Co-led by the World Health Organization (WHO), Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi, the Vaccine Alliance, COVAX recognizes the fact that poor countries won’t be able to strike bilateral vaccination supply deals with the COVID-19 vaccine manufacturers. In fact, Ghana and Côte d’Ivoire received their first COVID-19 doses in early March through the COVAX initiative.
Then life-saving COVID-19 vaccines were developed and everything changed. In the last 5 months of 2020, even before the vaccines had been approved, Canada, the US and other rich countries with white majorities hoarded most of the COVID-19 vaccines. They signed 44 bilateral COVID-19 vaccine supply deals with pharmaceutical companies developing COVID-19 vaccines, leaving dozens of developing countries with BIPOC (Black people, Indigenous people and People of Colour) majorities with next to nothing.
An editorial piece published by The Lancet on December 18, 2020, stated that “the EU, the UK, the USA, and Canada have already made deals with manufacturers to buy more than 50% of the doses expected to be available in 2021, despite these countries representing only 14% of the global population.”
At the beginning of 2020, Canada and other greedy rich countries signed 12 more bilateral COVID-19 vaccine supply deals with with pharmaceutical companies, according to the WHO.
Canada was the greediest of them all. By December 2020, Canada had grabbed a staggering 362 million doses of the different COVID-19 vaccines that had been developed. At the time, that was enough COVID-19 vaccine doses to vaccinate each one of Canada 38 million people at least 9.6 times over. Still, that was not enough for Canada. Canada is also grabbing hundreds of millions of vaccines doses through the COVAX facility. As I write, Canada has hoarded enough vaccines to give each person here, myself included, 10 COVID-19 vaccine shots.
In March, Nobel laureates Joseph Stiglitz and Michael Spence decried “the ugliness of vaccine and other aspects of pandemic nationalism” in an interim paper entitled, “The Pandemic and the Economic Crisis“. The paper noted that Canada was one of the rich, white-dominated countries that “have ordered vaccine shots for more than ten times their current population” in violation of the “ethos of COVAX” and the global alliance’s main objective of facilitating “access to vaccines for all”.
In a scathing joint statement issued in February, UNICEF Executive Director Henrietta Fore and World Heath Organization WHO Director-General Dr. Tedros Adhanom Ghebreyesus characterized western countries’ hoarding of COVID-19 vaccines as a “self-defeating strategy” that will a) “cost lives and livelihoods”, b) “give the virus further opportunity to mutate and evade vaccines” and c) “undermine a global economic recovery.” According to Dr. Ghebreyesus, as a direct result of the hoarding of COVID-19 vaccines by Canada and other western countries:
The world is on the brink of a catastrophic moral failure – and the price of this failure will be paid with lives and livelihoods in the world’s poorest countries.
Earlier this week, former British prime minister Gordon Brown added his voice the growing global criticism of the injustice of COVID-19 vaccine apartheid. According to Brown:
Immunising the west but only a fraction of the developing world is already fueling allegations of ‘vaccine apartheid’ and will leave Covid-19 spreading, mutating and threatening the lives and livelihoods of us all for years to come.
Even though effective and safe COVID-19 vaccines have been developed and are being widely deployed around the world, the global war against the deadly pandemic is far from being won. Below are a few of the key global news headlines on the coronavirus, COVID-19 vaccine “apartheid”, deadly virus variants and mutations, vaccine “blood clots” and side-effects, vaccination pauses and restriction, and the racist global politics around the distribution of life-saving COVID-19 vaccines for the week ending April 17, 2021, that we believe you will find informative and empowering:
Global COVID-19 vaccine “apartheid”
Preventing poor countries suffering from vaccine “apartheid” will require the G7 group of rich nations to commit $30bn (£22bn) a year to a global immunisation drive, Gordon Brown has said.
