New Coronavirus News from 17 Mar 2022

What to Know About a Fourth COVID-19 Vaccine Dose [TIME, 17 Mar 2022]

BY ALICE PARK

A health care administer gives the second dose of the Pfizer-BioNTech COVID-19 vaccine to a person at the L.A. Care Health Plan free testing and vaccination site at the First African Episcopal Church in Los Angeles, California, U.S., January 29, 2022.

Most people ages 12 and older are considered “up to date” with their COVID-19 vaccines if they received either three doses of the mRNA shots from Pfizer-BioNTech or Moderna, or two doses of Johnson & Johnson’s Janssen vaccine. But some public health experts say another dose might be needed in the coming months.

On March 15, Pfizer and BioNTech requested authorization from the U.S. Food and Drug Administration (FDA) for a fourth dose of their vaccine in people ages 65 and older. In the past few days, Albert Bourla, Pfizer’s CEO, has said that he believes everyone will one day need a fourth dose in order to help prevent infections (a move that would have obvious benefits for the company’s bottom line.)

In order to authorize a fourth shot, the FDA will consider still emerging data that don’t paint a definitive picture about whether an additional dose is necessary for most people. One the one hand, there are troubling signs that the immunity provided by the vaccines is starting to wane, which could make people more vulnerable to COVID-19’s more severe effects. Recent data published by the U.S. Centers for Disease Control and Prevention (CDC) show that protection against hospitalization for COVID-19 waned even after a booster dose of either the Pfizer-BioNTech or Moderna vaccines. From Aug. 2021 to Jan. 2022—a time span that includes waves of both Delta and Omicron variants—the booster was 91% effective at protecting against hospitalization in the first two months after people received it, but dropped to 78% four months after the shot. The vaccine efficacy against emergency room and urgent care visits for COVID-19 symptoms followed a similar decline, from 87% up to two months after the booster to 66% four to five months after the booster.

“We don’t know when you get to six months, seven months, or eight months after the third dose whether that 78% is going to go down to 60%, 50%, or 40%,” says Dr. Anthony Fauci, the White House’s chief medical advisor on COVID-19 and director of the National Institute of Allergy and Infectious Diseases. “For that reason, you are going to hear serious consideration for giving a fourth boost to the elderly and those with certain underlying health conditions.
What we might be seeing in the reasonable future is that individuals, merely on the basis of age, and perhaps some underlying health conditions yet to be determined, would get an immediate boost.”

On the other hand, another small study published in the New England Journal of Medicine among younger health care workers in Isreal showed that adding a fourth dose for people vaccinated and boosted with the Pfizer-BioNTech shot may only have “marginal benefits,” according to the researchers. While the additional dose raised levels of antibodies that can neutralize the virus, including Omicron, slightly, those levels were relatively similar to peak amounts of antibodies people generated after the first booster, or third dose. The study did not focus on elderly people or those with compromised immune systems.

The U.S. CDC already recommends a fourth mRNA vaccine dose for people with weakened immune systems, including transplant patients and those undergoing chemotherapy for cancer, and other countries have similar guidelines. Israeli health officials have gone one step further; on Jan. 22, as cases and hospitalizations crept upward, the country authorized a fourth dose of the Pfizer-BioNTech mRNA vaccine for health care workers and people over 60 years old. The decision was based on early data from Israel’s Ministry of Health and researchers at several Israeli universities showing that among nearly a million vaccinated people over age 60, a fourth dose of the vaccine offered up to twice the protection against getting infected, and up to three times the protection against severe illness, compared to those who received three doses.

There is also growing evidence that all types of vaccine-induced protection continue to wane. Scientists have long known that the antibodies people make immediately after getting vaccinated are relatively short-lived, but the vaccine triggers the body to also produce other immune defenses, including T cells, which tend to be more durable. Even those responses, however, start to taper after several months, says Dr. Otto Yang, professor of medicine, infectious diseases, microbiology, immunology, and molecular genetics at the University of California, Los Angeles. That means existing vaccine regimens may need to be supplemented with yet another booster dose to keep both antibody and T cell numbers high enough to protect people from severe disease, he says.

But whether everyone needs an additional vaccine dose, and whether or not we can anticipate getting one every year or every few years, depends on what we want the vaccines to accomplish. The vaccines were not designed to prevent people from getting infected by the virus, but to protect them from getting extremely sick with COVID-19, and to keep them from needing hospitalization and intensive care. Remembering that goal, says Dr. Paul Offit, director of the Vaccine Education Center and professor of pediatrics at Children’s Hospital of Philadelphia, is useful when thinking about whether a fourth dose is necessary for most people.
“We got hung up using the word ‘breakthrough’ in describing mild illness,” he says, referring to the term for any infection occurring among vaccinated and boosted people (most of which were mild or even asymptomatic). “But that’s a win—it meant the vaccine was working for you and protected you from serious illness. We have developed a zero tolerance strategy that we are going to have to get over: the idea that it’s not okay to have mild illness after you’ve been vaccinated.”

If the goal of a COVID-19 vaccine is to protect people from severe disease, Offit says that there is still insufficient data supporting the need for a booster for most healthy adults. “I think we have to accept the notion that this is a three-dose vaccine in certain groups and a two-dose vaccine in others,” Offit says.

Offit, who serves on the FDA vaccine advisory committee of independent experts that reviews data and makes recommendations to the FDA about whether or not a vaccine is safe and effective, says that trying to protect the world’s population from mild disease with continued booster doses isn’t a realistic or practical public health goal. The question becomes one of balancing any marginal benefit in protecting against mild illness against potential side effects, which for the mRNA vaccines include the risk of inflammation of heart tissue. “Everything has costs, including boosting,” he says. “If it doesn’t benefit you in terms of protection against serious illness, then you have to consider the side effects.”

Fauci says health officials will be watching the hospitalization rate among vaccinated and boosted people closely in coming weeks and months; if it creeps upward, then it would signal a concerning waning of protection even against severe disease, which could warrant another booster dose. “We don’t know now if we are going to need it, but as long as this virus hangs around, I would not be surprised if we are going to need one more shot than we have had,” he says.

He and others also don’t anticipate continuing to boost as new variants crop up. Up to this point, that strategy came out of the urgent need to tamp down the virus as quickly as possible in as many people as possible. But it’s not a durable or practical game plan over the long term. “We’ve been chasing our tails with every variant, and we will perpetually be behind [the virus],” says Dr. Kirsten Lyke, professor of medicine at University of Maryland, who spearheaded studies about mixing and matching different types of COVID-19 vaccines.

But now that a good portion of the U.S. population has some degree of immunity through infection, vaccination, or both, the National Institutes of Health is launching new studies in search of a more targeted approach to potential booster shots. Rather than responding to new variants as they emerge and hoping the existing vaccines continue to protect against severe disease, scientists there are mapping out SARS-CoV-2’s mutations and trying to design vaccines against broad collections of changes that would ideally quell a number of different, but related strains that the virus may generate in the future. The study will involve up to 1,500 people at 25 sites. “By mid-summer, we would like to put all the data together so we can make a more scientific assessment as to whether additional boosters will work, whether we will need them, and which one we might need to use,” says Lyke.

Whether a fourth dose will be recommended for most Americans likely depends on future hospitalization rates among vaccinated and boosted people; if they continue to increase, that might push health officials to consider recommending another booster dose. In the meantime, Fauci says scientists at the National Institute of Allergy and Infectious Diseases’ Vaccine Research Center are investigating whether that additional dose should come from the same vaccine people have been receiving, or whether that additional dose should be with a new vaccine that targets a specific variant, such as Omicron. So far, the original booster produces similar immune responses to those generated by a variant-specific boosters in non-human primates. “Given the fact we have waning immunity, we may need a regular boost at intervals yet to be determined,” Fauci says.

70% of COVID survivors in UK study had impaired memory, focus [CIDRAP, 17 Mar 2022]

by Mary Van Beusekom

An online UK study finds that about 70% of 181 adult COVID survivors had memory and concentration problems several months after infection, 75% reported persistent symptoms so severe that they couldn't work, and 50% said that medical professionals didn't take their symptoms seriously.

In the ongoing COVID and Cognition study, published as two papers today in Frontiers in Aging Neuroscience, a team led by University of Cambridge researchers report on the baseline characteristics and cognitive test performance of 181 long COVID patients and 185 never-infected peers.

Participants were recruited from the United Kingdom, Ireland, the United States, Canada, Australia, New Zealand, and South Africa, although 70% were White UK patients. Most COVID-19 survivors were infected 6 or more months before, and only a few had been ill enough to be hospitalized. Data collection on patients infected from March 2020 to February 2021 (when the Delta and Omicron variants were uncommon in the study countries) took place from October 2020 to March 2021.

Long COVID can be debilitating, affecting multiple organ systems, including the brain, and causing highly individual symptoms in the months after infection. Neurologic symptoms may include "brain fog," disorientation, headache, and forgetfulness.

Severe infection portends severe long COVID
In the first paper, the team found that the severity of acute illness was a significant predictor of the presence and severity of long COVID symptoms.

Six initial symptoms were associated with progression to long COVID, including limb weakness, brain fog, chest pain or tightness, dizziness, cough, and breathing problems. Those with more severe fatigue and neurologic symptoms such as dizziness and headache during infection were more likely than others to have severe lingering symptoms.

Among the 126 participants with long COVID, 77.8% reported problems with concentration, while 69% reported brain fog, 67.5% cited forgetfulness, 59.5% reported tip-of-the-tongue word-finding problems, and 43.7% said they struggled with saying or typing the correct word.

Participants who had been ill for longer were more likely to report having had cognitive symptoms throughout the ongoing illness and to still have them.

Among those with ongoing symptoms, upwards of 54.6% had experienced long periods in which they were unable to work, while 34.5% had lost their job due to illness, 63.9% reported difficulty coping with day-to-day activities, 49.6% had had difficulty getting medical professionals to take their symptoms seriously, 43.7% felt that they had experienced a trauma, and 17.6% had experienced financial problems owing to their illness.

Among the 109 participants who sought medical care, the most common diagnoses were hypoxia (low oxygen levels, 14.7%), blood clots (5.5%), and inflammation (4.6%). Number of weeks since infection was positive correlated with severity of ongoing cardiopulmonary symptoms and fatigue.

While the exact pathways haven't been elucidated, the study authors said that a dysfunctional or outsized immune response may lead to chronic inflammation and long COVID.

"There are a number of mechanisms by which COVID-19 infection may lead to neurological symptoms and structural and functional changes in the brain, and it is reasonable to expect that many of these may translate into cognitive problems," the researchers wrote. "Indeed, cognitive problems are one of the most commonly reported symptoms in those experiencing 'Long COVID'—the chronic illness following COVID-19 infection that affects between 10 and 25% of patients."

Memory loss may predict dementia
In the second paper, the researchers evaluated participants' performance on multiple tasks related to areas such as memory, language, and executive function.

They identified a significant negative influence of COVID-19 infection on memory, even after adjusting for age, sex, country, and education level, with poorer performance and slower reaction time on the Word List Recognition Memory Test than the non-COVID group. A much weaker pattern was seen with the Pictorial Associative Memory Test, which suggested poor performance among COVID group members but no difference in reaction time.

Pairwise analyses showed that participants with severe ongoing symptoms scored significantly lower on the percentage of correct answers and reaction time. Pairwise tests also revealed that those with severe ongoing symptoms had fewer correct words on the category fluency test than recovered participants, but no pairwise comparisons were significant for word repetitions. There was no difference on executive function testing.

"Given these findings, we suggest that, as others have found… 'objective' cognitive differences do exist between those that have and have not experienced the COVID-19 infection," the authors wrote.

They added that accumulating evidence, including previous findings of a loss of gray matter in the temporal lobe of the brain and reduced memory performance in this study, suggests that COVID-19 survivors may be at increased risk for future neurodegeneration and dementia.

"It is thus notable that, in this study, self-reported memory issues were associated with measurable reductions in memory ability and that these are linked with other neurological symptoms," the researchers wrote. "This suggests that neurological and neuropsychological assessment should be made more widely available to patients with Long COVID reporting cognitive deficits."

Cognitive symptoms are real
The researchers said that the results indicate that long COVID cognitive symptoms need to be taken seriously.

"This is important evidence that when people say they’re having cognitive difficulties post-COVID, these are not necessarily the result of anxiety or depression," study coauthor Muzaffer Kaser, MD, PhD, said in a University of Cambridge news release. "The effects are measurable—something concerning is happening."

Senior author Lucy Cheke, PhD, said that long COVID has garnered little political or medical attention, which belies its potential long-term impact on the workforce. "When politicians talk about 'Living with COVID'—that is, unmitigated infection, this is something they ignore," she said. "The impact on the working population could be huge."

Covid-19 surge in South Korea, Hong Kong. How worried should we be? [Firstpost, 17 Mar 2022]

There’s a jump in infections with 11 million new cases reported from 7 March to 13 March.

The WHO is calling it the “tip of the iceberg”

The pandemic is far from over. There has been a spike in cases in several countries across the world, especially in Asia, where lockdowns are back.

The World Health Organisation (WHO) sounded a warning to nations, as they become lackadaisical with a drop in testing. After more than a month of decline, COVID-19 cases have started to increase around the world last week, the WHO said on Tuesday.

New infections jumped by eight per cent globally compared to the previous week, with 11 million new cases and just over 43,000 new deaths reported from 7 March to 13 March. It is the first rise since the end of January, reported news agency Reuters.

“These increase are occurring despite reductions in testing in some countries, which means the cases we’re seeing are just the tip of the iceberg,” warned WHO’s head Tedros Adhanom Ghebreyesus while talking to the media.

Which are the countries which are seeing a rise in coronavirus cases? And how worried should India be? We answer a few questions.

According to WHO, the highly transmissible Omicron variant and its BA.2 sublineage have been fast-spreading, as countries relax social-distancing measures and other public health norms.

Parts of China under lockdown
The situation is worsening in China and South Korea, where deaths have risen by 27 per cent and cases by 25 per cent.

On Tuesday, China witnessed 5,280 new infections, two times more than the previous day. It forced the country to put more than 30 million under lockdown – 13 cities were fully locked down and in other cities partial restrictions were imposed.

The worst-hit was the northeastern province of Jilin; Shenzhen – the southern tech hub of 17.5 million people – was forced to shut factories, and China's largest city Shanghai has partial restrictions.

After the flare-up, new symptomatic local cases have declined. The country reported 1,226 new domestically transmitted COVID-19 infections with confirmed symptoms on 16 March.

South Korea records 6 lakh daily cases
The country recorded more than 600,000 new infections on Thursday, the most in the world. However, it has one of the lowest death rates globally.

On Thursday, the daily cases were at 621,320; hospitalisations have doubled but the intensive care unit capacity is at 65 per cent.

Yet the outbreak is not out of control and it’s because of the consistent deployment of mass-testing. Combined with an 88 per cent vaccination rate – and one of the highest booster shot take-ups in the world, especially among the elderly – South Korea has delivered a fatality rate of 0.14 per cent, reports news agency Bloomberg.

Half of Hong Kong infected
In Hong Kong, the Omicron wave has hit late. On 16 March, the country had over 14,000 cases.

The city with “zero-Covid” policy is now seeing the highest death rate in the word, according to Our World in Data. The death rate in Hong Kong has soared this month, surpassing 25 per 100,000 residents in the past week, reports The New York Times.

Since the end of December, over 760,000 infections have been reported, with more than 4,300 deaths. Now almost half of Hong Kong’s population of 7.4 million has been affected as of 14 March.

Hospitals and morgues are overflowing. The low vaccination rates among Hong Kong’s older people is making matters worse.

The lack of business has forced many shops to down shutters. Gyms and bars have been shut since January and won’t open until mid-April, reports The Associated Press.

It’s a big setback for the city which has gone for months without falling prey to the pandemic.

A surge from Africa to Europe
Africa has seen a 12 per cent rise in new cases and 14 per cent rise in deaths, according to a Reuters report. Cases are also rising in New Zealand and Singapore.

Europe has often been a few weeks before the US with Covid trends — and cases are now rising in Britain, Germany, Italy and some other parts of Europe. The main cause appears to be an even more contagious version of omicron, known as BA.2, reports NYT.

India on alert mode
With a surge in cases in Asia, Union Health Minister Mansukh Mandaviya chaired a high-level meeting on Wednesday. He has reportedly asked authorities to do some aggressive genome sequencing of samples to detect new variants if any. Local bodies have been instructed to intensify surveillance to identify hotspots early on.

For now, India is reporting a decline in cases. On Wednesday, the country reported 2,539 new cases.

COVID: S Korea reports record cases as Omicron wave nears peak [Al Jazeera English, 17 Mar 2022]

Country long hailed as a pandemic success story reports more than 621,000 cases and 429 deaths.

South Korea has reported new daily records for coronavirus cases and deaths as the Omicron variant continues to spread rapidly across the country.

The Korea Disease Control and Prevention Agency (KDCA) reported a staggering 621,328 new COVID-19 infections on Thursday, including 62 among arrivals from overseas, according to the Yonhap news agency.

Deaths also reached a record for a single day with 429 people confirmed to have lost their lives, bringing the overall toll since the start of the pandemic to 11,481.

The surging caseload comes as South Korea eases curbs designed to contain the spread of the virus, amid pressure from small businesses and others hit hard by the pandemic.

The government is due to announce on Friday whether it will further relax restrictions, which currently include a late-night business curfew and a ban on private gatherings of more than six people.

Yonhap noted that the number of critically-ill patients, which is being used to guide the official pandemic response, had dropped to 1,159 from 1,244 on Wednesday.

The country has scaled back the test, track, tracing, and quarantine strategy that helped keep earlier waves in check and despite Thursday’s record deaths, the country’s fatality rate of 0.14 percent remains low relative to other countries.

Health authorities also believe the Omicron wave could be close to its peak although the number of daily cases is far in excess of earlier predictions.

About 87 percent of South Korea’s 52 million people have been fully vaccinated with 63 percent having received a booster shot, according to the KDCA.

A government analysis of some 141,000 Omicron cases reported in the country over the past year showed that there were no deaths among people under 60 who had received a booster shot, Son Young-rae, a health ministry official, said on Wednesday, adding that the disease could be treated like the seasonal flu.

“We see this could be the last major crisis in our COVID responses, and if we overcome this crisis, it would bring us nearer to normal lives,” Son told a briefing.

A survey released earlier this week by Seoul National University’s graduate school of public health, showed the number of South Koreans who worry about a serious health impact from COVID-19 had dropped to about 48 percent, the lowest since the surveys began in January 2020.

At the same time, those who think they are likely to contract the virus was at its highest.
“People’s awareness about the virus’ danger has clearly changed,” said professor Yoo Myung-soon who led the study.

“Despite the Omicron variant’s much higher infectivity than Delta, its relatively low fatality appears to have alleviated people’s concerns.”

ABC 10News Exclusive: One-on-One With Dr. Fauci [ABC 10 News San Diego KGTV, 17 Mar 2022]

by Jared Aarons

Nation's top doc discusses Pandemic at 2-year mark

SAN DIEGO (KGTV) — For two years, he's been the face of the COVID-19 pandemic response in the US, for better or worse.

Now, as the country passes the two-year mark since the CDC declared COVID-19 an official pandemic, Dr. Anthony Fauci says the toll it has taken on Americans is "devastating."

"No one, in their wildest dreams, two years ago today, would have predicted that we have close to a million deaths in this country alone, and six or so million deaths worldwide," he says. "It never would have been imagined that we would have such a devastating impact of this virus."
The latest CDC data says the US is at 963,244 deaths and 79.4 million cases.

But, Fauci points out the number of cases, hospitalizations, and deaths have been declining since the peak of the most recent Omicron surge.

In an exclusive, one-on-one interview with ABC 10News Reporter Jared Aarons, he says the declines give him hope, even as the National Institute for Allergy and Infectious Diseases keeps an eye on the new BA.2 sub-variant of Omicron, also called "Stealth Omicron."

That variant has fueled a surge of cases in the UK and Europe. Meanwhile, wastewater testing in the US shows its presence increasing along the East Coast and throughout the Midwest.

"I would expect that we might see an uptick in cases here in the United States," he says. "Over the coming weeks, it will become more dominant (than Omicron)."

A week ago, Fauci says, the BA.2 variant accounted for 11% of the sequenced positive cases in the US. Now, that number is closer to 25-26%.

"It's more likely to transmit," Dr. Fauci says. "The somewhat encouraging news is that BA.2 variant doesn't appear to make the disease any more severe than BA.1 (Omicron) and doesn't seem to evade immune responses any more than BA.1."

Dr. Fauci adds if cases begin to surge again in the US, we may have to go back to mitigation strategies like masking indoors.

He says the CDC's new guidelines allow for that.

"We have to be careful that if we do see a surge as a result of that, that we're flexible enough to re-institute the kinds of interventions that could be necessary to stop an additional surge."

When Aarons asked Dr. Fauci about booster shots, he said older Americans and people who are immuno-compromised will "likely" need a 4th shot. But, he says there is no need for variant-specific boosters, as the original vaccine is still doing a good job preventing hospitalizations and deaths.

"It's holding pretty strong at around 78% efficacy against hospitalization," he says. "But if it goes any lower than that, you certainly would consider the possibility of a 4th dose boost."

And, like he's done for more than a year, Dr. Fauci stressed the need for everyone to get a vaccine and a booster shot once their eligible. He says that's the only way we'll beat COVID and end the pandemic.

New Coronavirus News from 9 Mar 2022

How Hong Kong Became China's Biggest COVID-19 Problem [TIME, 9 Mar 2022]

BY CHAD DE GUZMAN

Patients are treated at a makeshift area outside Caritas Medical Center in Hong Kong, March 2

Friday, Mar. 4 was an ominous day in the history of the COVID-19 pandemic in China. Health authorities recorded 294 cases, of which 233 were imported. To countries around the world that have made the decision to live with coronavirus and tally daily caseloads in the tens of thousands, these were figures to be envied. But with its zero-COVID policy, China steadfastly refuses to allow the virus to establish a foothold within its borders.

Worryingly, nearly half the imported figure—117 cases—were recorded in China’s most populous province, the southern economic powerhouse of Guangdong. The great majority of those cases, 96, were found in the city of Shenzhen, a booming technology and finance hub that is the jewel of the province. The others were discovered in nearby cities like Zhuhai and Zhongshan—and all but two of the imported cases originated from Hong Kong, where cases have exploded, fueled by the highly contagious Omicron variant. Two days earlier, on Mar. 2, the one-time British colony recorded more than 55,000 cases in a single day and earned the ghastly distinction of being the place with the highest COVID-19 mortality rate in the developed world.

Hong Kong’s differences with China are often emphasized. It is a Chinese territory, but operates semi-autonomously, with its own legal, political, and financial systems, and issuing its own travel documents. But while Hong Kong has an administrative border with China, it and the eight other cities of Guangdong’s Greater Bay Area are physically part of one vast, contiguous conurbation of 86 million people. The office towers of Shenzhen loom over Hong Kong’s northern suburbs and the two municipalities are connected by ferry, bus, and rail services that, at their quickest, take just 20 minutes.

Although only limited movement between Hong Kong and the mainland has been permitted during the pandemic, with significant restrictions on travelers, it is inevitable that Hong Kong’s COVID-19 crisis would spread to the densely populated hinterland, given its proximity.

Imported cases from Hong Kong have now been found in at least seven Guangdong cities and provincial authorities are scrambling to contain the damage.

The stakes are enormous. Modeling by Chinese researchers projects that hundreds of millions of infections would spread across the country, resulting in at least three million deaths, without aggressive zero-COVID policies. Given its patchy healthcare system and critically low number of ICU beds, a breach of the COVID defenses could spell disaster.

For now, most of the imported cases “will not spread infection because of the very strict precautions, the testing and the quarantine,” says Ben Cowling, who heads the division of epidemiology and biostatistics at the University of Hong Kong’s (HKU) School of Public Health. But, he warns, “the more opportunities the virus has, sooner or later, it will find a way.”