The former Labour prime minister said the UK should use June’s G7 summit in Cornwall to rekindle the moral purpose of the Make Poverty History campaign of 2005, paying for its share of the new fund by reversing the government’s “misguided” cut to the foreign aid budget.
Brown, who has written for the Guardian outlining his plan for a $30bn-a-year mass vaccination programme, said he was alarmed that vaccination in Africa had barely begun and warned that this would have repercussions for rich nations. (Elliott, April 12, 2021) READ FULL STORY
The relentless pace of death from the global Covid-19 pandemic is continuing unabated despite global vaccination efforts, and is now being increasingly borne by the poorest places in the world. More than 3 million lives have been lost as a result of the novel coronavirus that emerged in 2019, with the latest 1 million recorded deaths coming even faster than the first two. It took about 8.5 months after the initial fatality in China to mark the first million, and just another 3.5 months to reach the second million. (Hong, April 17, 2021) READ FULL REPORT
More than 200 Sudanese doctors, nurses and medical workers have died from Covid-19, according to sources close to the health ministry – more than three times the official figure. Like other countries across sub-Saharan Africa, Sudan has struggled to obtain vaccines and distribute them to frontline medical staff. Many of the doctors who have died were senior consultants in their 50s and 60s or older, and so were in high-risk categories. (Salih, April 13, 2021) READ FULL STORY
Millions of healthcare workers in sub-Saharan Africa continue to risk their lives to fight Covid-19 as authorities across the continent struggle to obtain and distribute vaccines to frontline medical staff. Though hundreds of millions of people in western nations are now protected from the virus, doctors, nurses and others on the frontline of the fight against Covid in Africa will have to wait months, or even years, for a vaccine. Last Thursday the World Health Organization (WHO) said less than 2% of the 690m Covid-19 vaccine doses administered globally to date were given in Africa, where most countries received vaccines only five weeks ago and in small quantities.” (Burke, April 13, 2021) READ FULL STORY
The COVID-19 pandemic has negatively affected healthcare programs in low- and middle-income countries (LMICs) that work to protect populations against HIV, tuberculosis (TB), and malaria, according to a new report by the Global Fund to Fight AIDS, Tuberculosis, and Malaria. The fund found that, from April to September 2020, HIV testing fell 41%, TB referrals declined 59%, and malaria diagnoses fell 31% among 502 health facilities in 32 LMICs in Africa and Asia.
According to 85% of the surveyed facilities, COVID-19 was the main reason patients no longer sought healthcare, with most reporting fear of transmission (28%), disruption to public transit (20%), lockdown or stay-at-home orders (20%), and general delayed care-seeking behaviors (15%). For instance, antenatal care visits fell 43%, and in seven Asian countries, they fell 66% while consultations for children under 5 dropped 74%. (April 13, 2021) READ FULL STORY
The coronavirus has killed an estimated 1,300 babies in Brazil since the beginning of the pandemic, even though there’s overwhelming evidence that Covid-19 rarely kills young children. While data from the Health Ministry suggest that over 800 children under age 9 have died of Covid-19, including about 500 babies, experts say the real death toll is higher because cases are underreported because of a lack of widespread coronavirus testing, according to the BBC, which first reported the story. (Acevedo, April 15, 2021) READ FULL STORY
COVAX, the global initiative to coordinate the distribution of COVID-19 vaccines in an equitable way, is crucial for bringing the pandemic under control. But COVAX’s aim of delivering 2 billion doses to participating countries by the end of 2021 – including 92 low-income countries that can’t afford to buy vaccines directly from manufacturers – is threatened by chronic under-investment, vaccine nationalism and export restrictions… The vulnerability of our vaccine procurement strategy has become clearer over the last few weeks, with supply blockages limiting vaccine imports from Europe and now the government’s warning about the AstraZeneca vaccine and its links to a rare blood-clotting disorder. (Gleeson, April 12, 2021) READ FULL STORY
The world has a COVID-19 vaccine access problem: Almost half of all doses administered so far have been in Europe and North America, while many poorer countries have vaccinated less than than 1% of their populations. With new coronavirus variants raising the health risk, South Africa and India have proposed that the World Trade Organization temporarily waive intellectual property rights for COVID-19 vaccines to help ramp up production.