Leo Poon, head of the public health laboratory science division at HKU, agrees. He points out that even if travelers from Hong Kong present negative tests when entering mainland China, “they may still be in the incubation period” and “be able to spread the disease.”

With the Shenzhen skyline visible in the background, construction workers assemble a temporary Covid-19 isolation facility in Lok Ma Chau, Hong Kong, Feb. 27.

Hong Kong’s COVID-19 exodus
There was a dramatic exodus from Hong Kong during the first two years of the pandemic, as businesses and individuals chafed under onerous travel restrictions—including a notorious 21-day quarantine—imposed by local authorities to keep COVID-19 out. The latest wave of infection is only fueling the outflow of people, as thousands choose to leave Hong Kong altogether or sit out the surge elsewhere.

Many are fleeing stringent isolation requirements that have seen babies separated from parents and people fully recovered from COVID-19 left to languish in makeshift government holding centers days after meeting discharge criteria. The mental toll of extended confinement can be severe. In February, four suicide attempts were recorded in just over 24 hours at the notorious Penny’s Bay quarantine center, which one inhabitant described as like “living inside a mad house.”

“We don’t know what the government situation is going to be like, what sort of measures they’re going to take,” Hong Kong resident Edward Zhao tells TIME. “It’s just the uncertainty of what happens in the situation where the government decides to put you in quarantine.”

The 32-year-old is eyeing New Zealand as a temporary refuge. Singapore is another popular bolt hole. Australia has also seen a recent spike, mostly from middle-aged Hong Kong residents enrolling in degree courses Down Under, in the hope that they can bring their dependents with them on student visas.

Thousands more, however, are simply trying their luck in mainland China. Not all enter legally and undergo the mandatory two-week quarantine at a government-specified hotel. According to media reports, a few have paid people smugglers to get them across the border—potentially bringing COVID with them.

Guangdong authorities have been galvanized into action. Some cities are offering the equivalent of almost $80,000—more than four times the province’s average annual salary—as a reward for information leading to the detention of anyone from Hong Kong on the mainland illegally. Shenzhen has imposed strict lockdowns on city districts that abut the Hong Kong border. Security personnel train powerful searchlights on the coastline nightly, looking for Hong Kong’s COVID-19 refugees.

The irony is not lost on anyone in Hong Kong. Throughout its brief history, the affluent territory has been a place of sanctuary for those fleeing turmoil further north, be it war, hunger or communist revolution. The pattern of migration has never been reversed, until now.

Customers purchase Covid-19 rapid antigen test kits from a store on March 1 in Hong Kong

Anthony Kwan—Getty Images
How bad is Hong Kong’s current COVID-19 situation?

From the start of the pandemic in early 2020, to the beginning of the latest surge on Dec. 31 last year, Hong Kong registered a little over 12,000 infections and some 200 deaths in a population of 7.4 million. Harsh travel restrictions may have virtually cut the city off from the world, but they allowed Hong Kong to avoid the dangerously overburdened healthcare systems and high death tolls caused by the coronavirus elsewhere. The local economy even rebounded in 2021, with a 6.4% gain wiping out the 6.5% contraction of the year before.

These days, however, Hong Kong’s COVID-19 defenses are in stunning collapse. In just over two months, cases have soared to more than half a million and deaths have increased tenfold.
Bodies are piling up in ER departments because mortuaries are full. Hospitals are bursting with COVID-19 patients. Hundreds of thousands have lined up for hours, in all weather, for mandatory tests, ordered if contact tracers deem somebody to be the close contact of a case. (The results can take more than 10 days to arrive however, severely undermining their usefulness.)

Hong Kong’s desperately overcrowded housing—which can see as many as eight people share a 200 sq. ft. apartment—meanwhile makes self-isolation a luxury. Some people testing positive are sleeping in tenement stairwells, or in parks, to avoid infecting loved ones. The government’s equivocal messaging on whether or not a lockdown will be imposed has sparked waves of panic buying, with supermarket shelves stripped bare. Adding to the confusion, neither Hong Kong’s top official, Chief Executive Carrie Lam, nor the health secretary, Sophia Chan, held a press conference on the crisis between Feb. 22 and Mar. 9. Hundreds of thousands of cases were recorded during that crucial period.

“The [Hong Kong] government is sending conflicting signals,” says Jean-Pierre Cabestan, professor of political science at Hong Kong Baptist University. “It’s really a mess.”

Perhaps most glaring is the failure to protect the community most vulnerable to COVID-19: the elderly. Coronavirus has rampaged through more than 80% of the city’s residential care homes for seniors, infecting over 19,000 residents and 5,300 staffers. Just 15% of care home residents have been jabbed. Unsurprisingly, nine out of every 10 COVID-19 deaths in Hong Kong have occurred among the unvaccinated, most of them over the age of 70.

Karen Grépin, associate professor in health economics and policy at HKU’s School of Public Health, says sensationalized media coverage of side effects fueled vaccine hesitancy. She also believes that early messaging from the government, which recommended seeking medical opinion before vaccination, created the idea that vaccines were only for the healthy. “The elderly and those with underlying medical conditions began to believe that they were not good candidates for vaccination,” she tells TIME via email.

The consequences have been devastating. As one local Twitter user put it, while posting a photo of patients lying on gurneys in the forecourt of an overcrowded hospital: “Hong Kong, you’ve had two years to prepare for this.”

A man sits on a hill overlooking a residential estate in Hong Kong on March 4. COVID-19 has spread rapidly in the city's densely populated urban environment

What is China doing about Hong Kong’s COVID-19 crisis?

The central government has not hidden its disappointment in the city’s leadership. On Feb. 16, two pro-Beijing newspapers in Hong Kong ran front page stories on a message relayed to Chief Executive Lam by President Xi Jinping. He reportedly asked her to “mobilize all power and resources to take all necessary measures to ensure the safety and health of the Hong Kong people.” That the instruction was delivered so openly was considered highly significant—in effect, it was letting the Hong Kong public know that Xi had put Lam on notice.

Two weeks later, the head of Beijing’s Hong Kong and Macau Affairs Office, Xia Baolong, tersely reminded Hong Kong’s most senior officials to uphold their oaths of office. “Top Hong Kong officials must have the courage to shoulder arduous responsibility, and do a good job in organization and leadership, and fulfill their inaugural oath with concrete actions in the battle against the pandemic,” he said. A mainland expert on Hong Kong’s constitutional affairs told local media that the remarks amounted to “a warning letter” and that “the central government is saying that this is huge trouble.”

More recently, on Mar. 6, Chinese vice premier Han Zheng met Hong Kong delegates to the nation’s top advisory body, the Chinese People’s Political Consultative Conference. He told them that this was no time for “weariness” in the fight against COVID-19, expressed concern at the territory’s mortality rate, and voiced the hope that reports of Hong Kong’s private hospitals turning away coronavirus patients were “fake news.”

Shortly afterward, Liang Wannian of China’s National Health Commission appeared to rebuke Hong Kong officials, who have made compulsory universal testing the cornerstone of their strategy to tame the current surge in infections. “Reducing infection, severe cases and deaths is Hong Kong’s most urgent and top priority at the current stage,” Liang told China’s Xinhua news agency, adding that mass testing could come “after we achieve the first target.” The local administration seemingly backed down, with unnamed insiders telling local media that the exercise could be postponed for a month.

Read More: What the World Can Learn From China’s COVID-19 Rules at the Beijing Olympics
Sensing the threat that Hong Kong poses to its zero-COVID record, Beijing has involved Vice Premier Sun Chunlan, who leads the mainland’s fight against COVID-19. The deputy head of the National Health Commission, Wang Hesheng, a veteran of the original Wuhan outbreak, is assisting. According to media reports, hundreds of personnel have set up a Shenzhen command center to respond to developments in Hong Kong, working 16 hour days and authorized to cut through any red tape, given the urgency of the situation.

The coming weeks will be crucial. On Mar. 6, China reported some of its highest COVID-19 figures since Wuhan—and of the 214 new cases, nearly a third were found in Guangdong, the province bordering Hong Kong.

China’s zero-COVID strategy has been extremely successful. Since the start of the pandemic, the world’s most populous nation has registered just over 111,000 cases, with 4,636 deaths. It even managed to stage the Winter Olympics without major mishap. Could that be about to change as a result of Hong Kong’s Omicron surge?

“I would imagine in the mainland, there’ll be a lot of concern right now about the risk posed by people traveling from Hong Kong,” says HKU’s Cowling.

“There’ll be an unlucky event, where there’s transmission to, maybe, local staff in a hotel, or to local testing staff, or something—and then that will start an outbreak.”

New Coronavirus News from 15 Mar 2022

China orders 51 million into lockdown amid worst COVID outbreak since early 2020 [KTRK-TV, 15 Mar 2022]

by Britt Clennett and Karson Yiu

The entire northeastern province of Jilin and southern cities of Shenzhen and Dongguan are locked down.

HONG KONG -- China is facing its worst COVID crisis since early 2020, when the world first witnessed an entire population locked down to contain the coronavirus in Wuhan and its surrounding province.

Two years on, it's now sending tens of millions of people into lockdown in the entire northeastern province of Jilin, where 24 million people live, and the southern cities of Shenzhen and Dongguan, with 17.5 million and 10 million, respectively.

China, the last major country to relentlessly pursue a COVID-zero policy, reported 1,437 cases across dozens of cities on Monday. That's a fourfold jump in a week.

Although record case numbers are testing the resilience of China's no-tolerance approach, there is no sign the country is willing to pivot to 'living with the virus."

The epicenter of the omicron variant outbreak is the Northeastern Jilin province, where 895 cases were recorded, but there are also outbreaks and containment measures in place Shanghai, the financial powerhouse, and Shenzhen, the southern tech hub.

Authorities announced on Monday afternoon that all 24 million people in Jilin province would go into lockdown, including the previously locked down city of Changchun. It's the first provincial lockdown since Wuhan and Hubei in January 2020.

On Sunday, China ordered all of Shenzhen's 17.5 million residents into a seven-day lockdown, with three rounds of testing. All public transport is halted and all businesses, except essential services, will be closed until March 20.

As a result, Apple supplier Foxconn has shut two of its plants in the area and relocated production elsewhere.

The lockdown and outbreaks threaten manufacturing and tech production in Shenzhen, known as China's Silicon Valley. It's home to Huawei and Tencent, and is home to one of the country's key ports.

Professor Heiwai Tang at Hong Kong University told ABC News that he doesn't expect these week-long lockdowns to have a significant impact on the country's gross domestic product.

"It seems the lockdowns will be shorter this time with more tracking, which means a short disruption of work and production," Tang said. "If it ends up lasting for weeks it's another issue, including inflation risks."

Professor Michael Song from Hong Kong's Chinese University estimated that the two-month lockdown in Wuhan cost China 2% of its GDP.

There's immense pressure on local authorities to contain the virus, with state media reporting that the Jilin City mayor and the head of the Changchun city health commission were dismissed from their roles over the weekend.

Shanghai-based virologist Zhang Wenhong called the flare-up "the most difficult moment in the past two years" of China's efforts to stamp out the virus. Shanghai has so far avoided a full-scale lockdown.

Across the border from Shenzhen, neighboring Hong Kong is also still tackling its deadliest wave yet, driven by Omicron. Hong Kong recorded 26,908 cases and 286 more deaths on Monday, officials said. Hong Kong's death rate is the highest in the developed world, in part because of sluggish vaccination rates among the elderly.

Mega isolation facilities are being built across the Hong Kong for people with mild cases. One facility, with 3,900 beds, was built in a week. ABC News witnessed several busloads of people arriving at the facility from all over the city.

Self-titled "Asia's world city," Hong Kong is undergoing strict social-distancing measures and still has strict border measures in place, leading to an expat exodus. Many businesses are closed until late April.

The mental-health strain of the strict lockdown has also becoming apparent. Last month, police reported three suicide attempts in 27 hours at one of the quarantine camps.