The U.S., Britain and the European Union rejected the idea, arguing that intellectual property rights – which give vaccine creators the power to prevent other companies from reproducing their products – are necessary to ensure innovation and waiving them would not result in increased production. They are now under pressure to change their minds. (Shabalala, April 14, 2021) READ FULL STORY
The following four COVID-19 virus-related news headlines are from before this week:
The New York Times: Rich Countries Signed Away a Chance to Vaccinate the World
The rapid development of Covid-19 vaccines, achieved at record speed and financed by massive public funding in the United States, the European Union and Britain, represents a great triumph of the pandemic. Governments partnered with drugmakers, pouring in billions of dollars to procure raw materials, finance clinical trials and retrofit factories. Billions more were committed to buy the finished product. But this Western success has created stark inequity. Residents of wealthy and middle-income countries have received about 90 percent of the nearly 400 million vaccines delivered so far. Under current projections, many of the rest will have to wait years.
By partnering with drug companies, Western leaders bought their way to the front of the line. But they also ignored years of warnings – and explicit calls from the World Health Organization – to include contract language that would have guaranteed doses for poor countries or encouraged companies to share their knowledge and the patents they control. (Gebrekidan and Apuzzo, March 21, 2021) READ THE FULL STORY
Financial Times: How to vaccinate the world
One day we could have mRNA-based vaccines for HIV, tuberculosis and cancer, says Ugur Sahin, co-founder of BioNTech and developer of Pfizer’s vaccine. RNA solutions could be used in agriculture instead of chemical pesticides, says GreenLight Biosciences. In fact, the potential of RNA is one reason why pharma companies are clinging to patents.
They aren’t interested in making money from vaccinating Africa against Covid-19. They are playing a longer, bigger game. With HIV drugs, we wasted a fatal decade. Doing the right thing this time could spur global medicine into a new era. It wouldn’t even be particularly expensive. (April 1, 2021) READ THE FULL STORY
… During the second week of March, the world had a chance to engage in multilateral collaboration to share the vaccine technology necessary to reach global herd immunity. At a general meeting of the World Trade Organization, South Africa and India proposed a waiver of the Trade-Related Aspects of Intellectual Property Rights agreement (TRIPS). That waiver would have temporarily suspended certain vaccine technology patent monopoly protections during the Covid-19 crisis and enabled access to the “recipe” and manufacturing protocols for effective vaccines to be shared with producers around the world. But it was sabotaged by trade representatives from the U.S., the United Kingdom, and other wealthy countries in the Global North who argued that current intellectual property rights were crucial to maintaining a innovation in the drug-development market.
Following the WTO’s failure to act, Biden’s best option to lead the world toward equitable vaccine access is by using his executive powers to extricate the Moderna, Pfizer, and Johnson & Johnson vaccine patents from the grip of stifling monopolies and license the Covid-19 vaccine technology to the World Health Organization’s Covid-19 Technology Access Pool, which would enable a rapid scale-up of generic vaccine manufacturing worldwide. (Shaffer, March 25, 2021) READ FULL STORY
If you live in Dubai, New York, or London, the pace of Covid-19 vaccinations makes it seem like the end to the coronavirus pandemic is in sight. But if you call Lagos or Nairobi home, the contrast is stark: fewer than 100,000 shots have been administered on the African continent, while the UAE, the US and the UK are vaccinating vastly more than that everyday.