New Coronavirus News from 14 Mar 2022

Two years into the coronavirus pandemic, Fauci hopes the world will not forget lessons from a 'catastrophic experience' [CNBC, 14 Mar 2022]

by Meg Tirrell

As the two-year anniversary of the coronavirus pandemic declaration approached last week, White House chief medical advisor Dr. Anthony Fauci was in no mood to predict the future.

“The answer is: We don’t know. I mean, that’s it,” Fauci told CNBC when asked what may come next for Covid-19 vaccinations. Given the durability of protection from the shots, “it is likely that we’re not done with this when it comes to vaccines,” he said.

Two years into a pandemic that has killed more than 6 million people globally, and nearly 1 million in the U.S., leaders in public health, academia and industry expressed ambivalence as much of the rest of the world — or at least the U.S. — appears to be trying to move on.
Despite progress in beating back the highly transmissible omicron variant, they stressed that globe leaders cannot let their vigilance lapse.

“Everybody wants to return to normal, everybody wants to put the virus behind us in the rearview mirror, which is, I think, what we should aspire to,” said Fauci, who is also the director of the National Institute of Allergy and Infectious Diseases.

While he acknowledged “we are going in the right direction” as cases, hospitalizations and deaths decline after the omicron surge, he pointed out “we have gone in the right direction in four other variants” before the pandemic took a devastating turn.

As states and cities scrap many of their pandemic restrictions, dire public health conditions linger. The U.S. is still recording more than 1,200 deaths per day from the coronavirus.
Hospitalizations have recently ticked higher in the United Kingdom, a previous harbinger for what may hit the U.S.

As the world on Friday marked two years since the World Health Organization first called the coronavirus a pandemic, the agency’s scientists argued last week that the more important anniversary came more than a month earlier. In January 2020, the WHO warned that the disease that would come to be known as Covid-19 was a Public Health Emergency of International Concern.

“Everybody wants to return to normal, everybody wants to put the virus behind us in the rearview mirror, which is, I think, what we should aspire to... We have been going in the right direction; however, we have gone in the right direction in four other variants.”
Dr. Anthony Fauci
DIRECTOR, NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

“What we were saying in January was: ‘It’s coming, it’s real, get ready,’” said Dr. Mike Ryan, executive director of WHO’s health emergencies program, in a briefing Thursday. “What I was most stunned by was the lack of response, was the lack of urgency, in relation to WHO’s highest level of alert.”

That lower level of urgency appears to have settled in once again. Congress last week sidelined new funding for the Covid response despite White House press secretary Jen Psaki’s warning that the U.S. needs funds to secure critical supplies.

She said that without more aid, the U.S. risks dropping testing capacity within weeks, running out of monoclonal antibody drugs by May — exhausting the only medicine to preventively protect the immunocompromised by July — and going through antiviral pills by September.

“I am concerned,” Pfizer Chief Executive Albert Bourla said on CNBC’s “Squawk Box” on Friday morning about the lack of new federal funding. He noted that because vaccine boosters and antiviral pills are only cleared through Emergency Use Authorization, the government is the only allowed purchaser.

“So if the government doesn’t have money, nobody can get the vaccine,” Bourla said.

While concerns about pandemic preparedness have not gone away, neither has work on the vaccines, new medicines and Covid surveillance.

Moderna said last week that it had started a trial of a vaccine against both omicron and the original strain of the virus to help inform public health authorities making decisions about boosters for the fall.

Bourla also said Friday that Pfizer expects to submit data to the U.S. Food and Drug Administration soon for a fourth shot, or a second booster, of its vaccine. He said data shows that while protection against hospitalization and death from the omicron variant is high with three doses, “it doesn’t last long — after three or four months, it starts waning.”

Dr. Clay Marsh, chancellor and executive dean for health sciences at West Virginia University and the state’s Covid czar, agreed that emerging information from Israel and the UK — both of which are administering additional doses to the elderly — supports considering additional boosters in the U.S.

“To me, that’s something that the [Centers for Disease Control and Prevention] and the FDA should be leading,” Marsh said. “And I don’t see it.”

Marsh said the state has enough vaccine supply to administer additional boosters, if authorized. He noted that antiviral pills — or at least the most preferred one, Pfizer’s Paxlovid — still are not plentiful.

States have received about 689,000 courses of Paxlovid since it started shipping in December, federal data shows, compared with more than 2 million courses of Merck’s antiviral pill, molnupiravir. But Merck’s drug is typically a last-choice option for prescribers due to lower efficacy and safety concerns for some groups, Marsh said.

He noted that Paxlovid can also be complicated to prescribe because it interacts with some commonly used medications, like statins.

Monoclonal antibody drugs are typically the next choice after Paxlovid, he explained. There are two available as treatments — sotrovimab, from Vir Biotechnology and GlaxoSmithKline, and bebtelovimab, just authorized from Eli Lilly — after omicron rendered earlier antibody drugs such as a Regeneron cocktail ineffective.

In an interview last week, Regeneron’s chief scientist said the company is assessing variants to decide on the best new combination of antibodies to bring through clinical testing and the FDA authorization process.

“What we learned is that no single antibody and even the cocktail of antibodies that we employed can withstand all these variants,” Regeneron’s Dr. George Yancopoulos explained.
“So what you have to have is a very large collection of different antibodies, which is what we’ve been assembling over the years.”

He said the company is discussing with the FDA a strategy to have a series of antibody drugs tested in humans for safety and initial data. In the case of a new surge, Regeneron would be able to rapidly choose the right antibodies to put in a new drug.

The timeline for getting that drug to market would depend on whether the agency adopts a more flexible regulatory pathway, similar to what it did for Covid vaccines, he said. It could mean the difference between months and weeks for the availability of a new drug during a surge.

Whether another surge will take place is, of course, an open question. Cases have climbed slightly in Europe, Evercore ISI’s Michael Newshel pointed out Thursday in his research note on Covid surveillance. What’s more, The U.K.’s rise in hospitalizations has perplexed experts there.

In the U.S., the University of California San Francisco’s Dr. Bob Wachter suggested the U.K. data may mean a “need to resume more caution in a month or two.”

If a new surge happens, the first clues may come from wastewater. While the U.S. system for monitoring sewage for upticks in the coronavirus is still piecemeal, in cities where it is employed, it can provide a lead time of as many as a few weeks before cases start to rise, said Dr. Mariana Matus, CEO and co-founder of Biobot Analytics.

The company works with a network of wastewater treatment plants across 37 states, covering about 20 million people. Each week, it tests samples comprising less than a cup of wastewater for their concentration of the coronavirus; one $350 test can represent between 10,000 and 2 million people, Matus said in an interview.

“People who get infected with the disease will start shedding very early on ahead of developing symptoms,” she explained. “So they start to produce a signal in the wastewater even before they feel that they should go and get a test. And that’s super powerful.”

Testing volumes have declined along with the omicron health crisis in the U.S., making this kind of passive surveillance more helpful, especially in large population centers like New York City and Los Angeles, Marsh said.

Though cases are declining, experts stressed it’s not time to become complacent about Covid.

“The problem here and throughout the world is that the memory of what happened fades very quickly,” Fauci warned. “I would hope that this completely catastrophic experience that we’ve had over the last two-plus years will make it so that we don’t forget, and we do the kind of pandemic preparedness that is absolutely essential.”

S. Korea's new COVID-19 cases above 300,000 for 3rd day as omicron rages [The Korea Herald, 14 Mar 2022]

South Korea reported more than 300,000 new COVID-19 cases for a third consecutive day Monday as the virus wave, fueled by the highly contagious omicron variant, continued to grip the nation.

The country added 309,790 new COVID-19 infections, the majority of which coming from local transmissions, putting the total caseload at 6,866,222, the Korea Disease Control and Prevention Agency (KDCA) said.

Monday's count is a drop from the previous day's 350,190, due largely to fewer tests on the weekend. South Korea logged an all-time high of 383,664 on Saturday, after reporting more than 300,000 virus cases for the first time last Wednesday.

The death toll from COVID-19 came to 10,595, up 200 from Sunday, with the fatality rate standing at 0.15 percent.

The number of critically ill patients hit a record high of 1,158, up 84 from the previous day.

As of 9 p.m. Monday, 324,917 new cases had been confirmed nationwide, up 23,373 from the same time the previous day, according to health authorities and local governments.

Daily cases are counted until midnight and announced the following morning.

South Korea has seen the infection cases spike exponentially since the beginning of this year, with the daily figures soaring from four digits to five digits in late January. It took 13 days to jump from 100,000 to 200,000 and eight days to top 300,000.

In a step to rein in the virus surge, the government announced the inoculation program for some 3.07 million children aged between 5 and 11 starting March 31.

The decision was made in consideration that those in the age group account for more than 15 percent of all COVID-19 patients, Interior Minister Jeon Hae-cheol said in a briefing on the virus response.

He added the vaccines have proven to be "safe and effective" in other countries that introduced the vaccination program ahead of South Korea.

The first batch of Pfizer vaccines, approved for children, was set to arrive in South Korea by air later in the day, officials said.

The government projects the omicron wave to enter its peak stage this week. The daily average of infected patients soared from 190,000 in the first week of March to 280,000 last week.

Sohn Young-rae, a senior health ministry official, told reporters that the government will consider readjusting social distancing rules. The current measures, which are due to end this week, include an 11 p.m. curfew for restaurants and cafes, and a six-person cap on private gatherings.

Health authorities have shifted the focus to treating serious cases and preventing deaths, ending its rigorous contact tracing program seen as a successful containment strategy in the early days of the pandemic.

Starting this week, uninfected students and school staff members can attend school in person even if family members who live with them are virus positive.

Of the locally transmitted cases reported Monday, 56,807 cases came from Seoul and 77,420 from the surrounding Gyeonggi Province.

The western port city of Incheon reported 18,238 cases. Cases from overseas rose 62 to 30,302.

Of the 52 million population, 32.1 million people, or 62.6 percent, had received booster shots as of Monday. The number of fully vaccinated people came to 44.43 million, representing 86.6 percent.

Vaccine maker stocks rise as China battles worst Covid outbreak since 2020 [CNBC, 14 Mar 2022]

by Spencer Kimball

Shares of the major vaccine makers rose on Monday as China battles its worst Covid outbreak since 2020, fueling fear that the pandemic will drag on which could drive demand for future vaccine orders.

Moderna’s stock jumped more than 8% to close at $150.07. In the morning, the biotech company’s stock had surged nearly 20% to hit an intraday high of $166.75.

BioNTech soared 12% to close at $151.92, Pfizer jumped 4% to $52.25, and Johnson & Johnson rose more than 1% to $171.69. Novavax turned negative and closed down more than 1% at $71.93, after jumping nearly 15% in the morning to hit an intraday high of $83.25.

The vaccine makers’ stocks rose even as the broader market fell, with traders monitoring the impact of the war in Ukraine and anticipating a rate hike by the Federal Reserve this week.

Major cities in China have placed fresh restrictions on business activity to fight the outbreak, driven by the omicron Covid variant. Shenzhen, a major tech hub in southern China, has told companies to halt all non-essential business activity or have employees work from home, while Changchun in the northeast has entered a lockdown. Apple supplier Foxconn has halted production in Shenzhen, while Toyota and Volkswagen have suspended production in Changchun.

In Shanghai, China’s financial hub, schools have gone back to online classes and officials told residents not to leave the city unless absolutely necessary. China has a strict zero-Covid strategy that uses tough measures to quickly stamp out outbreaks.

Mainland China reported more than 1,400 new Covid infections as of Sunday for a total of over 8,500 domestically transmitted cases, according to China’s National Health Commission. While low by international standards, it’s the most in China since March of 2020. China has not reported any new Covid deaths.

Jefferies’ analysts, in a note on Monday, said the outbreak and lockdowns in China have fueled fear among investors that the pandemic will take longer to resolve than expected.


“Vaccine makers will continue to trade on global fear of more waves,” Michael Yee, an equity analyst, wrote in the Monday note.

While China will likely continue to rely on its domestic vaccine Sinopharm, the outbreak will keep the world on alert and probably drive demand for Moderna’s vaccine on the margins, according the Jefferies’ note. Moderna is projecting at least $19 billion in vaccine sales for 2022, while Pfizer is projecting $32 billion in revenue for its shots.

In the U.S., Covid infections continue to decline after an unprecedented surge of infection driven by the omicron variant in December and January. The U.S. reported an average of more than 35,000 new Covid cases on Sunday, a 24% drop from the week prior, according to a CNBC analysis of data from Johns Hopkins University. New Covid cases in the U.S. peaked at an average of more than 800,000 cases a day on Jan. 15. However, more than 1,200 people are still dying every day on average from Covid in the U.S., though that’s down 9% from the week prior, according to the data.

The Centers for Disease Control and Prevention said last week that 98% of people in the U.S. now live in areas where they no longer need to wear facemasks in indoor public places.

Dr. Gottlieb says China is 'very vulnerable' to omicron subvariant spread despite 'zero-Covid policy' [CNBC, 14 Mar 2022]

by Krystal Hur

Low levels of natural immunity are complicating China’s efforts to limit spread during its recent surge in cases of the new Covid omicron BA.2 subvariant, Dr. Scott Gottlieb told CNBC on Monday.

“China has a population that’s very vulnerable to this new variant. This is a much more contagious variant, it’s going to be harder to control, and they don’t have a population that has natural immunity,” the former Food and Drug Administration commissioner said in an interview on “Squawk Box.”

The BA.2 omicron subvariant, colloquially called “stealth” omicron, was first identified in late 2021.

“They haven’t deployed vaccines that are very effective against this particular variant, this omicron variant, and so they’re very vulnerable to spread right now. They didn’t use the time that they bought themselves to really put in place measures that would prevent omicron from spreading,” said Gottlieb, who is on the board of Covid vaccine maker Pfizer.

The increasing number of BA.2 cases in mainland China has led some major cities on Monday to shutter nonessential businesses and move schools to online instruction. The outbreak is the mainland’s worst since the height of the pandemic in 2020, and the strict response to it indicates a continuation of China’s zero-Covid strategy.

China’s zero-Covid policy entails strict quarantines and travel restrictions both domestic and international. While the policy has successfully kept cases down since the height of the pandemic, health officials have warned that China’s resulting lack of exposure to Covid leaves it vulnerable to harder-to-control strains such as omicron.

The latest omicron outbreak in China also has economic repercussions, since it could hinder already struggling supply chains, particularly for tech companies.

Apple shares dropped more than 2% midday, as the Chinese city of Shenzhen’s health orders halted activity at production plants of Foxconn, an important supplier to the iPhone maker. Activity will resume once Foxconn receives government approval to do so, the company told CNBC.

Gottlieb said China’s outbreak could be bigger than what is being reported, adding uncertainty to the situation.

“We really don’t know how large the outbreak is in China right now,” Gottlieb said. “We don’t know if there’s tens of thousands of cases or hundreds of thousands of cases.”

Mainland China reported 1,437 new confirmed cases as of Sunday for a total of 8,531 domestically transmitted active cases.

“People are going to get infected in those homes where they’re confining people right now, and the big question is: How much infection do they have and how long will this last?” Gottlieb said.

Disclosure: Scott Gottlieb is a CNBC contributor and is a member of the boards of Pfizer, genetic testing start-up Tempus, health-care tech company Aetion and biotech company Illumina. He also serves as co-chair of Norwegian Cruise Line Holdings’ and Royal Caribbean’s “Healthy Sail Panel.”

China locks down entire buildings and even cities as "stealth Omicron" variant fuels record COVID cases [CBS News, 14 Mar 2022]

Taipei, Taiwan — China banned most people from leaving a coronavirus-hit northeastern province and mobilized military reservists Monday as the fast-spreading "stealth Omicron" variant BA.2 fuels the country's biggest outbreak since the start of the pandemic two years ago.

The National Health Commission reported 1,337 locally transmitted cases in the latest 24-hour period, including 895 in the industrial province of Jilin. A government notice said that police permission would be required for people to leave the area or travel from one city to another.

The hard-hit province sent 7,000 reservists to help with the response, from keeping order and registering people at testing centers to using drones to carry out aerial spraying and disinfection, state broadcaster CCTV reported.

Hundreds of cases were reported in other provinces and cities along China's east coast and inland as well. Beijing, which had six news cases, and Shanghai, with 41, locked down residential and office buildings where infected people had been found.

"Every day when I go to work, I worry that if our office building will suddenly be locked down then I won't be able to get home, so I have bought a sleeping bag and stored some fast food in the office in advance, just in case," said Yimeng Li, a Shanghai resident.

While mainland China's numbers are small compared to many other countries, and even the semi-autonomous city of Hong Kong, they are the highest since COVID-19 killed thousands in the central city of Wuhan in early 2020. No deaths have been reported in the latest outbreaks.

Hong Kong on Monday reported 26,908 new cases and 249 deaths in its latest 24-hour period. The city counts its cases differently than the mainland, combining both rapid antigen tests and PCR test results.

The city's leader, Carrie Lam, said authorities would not tighten pandemic restrictions for now. "I have to consider whether the public, whether the people would accept further measures," she said at a press briefing.

Mainland China has seen relatively few infections since the initial Wuhan outbreak as the government has held fast to its zero-tolerance strategy, which is focused on stopping transmission of the coronavirus by relying on strict lockdowns and mandatory quarantines for anyone who has come into contact with a positive case.

The government has indicated it will continue to stick to its strategy of stopping transmission for the time being.

Officials on Sunday locked down the southern city of Shenzhen, which has 17.5 million people and is a major tech and finance hub that borders Hong Kong. That followed the lockdown of Changchun, home to 9 million people in Jilin province, starting last Friday.

On Monday, Zhang Wenhong, a prominent infectious disease expert at a hospital affiliated with Shanghai's Fudan University noted in an essay for China's business outlet Caixin that the numbers for the mainland were still in the beginning stages of an "exponential rise."

China's vast passenger rail network said it would cut service significantly, and both China Railway and airlines said they would offer free refunds to people who had already bought tickets. Shanghai suspended bus service to other cities and provinces.

Shanghai has recorded 713 cases in March, of which 632 are asymptomatic cases. China counts positive and asymptomatic cases separately in its national numbers. Schools in China's largest city have switched to remote learning.

In Beijing, several buildings were sealed off over the weekend. Residents said they were willing to follow the zero-tolerance policies despite any personal impact.

"I think only when the epidemic is totally wiped out can we ease up," said Tong Xin, 38, a shop owner in the Silk Market, a tourist-oriented mall in the Chinese capital.

Much of the current outbreak across Chinese cities is being driven by the variant commonly known as "stealth Omicron," or the B.A.2 lineage of the Omicron variant, Zhang noted. Early research suggests it spreads faster than the original Omicron, which itself spread faster than the original virus and other variants.

"But if our country opens up quickly now, it will cause a large number of infections in people in a short period of time," Zhang wrote Monday. "No matter how low the death rate is, it will still cause a run on medical resources and a short term shock to social life, causing irreparable harm to families and society."

Covid-19 cases continue to rise in China's worst outbreak since Wuhan [CNN, 14 Mar 2022]

(CNN)China reported thousands of new local Covid-19 cases Sunday as the Omicron variant drove the worst outbreak in the country since Wuhan in early 2020, according to the National Health Commission (NHC).

Health officials said 2,125 cases were reported across 58 cities in 19 of 31 mainland provinces, marking the fourth consecutive day China reported more than 1,000 daily local cases. More than 10,000 cases have been reported since the latest outbreak began in early March, the NHC said.

Saturday, the commission reported 3,122 local cases -- the highest number of daily infections since the Wuhan outbreak and the first time new cases have exceeded 3,000 in a day, NHC data showed.

Throughout the pandemic, China has adhered to a strict zero-Covid policy that aims to stamp out all outbreaks and chains of transmission using a combination of border controls, mass testing, quarantine procedures and lockdowns.

Nearly half of the total infections in the latest outbreak have been reported in northeastern Jilin province, with 4,605 cases since March 1, when the first clusters of cases in Jilin's border city Yanbian were identified, according to the provincial government.

The bulk of cases on Sunday, 1,026, were also reported in Jilin province, according to the NHC. Jilin province's city of Jilin has locked down 504 neighborhoods and launched eight rounds of mass testing, the municipal government said.

Two major Chinese cities -- northeastern industrial hub Changchun and southern economic hub Shenzhen -- are under lockdown, with more than 26 million residents forbidden from leaving their homes.

Shenzhen, which borders Hong Kong, recorded 66 positive cases Saturday and health authorities announced in a news release Sunday evening that from March 14 to March 20, all businesses in the city -- apart from those deemed essential or supplying Hong Kong -- would suspend operations or introduce work from home measures.

Public transport has also been suspended, as well as indoor dining, while all public venues excluding grocery stores and pharmacies have been closed, the authorities said.

Shenzhen will conduct three rounds of mass PCR testing for all residents during the lockdown, according to the release. Residents have been advised to avoid leaving the city unless necessary, and those who need to travel must present a negative PCR result issued within 24 hours of their departure.

Major Apple supplier Foxconn announced it suspended its operations in Shenzhen to comply with Covid-19 restrictions in the city.

"The date of factory resumption is to be advised by the local government," Foxconn said, adding "Due to our diversified production sites in China, we have adjusted the production line to minimize the potential impact."

The restrictions imposed on Shenzhen appear less stringent than those on Changchun, a city of 9 million that entered a strict lockdown Friday. Residents there have been banned from leaving their homes, while only one person per household is permitted to go grocery shopping every second day.

In Shanghai, 169 cases were reported Sunday, bringing its total number of infections in this latest outbreak to at least 778 since March 1, according to the municipal government
The city launched a "2+12" policy mandating people in the same neighborhood, workplace or school with close contacts of Covid cases to follow two days of home isolation and 12 days of health monitoring, according to the municipal government. The city also advised its 24.87 million residents not to leave the city unless necessary.

Chinese officials have been under pressure to bring outbreaks under control and have been reprimanded by higher administrations for "poor performance" as cases grow.

China has dismissed at least 26 government officials this month in cities where outbreaks have occurred, including a mayor and a director of municipal health commission in Jilin province, and a vice mayor and a deputy director of the provincial police department in Guangdong.

New Coronavirus News from 13 Mar 2022

Lauterbach expects corona case numbers to continue to rise [The Germany Eye, 13 Mar 2022]

Federal Health Minister Karl Lauterbach has warned against carelessness ahead of the planned imminent abolition of Corona restrictions in Germany. "The situation is objectively much worse than the mood," the SPD politician said in Berlin on Friday, referring to a renewed sharp rise in infection figures.

He called the situation critical and objected to sweeping assessments that the Omicron variant is milder. The variant can be fatal, he said, affecting unvaccinated people, "but even those who are vaccinated can become seriously ill and develop long-term consequences."

And, "We cannot be satisfied with a situation where 200 to 250 people die every day." This, he said, is an unsustainable situation that needs to be addressed.

The Robert Koch Institute (RKI) on Friday reported the ninth consecutive day of increase in seven-day incidence to now 1439.0 new infections per 100,000 population in seven days.

Accordingly, the health offices reported 252,836 new cases in one day, and 249 additional deaths were also registered within 24 hours. For comparison, the previous day the value had been 1388.5. A week ago, the nationwide incidence was 1196.4 (previous month: 1472.2).

The new version of the Infection Protection Act therefore provides that measures such as masking and testing obligations could continue to be taken in hotspots, Lauterbach said.
Hotspots could certainly be large areas and not just individual cities or regions.

Such protective regulations could then "also affect an entire state." Action will be taken where there is an outbreak, Lauterbach said.

However, the new Infection Protection Act, which is to be passed by the Bundestag next week, does not specify a concrete limit value for hotspots. This is always dependent on the current Corona variant, he said, which is why the states need leeway here. "There is no other way."

It would be best for the states to coordinate. Cologne is currently a hotspot, he said, which is probably related to Carnival. As a result, scheduled operations had to be postponed at the university hospital, for example.