The pandemic will not end until everyone is vaccinated – and quickly. At the current pace, full vaccination will not occur until the end of 2022, but we must find a way to make enough vaccines, about 15 billion doses, before serious vaccine-resistant variants overtake us. That’s daunting, but it is possible to meet the challenge… Vaccines for Covid-19 cannot yet be manufactured in Africa. Local manufacturing – that is to say, a factory on the continent itself – would help meet the demand and increase the pace of vaccinations. The Covax initiative plans to send 600 million doses to Africa, enough for only about 20 per cent of its population; so far only 20 million have been delivered. Africa is, essentially, at the back of the line. (Zarur, April 2, 2021) READ FULL STORY
COVID-19 and “rare blood clots”
As of April 12, more than 6.8 million doses of the Johnson & Johnson (Janssen ) vaccine have been administered in the U.S. CDC and FDA are reviewing data involving six reported U.S. cases of a rare and severe type of blood clot in individuals after receiving the J&J vaccine. In these cases, a type of blood clot called cerebral venous sinus thrombosis (CVST) was seen in combination with low levels of blood platelets (thrombocytopenia). All six cases occurred among women between the ages of 18 and 48, and symptoms occurred 6 to 13 days after vaccination. Treatment of this specific type of blood clot is different from the treatment that might typically be administered. Usually, an anticoagulant drug called heparin is used to treat blood clots. In this setting, administration of heparin may be dangerous, and alternative treatments need to be given. (CDC, April 13, 2021) READ FULL STATEMENT
Although still murky, a picture is starting to emerge about the connection between two types of COVID-19 vaccines and rare blood clots. The Johnson & Johnson vaccine, which has been delivered to more than 6.8 million Americans, has been associated with at least six cases of severe and very uncommon blood clots in women ages 18 to 48. “It just doesn’t happen in healthy people out of the blue, and that’s what’s happening,” said Dr. Hanny Al-Samkari, a hematologist and clinical investigator at Massachusetts General Hospital. (Weintraub, April 14, 2021) READ FULL STORY
The AstraZeneca vaccine and the rare but serious blood clots it’s associated with have been on everyone’s mind lately. That condition has been given the term Vaccine Induced Immune Thrombotic Thrombocytopenia or VIIT. As physicians, health advocates and science communicators, we are frustrated with the confusing discourse around AstraZeneca and the many misguided opinions on the topic. We see sensational posts from both sides of this discussion. (Vohra-Miller and Pai, April 17, 2021) READ FULL STORY
The Atlantic: The Blood-Clot Problem Is Multiplying
For weeks, Americans looked on as other countries grappled with case reports of rare, sometimes fatal blood abnormalities among those who had received the AstraZeneca vaccine against COVID-19. That vaccine has not yet been authorized by the FDA, so restrictions on its use throughout Europe did not get that much attention in the United States. But Americans experienced a rude awakening this week when public-health officials called for a pause on the use of the Johnson & Johnson vaccine, after a few cases of the same, unusual blood-clotting syndrome turned up among the millions of people in the country who have received it. The world is now engaged in a vaccination program unlike anything we have seen in our lifetimes, and with it, unprecedented scrutiny of ultra-rare but dangerous side effects. (Khamsi, April 16, 2021) READ FULL STORY
She had seen the conspiracy theories on Facebook, the endless anti-vaccine videos. Aminata Gueye shrugged it all off as silly chatter and signed up for an AstraZeneca shot courtesy of a World Health Organization-backed vaccine push called Covax. Then came some news on the radio in Dakar: Some European countries had suspended use of the vaccine after regulators found apparent links to rare, but potentially fatal, blood clots. Gueye never went to the clinic. “I was impatient to get vaccinated,” said Gueye, 38. “Now I have doubts.”