The president of the Robert Koch Institute, Lothar Wieler, also considers the current corona situation in Germany to be tense and urges great vigilance. "Far too many people still fall seriously ill with Covid and too many people still die from this disease. And still many people also suffer long-term consequences from Covid," Wieler said at the joint press conference with Lauterbach.

Especially in the older age groups, the hospitalization rate is rising; in about half of the current Covid patients in intensive care units are over 70 years old, Wieler said. This is also due to the gradual relaxation of infection control measures in many places and the associated change in behavior of many people, he said.

He also focused on possible long-term consequences after infection, which could affect adults and - although probably less frequently - adolescents and children as well. Some of these people remain severely limited in the long term. However, the data available on the long-term consequences is still limited.

"So the situation remains tense, but we can influence the incidence of infection with our behavior," Wieler said. Reiterating his calls for vaccination, he stressed that many severe courses, deaths and long-term sequelae can be avoided through vaccination. "Vaccination remains the best and safest path to immunity," he said. He also urged all people to adhere to other known protective measures, maintain vigilance and pay particular attention to vulnerable groups.

Lauterbach said four scenarios are conceivable for the fall, which variants of the coronavirus dominate in Germany. Under all scenarios, he said, the general vaccination requirement under discussion is necessary because the genome of the coronavirus is 96 percent identical regardless of the variant. "We absolutely need the general vaccination requirement," Lauterbach said. The arguments against it are scientifically wrong, he added.

‘Pandemic is not over’: ministers criticised for scrapping UK Covid surveillance [The Guardian, 13 Mar 2022]

by Linda Geddes

Schemes coming to an end is ‘yet another example of short-term thinking’

Ministers have been accused of “turning off the headlights at the first sign of dawn” after scrapping nationwide Covid surveillance programmes, with scientists saying it will almost certainly end up costing more money in the long run.

Last week, scientists announced that the React study – which randomly tests about 150,000 people across England each month to see how many are infected with coronavirus – will be scrapped at the end of March, and no further data will be collected beyond that point.

Funding is also being withdrawn from the Zoe covid symptom study, the Siren and Vivaldi studies (which monitor infections in health workers and care homes) and the CoMix social contacts survey, while mass free testing is due to end on 1 April.

The Office for National Statistics’ Covid infection survey, which regularly samples the same 180,000 people to estimate what percentage of the UK populations is infected, will continue.

It comes as growing numbers of new infections in multiple countries led one expert to prompt speculation that Europe could be at the start of a sixth wave of Covid infections, partly driven by the “stealth” BA.2 Omicron variant.

Dr Stephen Griffin, a virologist at the University of Leeds, said the decisions on Covid surveillance would slow the country’s ability to respond and adjust to future waves or surges of infection, making the current reliance on emergency booster programmes progressively less viable, and were at best “shortsighted”.

Griffin said: “At worst, it is symptomatic of a policy-driven movement to ignore the fact that the pandemic is not over, and that we remain in a highly dynamic situation with respect to immunity versus infection and virus evolution. This is about as far from ‘following the science’ as you can get.

“Losing these programmes will almost certainly end up costing more in terms of disruption than saved. It is a false economy, and yet another example of short-term thinking.”

Stephen Reicher, a psychologist at the University of St Andrews, said the decisions made no sense on public safety or public health grounds. “It is like turning off the headlights at the first sign of dawn. You can’t see what’s coming and you don’t know when it makes sense to turn them on again,” he said.

Earlier this month, the government announced that its Scientific Advisory Group for Emergencies (Sage) would no longer regularly meet to discuss coronavirus. Reicher, who sat on the Sage behavioural science subcommittee, said the decision to stop funding these surveillance studies was “far more significant than standing down Sage”.

He said: “Those scientists are still working and can reconvene quickly. But how can they work – or know if they need to reconvene – if the data isn’t there?”

The ending of free mass testing on 1 April could make the situation even worse. “Johnson’s insistence that ‘tests will be available for anybody to buy’ completely misses the point,” said Dr Kit Yates, a mathematical biologist at the University of Bath. “Many people in the UK will not be in the position to spend a significant portion of their budget on testing each week. Others will simply be put off by the cost.

“The consequence will be that testing drops significantly, people become less aware when they are infectious, and consequently less able to take the ‘personal responsibility’ that the government has been highlighting so vociferously in the aftermath of their removal of other Covid mitigations.”

According to the latest ONS figures, the percentage of people estimated to have tested positive for coronavirus rose in England, Wales, Scotland and Northern Ireland in the week ending 5 March, while the percentage of infections compatible with the Omicron BA.2 variant also increased across all countries.

Austria, the Netherlands, Switzerland, Germany and many other European countries have also seen a sharp increase in daily confirmed cases since the start of March.

Dr Eric Topol, director of the Scripps Research Translational Institute in La Jolla, US, said the uptick could mark the beginning of a sixth wave of Covid infections in Europe, driven by a combination of the BA.1 and BA.2 Omicron variants and the relaxation of restrictions in many countries.

Topol said: “There are definitive signs of a new wave starting throughout many countries in Europe, some of which also are also showing increases in Covid hospitalisations. It is hard, at this point, to determine if the cause is reducing or eliminating restrictions, BA.2’s higher rate of transmission, or waning of immune protection from vaccines.

“Right now is the last time that countries like the UK and US should be cutting funding or abandoning any surveillance and testing measures. As much as we all would like it to be, the pandemic is far from over.”

Hong Kong leader vows more help for 300,000 residents stuck in home quarantine [South China Morning Post, 13 Mar 2022]

by Natalie Wong, Rachel Yeo and Jack Tsang

The government has vowed to step up assistance for an estimated 300,000 Covid-19 patients and their close contacts quarantining at home in Hong Kong, as the number of deaths related to the virus surpassed the total recorded in the mainland Chinese city of Wuhan, where the pandemic first emerged.

With the rest of the nation is battling its worst outbreak in two years, Chief Executive Carrie Lam Cheng Yuet-ngor sought to reassure residents on Sunday that the mainland’s support in tackling the city’s fifth wave of infections would continue and the supply of goods and resources would be unaffected.

But her comments came as Shenzhen authorities announced that Hong Kong truck drivers would no longer be allowed to cross the border and people could not leave the mainland city unless they provided a negative Covid-19 test result.

Coronavirus: Hong Kong business leaders warn of mass closures, bankruptcy as city’s universal testing plan remains uncertain

• Business leaders across different sectors are angry over inconsistent timeline for mass testing, concerned by possible prolonged closures
• Without detailed plans from government, owners cannot plan recruitment and logistics, catering group chairman says

Struggling Hong Kong businesses are stuck in limbo and cannot make plans for the future amid rising fears of shutdowns or bankruptcy after government proposals for mass Covid-19 testing were left hanging in the balance.

Various industry leaders told the Post that many businesses and their employees felt angry and frustrated over the government’s “inconsistent and self-conflicting” anti-Covid-19 measures, which created financial uncertainty during the ongoing outbreak.

They also warned of waves of bankruptcies, business closures and job losses as postponed mass testing was likely to further delay the resumption of operations. Currently, 16 types of premises are temporarily shut down under social-distancing measures which were expected to be lifted on April 21 after mass testing was completed.

Industry leaders said they were concerned after Chief Executive Carrie Lam Cheng Yuet-ngor announced a policy U-turn on Wednesday to focus on “reducing deaths, severe cases and infections”.

Lam has refused to provide a definite timetable for mass testing, after previously saying it would be conducted in March.


Joseph Ho Shiu-chung, chief supervisor of the Cosmetic and Perfumery Association of Hong Kong, whose members include beauty parlour owners, said some operators were upset by the government’s inconsistent decision to allow only hairdressers to reopen on Thursday.

“Many manicure salon operators were angry hearing the news and reduced to tears,” he said.

“They were very disappointed over why they could not reopen but hair salons were allowed to do so.”

The government cited “residents’ actual demand” for hairdressing services as the reason for lifting the temporary shutdown.

But Ho accused the government of using odd reasoning.

“The government’s rationale is very strange. People also have manicure needs and I know many patrons have had their nails broken and badly need manicure services,” he said.

Ho said Hong Kong’s 11,000 beauty and manicure salons were fully prepared to reopen on April 21, with all employees fully inoculated to meet the requirements for the city’s vaccine pass, which restricts entry to various premises for people who have not received Covid-19 jabs.

“If they can’t reopen on April 21, the consequences will be unimaginable. There might be a lot of bankruptcies,” he warned.

Beauty and Fitness Professional General Union chairwoman Amy Hui Wai-fung said workers in the sector felt they were stuck in limbo.

“The constant change in policy doesn’t make sense. We need a clear timetable about when we can really work again,” she said. “The government can’t expect us to stop working for an indefinite period. Without any income how can we survive?”

Members of the catering sector were also left frustrated, with Ray Chui Man-wai, chairman of the industry group Institute of Dining Art, saying he felt angry about the government’s contradictory Covid-19 policies.

“Originally we envisage that from April 21 onwards the government would further relax the dine-in curbs at restaurants from the present 6pm to 10pm,” he said.

“But given the change in the government’s stance on universal testing, I am afraid there will be no end in sight on the further relaxation of restaurant operations.”

Chui, who also serves as chairman of Kam Kee Holdings and operates 44 restaurants, said the uncertainties had made it impossible for the industry to plan ahead.

“During the mass testing, restaurants may need to suspend operations. Without a specific timetable, we can’t make business plans such as manpower, purchases of food and supplies, and rental negotiations with landlords,” he said.

The catering industry leader said more than 2,000 outlets could permanently close next month. “Where does our future lie? We have no idea,” he said.

Crucindo Hung Cho-sing, chairman of the Hong Kong Motion Picture Industry Association, said he did not expect cinemas to reopen next month.

“I am very pessimistic. I don’t think the city’s cinemas can resume operations on April 21. The earliest possible time will be in June,” he said.

He said Hong Kong’s movie industry had received the smallest amount of government support during the pandemic.

“We are the most miserable industry,” he said. “The government has offered no financial aid to the related businesses such as film distribution, production, advertising and public relations.

The employees can only be on their own.”


Without any hope of decisive measures from authorities, Small and Medium Enterprises Association honorary chairman Danny Lau Tat-pong warned of waves of business closures and bankruptcies.

“If [business owners] can’t see the future, they might give up on their businesses. The city’s economy will be on the brink of collapse and everyone has to pay a heavy price,” he said. “If you don’t let firms open doors, how can they survive?”

A spokeswoman for the Food and Health Bureau said the government would closely monitor the Covid-19 situation and review social-distancing measures from time to time.

“When the epidemic situation permits, we will suitably adjust our social-distancing measures having regard to factors including public health risk assessment, vaccination progress, economic situation and social acceptance, etc,” she said.

Lockdown announced in Shenzhen city as Corona cases surge in China [Uttarakhand News Network, 13 Mar 2022]

Corona has once again returned to China. The situation has become such that the administration has started imposing restrictions like lockdown in many cities. Corona lockdown has been implemented in Shenzhen city. After which 1.7 crore people living in the city have been confined to their homes. Earlier, the local administration of China has started Corona Rapid Tests for the first time.

Corona virus is once again wreaking havoc in China. More than 3,300 Covid-19 infections were found here on Saturday, which is the highest daily cases in the last two years. The National Health Commission has informed that 1,807 local infections and 1,315 asymptomatic cases have been confirmed. The northeastern province of Jilin recorded more than 2,100 cases. During this, 200 Covid patients coming from outside were confirmed. In this sequence, now a lockdown has been imposed in Shenzhen city of China.

Restrictions also apply in Beijing
Schools and parks have been closed in Shanghai, while in Beijing, entry into residential areas has been banned. After receiving new cases, the administration in Beijing asked people not to come out of their homes.