Lingering hesitation about the two-dose AstraZeneca coronavirus vaccine may shape the next phase of the effort to vaccinate the world. The easy-to-store and affordable AstraZeneca shot, developed with the University of Oxford, is central to the WHO-led Covax initiative to distribute doses globally, particularly in developing countries left out of the global vaccine race. Delays and questions about safety – especially the potential risk of blood clot risks for younger women – have brought new challenges to Covax just as the rollout was getting underway. (Paquette, Rauhala, Morris and Sly, April 16, 2021) READ FULL STORY
A week after receiving the AstraZeneca Covid-19 vaccine, a 37-year-old woman in Norway went to the emergency department with fever and persistent headaches. A CAT scan of her head showed a blood clot in blood vessels involved in draining the brain, but her levels of platelets, involved in clotting, were low. She was treated with platelet infusions and a blood thinner, but had a bleed in her brain the next day. She underwent surgery to relieve the pressure on her brain but died two days later.
This is the side effect, known as cerebral venous sinus thrombosis, that has caused a week of worries around the Covid-19 vaccine developed by AstraZeneca. On Tuesday, the U.S. government said that it had seen the same effect six times among the 6.8 million people given a dose of a similar vaccine, from Johnson & Johnson, and that it recommended a pause on use of that vaccine “out of an abundance of caution,” while researchers investigated. (Herper, April 15, 2021) READ FULL STORY
COVID-19 – the actual disease – poses 8 to 10 times the threat of blood clots in the brain than do coronavirus vaccines, a large, non–peer-reviewed study led by University of Oxford researchers finds. The study, published today on the preprint server OSF, involved an electronic health records network of 81 million patients at 59 healthcare systems, mainly in the United States.” (Van Beusekom, AprIL 15, 2021) READ FULL STORY
A study by researchers at Oxford University in England suggests the risks of experiencing dangerous, rare blood clots in the brain are far higher in those who catch the coronavirus than in those who get either the AstraZeneca vaccine, or the vaccines made by Pfizer and Moderna in the U.S. Another finding of the research, which was disputed by Pfizer and called “confusing” by the top infectious disease expert in the U.S., was that the number of people who experience clots after getting the vaccines made by the American companies appears very similar to the number who get the rare condition after a shot of the AstraZeneca drug, which was developed in conjunction with Oxford’s vaccine institute. (Reals and Berriman, April 16, 2021) READ FULL STORY
COVID-19 vaccine pauses, restrictions and permanent suspensions
South Africa has suspended the rollout of Johnson & Johnson’s (J&J) COVID-19 vaccine, its health minister said on Tuesday, after U.S. federal health agencies recommended pausing its use because of rare cases of blood clots. The U.S. Food and Drug Administration (FDA) said the pause there was expected to be a matter of days. Six women under 50 developed rare blood clots in the United States among more than six million people given the J&J shot so far.
“I held urgent consultations with our scientists, who have advised that we cannot take the decision by the FDA lightly,” Health Minister Zweli Mkhize told reporters. “We have determined to voluntarily suspend our rollout until the causal relationship between the development of clots and the Johnson & Johnson vaccine is sufficiently interrogated,” Mkhize added, saying there had been no reports of such clots in South Africa after roughly 290,000 vaccinations.(Winning, April 13, 2021) READ FULL STORY
Denmark became the first country in the world to permanently stop using the AstraZeneca vaccine on Wednesday, as the European Commission president hinted that Brussels would not renew its contract with the company next year. Danish health authorities said they would stop using the Oxford University jab because of a possible link between the AstraZeneca vaccine and cerebral venous sinus thrombosis (CVST), a brain blood clot. Denmark was the first EU country to suspend the use of the shot on March 11. The European Medicines Agency (EMA) has said that the benefits of the vaccine, which is significantly cheaper than the others and easy to story, far outweigh the health risks. (Crisp, April 14, 2021) READ FULL STORY
South Africa has faced blow after blow to its pandemic-control efforts: A worrisome variant swept across the country, driving a devastating second wave of coronavirus cases. Then officials had to scramble for an alternative when the vaccine it had bet on, from AstraZeneca, proved ineffective against the variant, which can partially dodge the body’s immune system response. Now the alternative – Johnson & Johnson’s single-dose vaccine, the only one now in use in South Africa – has run into trouble as well, over concerns of rare blood clots that emerged in a handful of people in the United States who had received the shot. It is unclear whether the vaccine is responsible.