New Coronavirus News from 11 Mar 2022b

Germany to co-host 2022 Gavi COVAX AMC Summit, pledges additional funding for COVID-19 vaccination in lower-income countries - World [ReliefWeb, 11 Mar 2022]

• Germany will co-host the 2022 AMC Summit to help raise urgent funding to support lower-income countries' dynamic COVID-19 vaccination needs
• In addition, Germany has pledged an additional EUR 350 million to Gavi for the COVAX AMC, as part of a broader US$1.22 billion funding package for the ACT-Accelerator, pending cabinet and parliamentary approval.
• Both the Summit and pledge are in support of Germany's G7 Presidency goal to promote healthy lives worldwide, strengthen efforts to address COVID-19 on a global scale, and prepare for future pandemics and health crises.
• Prof. José Manuel Barroso, Board Chair of Gavi, the Vaccine Alliance: "Germany's support for global vaccination and the fight against COVID-19 has been clear from the beginning. We thank the German government in their G7 Presidency year for their support in helping to break the COVID-19 pandemic by hosting this summit and pledging additional funding to the Gavi COVAX AMC and ACT-Accelerator. We particularly recognize and value that this leadership comes at a time when Berlin along with many other capitals are mobilizing to respond to the terrible civilian suffering created by the conflict in Ukraine."
• Svenja Schulze, German Minister for Economic Cooperation and Development: "To be agile and flexible in our response, we need sufficient resources -- this is one of the key lessons learned in 2021 and essential to pandemic preparedness. We need to respond quickly to in-country needs and invest in strengthening country delivery systems in order to put an end to this pandemic. No one is safe until everyone is safe."

Geneva, 11 March 2022 -- Gavi, the Vaccine Alliance announced today that the Government of Germany will host a leader-level meeting aimed at helping raise at least US$5.2 billion in urgent financial support for COVAX, including US$ 3.8 billion in donor funding for lower-income countries supported by the Gavi COVAX Advance Market Commitment (Gavi COVAX AMC).
The virtual event -- "2022 Gavi COVAX AMC Summit: Break COVID Now" -- will be co-chaired by Svenja Schulze, German Minister for Economic Cooperation and Development and José Manuel Barroso, Gavi Board Chair. It will take place on 8 April 2022.

Almost 1.2 billion funded and donated doses have now been provided through the Gavi COVAX AMC to lower-income countries and territories around the world, and a rapid scale up in deliveries through the end of 2021 has helped narrow the vaccine equity gap while providing countries with critical longer-term visibility on supply -- but significant challenges still remain.
Hundreds of millions of people, mainly in lower-income countries, remain unvaccinated and unprotected, while the virus continues to evolve in uncertain ways: a major variant has been identified every 4 months, on average, since the pandemic was declared.

In 2022, COVAX will be focused on building on the foundation in place to tackle those challenges, serving as an adaptable and flexible mechanism to support lower-income countries' national COVID-19 vaccine objectives, and contributing to the global effort to break COVID.
That will mean providing urgent delivery support to those furthest behind in coverage -- while closely monitoring each country's continually evolving needs and strategies, including the need to prioritise and sequence COVID-19 immunization alongside routine immunization and other essential health systems activities. It will also mean learning from the lessons of the past year and making sure funding is available now to support countries' needs in the face of inevitable future evolutions of the pandemic. To support these goals, COVAX is seeking urgent additional funding of at least US$5.2 billion, of which Gavi is seeking to raise US$3.8 billion from sovereign and private donors.

Catalytic delivery funding will help countries increase rates of administration, now that supply is in place, and there is short and medium-term visibility of supply for the first time in the 12 months that vaccines have been available to AMC participants. In response to the high demand to-date for the $900m COVID-19 Delivery Support package that Gavi and partners have already put in place, urgent additional funding of US$ 1 billion will help lower-income countries rapidly protect more people against COVID-19. Of this amount, Gavi is seeking US$ 600 million to build on its Alliance work and provide direct support to lower-income governments for a range of readiness activities, while UNICEF is seeking US$400 million to support the critical work of its offices in lower-middle income countries and humanitarian contexts. Germany has also committed to work towards this effort with additional funding.

While seeking to build on the progress made, however, it is equally critical that we do not squander the lead we finally have in terms of supply meeting demand. COVAX's current portfolio can meet current demand, but this situation will not remain static. It is essential that we continue to mitigate and guard against future risks: variant-adapted vaccines, new vaccines, changes in booster policies or target populations, shift towards an annual shot model are all potential scenarios that the world must account for. Financing will need to already be in place to respond quickly in each scenario. Failing to do so will result in repeating the past, with lower-income countries once again being at the back of the queue.

To avoid such a situation and manage those risks, Gavi is seeking urgent funding for a "Pandemic Vaccine Pool" -- a flexible financial instrument that blends direct, contingent and innovative financing and will be able to act as a rapid response mechanism to support lower-income countries' needs in the face of these inevitable changes. Alongside US$ 2.7 billion in funding from sovereign and private sector donors, multilateral development banks and lower-income countries can also contribute via cost-sharing, providing another source of rapid funding for vaccines made available through the pandemic vaccine pool to the COVAX AMC.

Gavi is also seeking US$545 million to fund ancillary costs of dose donations, buying syringes and paying for logistics to get doses to countries, helping donations continue to be a sustainable and complementary source of supply alongside funded doses from COVAX agreements.

"To be agile and flexible in our response, we need sufficient resources -- this is one of the key lessons learned in 2021 and essential to pandemic preparedness. We need to respond quickly to in-country needs and invest in strengthening country delivery systems in order to put an end to this pandemic. No one is safe until everyone is safe," said German Minister for Economic Cooperation and Development Svenja Schulze.

COVAX is the vaccines pillar of the Access to COVID-19 Tools Accelerator (ACT-A). To help COVAX meet its goals, Germany has pledged an additional EUR 350 million in funding to the Gavi COVAX AMC, as part of a broader US$ 1.22 billion funding package for ACT-A to support access to COVID-19 treatments, tests, vaccines, and personal protective equipment. This new pledge, which is pending formal approval, builds on existing German pledges of EUR 1.03 billion, bringing the total German contribution to the global COVID-19 vaccination effort to EUR 1.38 billion. Germany has also pledged to donate 175 million doses of vaccines to COVAX, of which 90 million have already been shipped.

"Germany's support for global vaccination and the fight against COVID-19 has been clear from the beginning. We thank the German government in their G7 Presidency year for their support in helping to break the COVID-19 pandemic by hosting this summit and pledging additional funding to the Gavi COVAX AMC and ACT-Accelerator. We particularly recognize and value that this leadership comes at a time when Berlin along with many other capitals are mobilizing to respond to the terrible civilian suffering created by the conflict in Ukraine," stressed Prof. José Manuel Barroso, Board Chair of Gavi, the Vaccine Alliance.

"COVAX will need additional support through 2022 to ensure we can act now to support readiness and delivery to continue to accelerate rollout in countries, and anticipate and address future risks rapidly to meet future country demand. We must hope for the best, and plan for the worst: COVAX cannot again be at the back of the queue," added Dr. Seth Berkley, CEO of Gavi, the Vaccine Alliance. "We look forward to bringing countries, manufacturers, donors, civil society and the private sector together on April 8th to strengthen the world's collective response to COVID and commitment to future pandemic preparedness -- and thank Germany for helping lead this effort."

About COVAX
COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, is co-led by CEPI, Gavi and WHO -- working in partnership with developed and developing country vaccine manufacturers, UNICEF, PAHO, the World Bank, and others. It is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are available worldwide to both high-income and lower-income countries.

Gavi's role in COVAX
Gavi leads on procurement and delivery at scale for COVAX: designing and managing the COVAX Facilityand the Gavi COVAX AMC and working with its traditional Alliance partners UNICEF and WHO, along with governments, on country readiness and delivery.

As part of this role, Gavi hosts the Office of the COVAX Facility to coordinate the operation and governance of the mechanism as a whole, holds financial and legal relationships with 193 Facility participants, and manages the COVAX Facility deals portfolio: negotiating advance purchase agreements with manufacturers of promising vaccine candidates to secure doses on behalf of all COVAX Facility participants. Gavi also coordinates design, operationalisation and fundraising for the Gavi COVAX AMC, the mechanism that provides access to donor-funded doses of vaccine to 92 lower-income economies. As part of this work, Gavi provides funding and oversight for UNICEF procurement and delivery of vaccines to all AMC participants -- operationalising the advance purchase agreements between Gavi and manufacturers -- as well as support for partners' and governments work on readiness and delivery. This includes tailored support to governments, UNICEF, WHO and other partners for cold chain equipment, technical assistance, syringes, vehicles, and other aspects of the vastly complex logistical operation for delivery. Gavi also co-designed, raises funds for and supports the operationalisation of the AMC's no-fault compensation mechanism as well as the COVAX Humanitarian Buffer.

About Gavi, the Vaccine Alliance Gavi, the Vaccine Alliance is a public-private partnership that helps vaccinate half the world's children against some of the world's deadliest diseases. Since its inception in 2000, Gavi has helped to immunise a whole generation -- over 888 million children -- and prevented more than 15 million future deaths, helping to halve child mortality in 73 lower-income countries. Gavi also plays a key role in improving global health security by supporting health systems as well as funding global stockpiles for Ebola, cholera, meningitis and yellow fever vaccines. After two decades of progress, Gavi is now focused on protecting the next generation and reaching zero dose children remaining deprived of even a single vaccine shot still being left behind, employing innovative finance and the latest technology -- from drones to biometrics -- to save millions more lives, prevent outbreaks before they can spread and help countries on the road to self-sufficiency. Learn more at www.gavi.org and connect with us on Facebook and Twitter.

Gavi is a co-convener of COVAX, the vaccines pillar of the Access to COVID-19 Tools (ACT) Accelerator, together with the Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO). In its role Gavi is focused on procurement and delivery for COVAX: coordinating the design, implementation and administration of the COVAX Facility and the Gavi COVAX AMC and working with its Alliance partners UNICEF and WHO, along with governments, on country readiness and delivery.

The Vaccine Alliance brings together developing country and donor governments, the World Health Organization, UNICEF, the World Bank, the vaccine industry, technical agencies, civil society, the Bill & Melinda Gates Foundation and other private sector partners. Post this on LinkedIn

COVID digest: Germany's situation 'critical,' Lauterbach says [DW (English), 11 Mar 2022]

The German health minister has called on the federal states to reevaluate the coronavirus rules before restrictions are lifted. In other news, a Chinese city locks down as COVID cases rise.

German Health Minister Karl Lauterbach said the impact of COVID-19 in the country had reached a "critical" level after the number of infections rose to a record high this week.

"We are in a situation that I would like to describe as critical,'' Lauterbach said at the weekly coronavirus press briefing in Berlin on Friday. "We have strongly rising case figures again. [...] I keep reading that the omicron variant is a milder variant but that's only true to a limited extent."

Despite planning to further relax COVID-19 rules, Germany logged a record high number of coronavirus infections in 24 hours on Thursday, and a figure almost as high, 252,836 cases, on Friday.

"The situation is objectively worse than the public mood," the health minister said.

He said that some people's belief in Germany, including politicians, that the pandemic was now over, was an "error of judgement."

"We can not be satisfied with a situation in which 250 people are dying every day and the prospect is that in a few weeks more people will die,'' he said.

Germany will lift most coronavirus restrictions on March 20 after a period of easing them.

From then on, state governments will be allowed to require measures such as wearing masks, testing and other measures in virus "hot spots" at their own discretion.

Masks will remain mandatory on long-distance trains and flights.

Africa
The government in Kenya announced on Friday that it would scrap wearing of masks in public to ease COVID-19 restrictions that had been in place for two years.

"The mandatory wearing of face masks in open public spaces is now lifted," Health Minister Mutahi Kagwe said in a statement on Friday.

It comes as rates of COVID infection in Kenya had dropped to one percent or less over the past month, the minister explained.

Double vaccinated people will also be allowed into sporting events and all in-person worship services can resume at full capacity so long as the attendees are fully jabbed, he said.

But he also added: "This, however, is not to say that we are already completely out of the woods."

Kagwe encouraged the continued use of masks indoors and social distancing in public places.

Asia China ordered the lockdown the northeastern city of Changchun following a new spike in local COVID-19 cases attributed to the omicron variant.