South Africa’s health minister, Dr. Zwelini Mkhize, announced on Tuesday that the country would temporarily halt its vaccine program for medical workers, which has inoculated around 290,000 people so far. Dr. Mkhize said he expected the program – a clinical trial – to resume in a few days, after the authorities have had a chance to look into the blood clot cases in the United States. (Goldbaum, April 14, 2021) READ FULL STORY
The European Union’s drug regulator is accelerating its review of blood-clot reports with Johnson & Johnson’s Covid-19 vaccine and said it expects to issue a recommendation next week. EU member states should store doses as they await guidance, and the European Medicines Agency said in an emailed statement it will decide shortly whether “regulatory action is necessary.” U.S. officials paused immunizations on Tuesday after six women suffered a type of brain blood clot similar to that reported as a rare side effect to the AstraZeneca Plc vaccine. The delay marks another blow to efforts to vaccinate the world and bring the pandemic to a close. (Fourcade, April 13, 2021) READ FULL STORY
Modern Healthcare: Long-Term Care Providers Concerned By Effects Of J&J COVID-19 Vaccine Pause
The American Health Care Association and the National Center for Assisted Living are calling for the federal government to prioritize the vaccination of long-term care residents and staff after federal regulators suggested temporarily halting use of the Johnson & Johnson COVID-19 vaccine over concerns about blood clots. “Unfortunately, today’s development essentially halts vaccinations in long term care, as the federal government was primarily allocating the Johnson & Johnson vaccine to nursing homes and assisted living communities,” Dr. David Gifford, chief medical officer for AHCA/NCAL, said in a prepared statement. “Without swift action to replace these vaccines, we could see tragic consequences.” (Christ, April 13, 2021) READ FULL STORY
The potential side effect is a blood clot in the veins that drain blood from the brain. This is called central venous sinus thrombosis. In the vaccine-associated cases of this, platelets in blood, which are important for making clots, have been lower than normal. This same side effect has been seen in the AstraZeneca COVID-19 vaccine that also uses an adenovirus to deliver the coronavirus spike glycoprotein. In the case of the AstraZeneca vaccine, the clotting disorder has been linked to antibodies against platelet factor 4 (PF4) that are apparently induced by the adenovirus backbone of the vaccine. This antibody causes the clotting disorder by activating platelets to clot. It is important to note that this disorder, called vaccine-induced immune thrombotic thrombocytopenia, is not a problem with the mRNA-based Pfizer and Moderna COVID-19 vaccines. (Petri, April 13, 2021) READ FULL STORY
The FDA’s decision to pause the use of Johnson & Johnson’s coronavirus vaccine has set off a chain reaction of fear — about the safety of the vaccine, and about whether the FDA is overreacting — that’s causing unnecessary drama just as the vaccine effort is finally picking up speed. Throughout the pandemic, the public and the media, and sometimes even regulators, have struggled to keep risks in perspective — to acknowledge them without exaggerating them, and to avoid downplaying them because other people will exaggerate them. (Baker, April 14, 2021) READ FULL STORY
COVID-19 virus surges
For the first time since the pandemic began, Canada has passed a grim milestone, with more new Covid-19 cases per capita than the U.S. There have been roughly 22 new recorded cases per 100,000 people in the country over the past seven days. Ontario is being hit the hardest with hospitals coming under increasing strain, especially in Toronto, the country’s largest city. “This is the worst moment of the pandemic, thus far,” Kevin Smith, Chief Executive Officer of the University Health Network, said in an interview Monday. “Our ICUs are full.” (Bochove and Hertzberg, April 12,2021) READ FULL STORY
The head of the World Health Organization said Friday that an alarming rise in Covid cases has pushed global infections toward their highest level in the pandemic.
“Around the world, cases and deaths are continuing to increase at worrying rates,” WHO Director-General Tedros Adhanom Ghebreyesus said in a briefing focused on Papua New Guinea and the western Pacific. “Globally, the number of new cases per week has nearly doubled over the past two months. This is approaching the highest rate of infection that we have seen so far during the pandemic,” he continued. (Meredith, April 16, 2021) READ FULL STORY
More than three million people globally have died of Covid-19 since the start of the pandemic, Johns Hopkins University said on Saturday. With 566,224 deaths, the US has the highest number of fatalities, followed by Brazil with 368,749 and Mexico with 211,693. The World Health Organization (WHO) said on Monday the pandemic was at a “critical point” and warned that the world needed a reality check. After a brief decrease in March, the number of deaths worldwide is on the rise again, with an average of approximately 12,000 deaths, approaching the 14,500 daily death toll (7-day rolling average) recorded at the end of January. Countries such as the US and the UK have seen their number of new daily deaths falling since late January due to vaccination campaigns, whereas India and Brazil are facing unprecedented surges in infections. (Goillandeau, April 17, 2021) READ FULL STORY
Many Indian hospitals were scrambling for beds and oxygen as COVID-19 infections surged to a new daily record on Thursday, with a second wave of infections centred on the rich western state of Maharashtra. India’s tally of total infections is second only to the United States, with experts blaming everything from official complacency to aggressive variants. The government has blamed failure to practise physical distancing. (Ravikumar and Arora, April 15, 2021) READ FULL STORY
The New York Times: Ontario, hit with a virus surge, backtracks on sweeping new police powers
Just a day after extending and expanding its stay-at-home orders, Ontario – Canada’s most populous province – limited sweeping new powers that it had granted to the police to enforce the mandates in an effort to curb rising case numbers and hospitalizations. On Friday, Doug Ford, the premier, announced that the police would be able to randomly stop and question people, including those in vehicles, to make sure that their trips outside home were essential. Anyone outside their home and not following the rules could face fines.
While polls suggest that there is general public support for restrictions throughout Canada, Mr. Ford’s plan for the police to conduct random checks immediately provoked a backlash. In announcing that his organization would begin a legal challenge on Saturday, Michael Bryant, the president of the Canadian Civil Liberties Association, said in a statement that “the regulation brings back the odious ‘driving while Black’ police stop, and introduces a ‘walking while Black’ offense.” (Austen, April 17, 2021) READ FULL STORY
COVID-19 variants and mutations
The P1 SARS-CoV-2 variant, which was first identified in Brazil, may be more than twice as transmissible as non-P.1 lineages, and it may lower protective immunity from non-P1 variants 21% to 46%, according to a study published yesterday in Science. From November 2020 to January 2021, the researchers conducted genomic sequencing on 184 COVID-19 samples collected from the city of Manaus in Brazil’s Amazonas state, which has experienced two major COVID-19 surges. Phylogenetic analysis showed that P1 and another lineage, P2, were descendants of lineage B1128, and that P1 probably diverged around Nov 15 after a period of faster molecular evolution. This was 3 to 4 weeks before Manaus, home to 2.2 million people, saw a COVID resurgence. Within about 7 weeks from late 2020 to early 2021, the fraction of samples classified as P1 increased from 0% to 87%. (April 15, 2021) READ FULL STORY
With Covid-19 vaccines, the world hopes to beat back the virus that causes the disease. But some scientists are increasingly concerned that, because of a quirk of our own biology, future iterations of the vaccines might not always be quite as effective as they are today. The concerns stem from a phenomenon that is known as imprinting, sometimes called original antigenic sin, which is believed to affect how we respond to some pathogens. In short, when your body is introduced to a particular threat for the first time – either through infection or a vaccine – that encounter sets your immune system’s definition of that virus and what immune weapons it needs to detect and protect against it in the future. (Branswell, April 16, 2021) READ FULL STORY