Mainland China reported over 1,000 new COVID-19 infections, spread across dozens of cities, its highest daily count in about two years, according to the latest daily official count released on Friday.

Residents living in the city of 9 million must stay at home, with one family member allowed to leave the house to buy food and other essentials every two days.

All residents also have to undergo three rounds of mass testing, meanwhile non-essential businesses have been closed and transport links suspended.

In Hong Kong, leader Carrie Lam called for more vaccinations as rising infections raise alarm bells. Lam said on Friday that the city's COVID-19 vaccination program will focus on its elderly and children while authorities battle to curb climbing infections and death rates.

Health authorities reported 29,381 new infections and 196 deaths on Friday. Since early 2020, Hong Kong had recorded almost 650,000 COVID-19 infections and about 3,500 deaths, most of which are from the past two weeks.

A World Health Organization (WHO) official on Friday had urged the Philippines to remain vigilant against Covid-19, warning that another surge was "inevitable."

As cases continue to drop to less than 1,000 per day, authorities in the Philippines had been looking to ease restrictions. Since the start of the month, 40 areas in the country, including the capital, had remained under Level 1 of a five-tier alert system.

This meant businesses have been allowed to operate at full capacity but face masks and social distancing are still required.

Rajendra Prasav Yadav, WHO's acting country representative, said it was "too early to declare victory against the virus."

"When we start lowering our guards and masks, this is a disaster because we're seeing the vaccination pace slow down considerably in the past few days," he said in a television interview.
"We have to be actively careful, stay alert and get ready for the next wave, which I think is inevitable."

Americas
The United States is extending the requirement of wearing masks on planes and public transport for one more month, federal officials said.

It announced the decision while also deliberating on steps that could lead to lifting the rule entirely.

The mandate to wear masks was scheduled to expire March 18, but now has been extended to April 18, Transportation Security Administration (TSA) said.

Opinion | The Covid-19 Pandemic Didn’t Have to Be This Way [The New York Times, 11 Mar 2022]

By Zeynep Tufekci
Opinion Columnist
This article is part of Times Opinion’s reflection on the two-year mark of the Covid pandemic.

We cannot step into the same river twice, the Greek philosopher Heraclitus is said to have observed. We’ve changed, the river has changed.

That’s very true, but it doesn’t mean we can’t learn from seeing what other course the river could have flowed. As the pandemic enters its third year, we must consider those moments when the river branched, and nations made choices that affected thousands, millions, of lives.

What if China had been open and honest in December 2019? What if the world had reacted as quickly and aggressively in January 2020 as Taiwan did? What if the United States had put appropriate protective measures in place in February 2020, as South Korea did?

To examine these questions is to uncover a brutal truth: Much suffering was avoidable, again and again, if different choices that were available and plausible had been made at crucial turning points. By looking at them, and understanding what went wrong, we can hope to avoid similar mistakes in the future.

What happened in the first weeks: China covered up the outbreak.

Our information about what happened when the coronavirus apparently was first detected in Wuhan, China, in December 2019, remains limited. Reporters working for Western media have been kicked out, and even local citizen journalists who shared information during the early days were jailed. But evidence strongly suggests that China knew the danger long before it told the world the truth.

The South China Morning Post, a newspaper owned by a major Chinese company, reported that Chinese officials found cases that date to Nov. 17, 2019. Several Western scientists said colleagues in China had told them of the outbreak by mid-December. Whistleblower doctors reported being silenced from mid-December on. Toward the end of December, hospitals in Wuhan were known to be quarantining sick patients, and medical staff members were falling sick — clear evidence of human-to-human transmission, the first step toward a pandemic.

Finally, on Dec. 31, 2019, as rumors were growing, the Wuhan health officials acknowledged 27 cases of an “unexplained pneumonia” caused by a virus, but claimed there was no evidence of “obvious human to human transmission.” The next day, a Chinese state media outlet announced that authorities had disciplined eight people for spreading rumors about the virus, including Dr. Li Wenliang, who had noted that the mystery pneumonia cases resembled SARS and warned colleagues to wear protective gear, and who would later die of Covid.

Not until Jan. 20, 2020, did Chinese authorities publicly admit that the virus was clearly passing from person to person. Three days later, they shut down the city of Wuhan.

At that point, the virus had had weeks to spread far beyond China’s borders and was beginning to establish outbreaks globally. A pandemic was on its way.

What could have happened: China tells the world the truth and the pandemic is avoided.

China could have notified the World Health Organization sometime in early to mid-December that it had an outbreak of a previously unknown coronavirus similar to the dreaded SARS pathogen, and immediately sequenced the virus and shared the genome, allowing tests to be developed. The rest of the world would have had to act, too. Governments could have made sure tests were immediately developed to find as many cases as possible. Health authorities could have isolated infected people and traced and quarantined their contacts. Travel restrictions and testing could have been put in place to prevent the spread outside China.

It may seem like a fantasy to suggest that the outbreak could have been extinguished before it became a pandemic, but later outbreaks of this virus were contained. This first wave could have been, too, and the pandemic might have been completely avoided, saving millions of lives and much suffering.

What happened after China covered up: The world failed to heed warnings and take action.

On Dec. 30, 2019, ProMED, a service that tracks infectious disease outbreaks globally, warned of “unexplained pneumonia” cases in Wuhan. The veteran infectious disease reporter Helen Branswell shared the news alert on Twitter the next day and said it was giving her “#SARS flashbacks.” That same day, Taiwan’s Centers for Disease Control — with its close contacts on the ground in China — fired off an email to the W.H.O. with its concerns that patients were being isolated in Wuhan — a clear sign of an outbreak with person-to-person spread.

On Jan. 11, 2020, a Chinese scientist bravely allowed an Australian colleague to upload the virus’s genome to a gene bank, without official authorization. This meant that the whole world could now see this was a novel coronavirus, closely related to SARS. The next day, the scientist’s lab was shut down.

Doubts over whether the virus was capable of spreading from person to person should have been swept away in mid-January 2020 by reports that a woman in Thailand and a man in Japan had tested positive without having been to the Wuhan seafood market that Chinese authorities had said was the center of the spread. Meanwhile, despite such clear evidence of the virus’s transmissibility, the number of cases that China reported remained at 44. (We’d later learn that medical professionals weren’t even allowed to report cases that weren’t connected to the seafood market.) Yet the W.H.O. kept repeating China’s line that there was no evidence of human-to-human transmission.

It wasn’t until China shut down Wuhan on Jan. 23, 2020, that the rest of the world could see how serious the threat was — even then, the global response remained feeble.

What could have happened: The world sees through China’s deception and takes action.
How could nations have gotten around China’s smokescreen? They could have done what Taiwan did.

On Dec. 31, 2019, the same day Taiwan officials sent that email to the W.H.O., they started boarding every plane that flew there directly from Wuhan, screening arriving passengers for symptoms like fever.

“We were not able to get satisfactory answers either from the W.H.O. or from the Chinese C.D.C., and we got nervous and we started doing our preparation,” foreign minister Joseph Wu told Time magazine.

Masks were rationed, to ensure there were enough for the entire population, and were distributed to schools. Soldiers were put on production lines at mask factories to increase supply. The country quickly allocated money to businesses that lost customers and revenue.

For most of 2020, Covid was rare in Taiwan. On 253 consecutive days that year there were no locally transmitted cases there, even though there had been extensive travel to China, including Wuhan, before January 2020. With extensive testing and tracing, they squashed two major outbreaks — one that started in March 2020, and more impressively, a major outbreak of the more transmissible Alpha variant in summer 2021 — bringing local cases back to zero. That shows what was possible with an early and robust response.

Taiwan has suffered 853 deaths. If the United States had suffered a similar death rate, we would have lost about 12,000 people, instead of nearly a million.

Taiwan shows that even in early January, there was enough information to be concerned about the virus, and the potential to suppress any outbreak.

What happened after the outbreak went global: The real contagious threat was ignored.
On the precipice of a pandemic, too many important officials failed to understand how the virus was spreading, despite emerging evidence, keeping them from effectively limiting its spread and costing thousands of lives.

On Feb. 3, 2020, the cruise ship Diamond Princess was ordered to stay in Yokohama harbor, in Japan, two days after a passenger who had disembarked in Hong Kong tested positive for Covid. After 10 other people on the ship were found to be infected, the ship was quarantined. Eventually there would be 712 cases, about 19 percent of those on board, with 14 deaths.

Nine public health workers attending to the ship were infected. It seemed quite unlikely, the Japanese virology professor Hitoshi Oshitani noted, that all these professionals with expertise in infection control had failed to take the recommended precautions.

At that point the guidelines from the W.H.O. and the Centers for Disease Control and Prevention were based on the assumption that this virus was spread by large droplets from the nose and mouth that quickly fell to the ground or to surfaces, because of their size. People were advised to keep enough distance from others to stay out of the range of these droplets, and to wash their hands in case they picked them up from surfaces.

If the workers became infected despite those precautions, and if passengers were infected even when they were quarantined, Oshitani suspected that the virus was probably spread by airborne transmission of tiny particles — aerosols — that could spread more widely, float around and concentrate, especially indoors.

This case for aerosol spread strengthened after 61 people attended a choir practice in Skagit, Wash., on March 10, 2020. The church followed droplet-based guidance by propping the door open so nobody would touch the door knob and avoiding handshakes or hugs. No one was six feet in front of the person suspected to have been the single initial source. Nevertheless, 52 people — 85 percent of those present — became infected.

Many Western experts, including in the United States and Europe and at the W.H.O., discounted these and other evidence of airborne transmission. Countries like the United States did not require masks to limit airborne spread but worried instead about germs spreading on people’s mail and groceries.

After more evidence, and organized attempts by hundreds of aerosol scientists, minor course corrections started later in 2020, but they were halting, incomplete and underpublicized. For example, it wasn’t until December 2020 that the W.H.O. started recommending that masks be worn indoors regardless of distance, and even then only if the space was poorly ventilated, and it wasn’t until December 2021 — two years after it all began — that it recommended highly protective masks for health care workers.

It was also assumed that only people with symptoms — like fever — would be infectious, even though evidence to the contrary had emerged early.

On Jan. 26, 2020, the Chinese minister of health gave a news conference warning that people without symptoms could transmit the virus. The same week an article in The Lancet had documented a case in which infection was visible in the lungs of a patient who had shown no symptoms. An article published in the New England Journal of Medicine, also the same week, noted cases presenting only mild symptoms, with the authors stressing that this would make it easy to miss them. Multiple reports from German scientists soon disclosed similar conclusions based on cases there.

However, many health authorities ignored, denied and even belittled evidence of spread without symptoms. It took until well into March for officials in the United States, for example, to accept that people without symptoms could be infectious.

The failure to acknowledge this type of transmission meant that the urgency for mass testing wasn’t realized and the virus spread silently, without critical precautions being taken, until explosive growth occurred in places like New York City. The need to identify and quarantine people who had come in contact with those who were infected was considered unnecessary and alarmist in the United States. The C.D.C. and the W.H.O. initially recommended masks only for the sick.

Another crucial misstep was the failure to recognize the virus’s dominant pattern of spread, in large bursts.

That February, Oshitani and his colleagues concluded that a vast majority of infected people didn’t transmit at all, while a small number of individuals were superspreading, in closed indoor settings like restaurants, night clubs, karaoke bars, gyms and such — especially if the ventilation was poor. They developed new approaches to trace infections to their origin, to find cluster transmission and thus look for other cases.

What could have happened: Officials put in place effective and early mitigation strategies.

The rest of the world could have understood the virus as Japanese officials did. Based on their understanding, which was arrived at in February 2020, that Covid was airborne, spread without symptoms and driven by clusters, by early March they were recommending mask-wearing, emphasizing the need for ventilation and advising the public to avoid the three Cs: closed spaces, crowded places and close-contact settings.

Americans, on the other hand, were disinfecting their groceries, and the W.H.O. kept emphasizing hand-washing and social distancing, or remaining six feet apart. Japan has had about 25,000 Covid deaths, which would be the equivalent of just under 66,000 in a country the size of the United States.

Mass testing could have detected people who were infectious before they even knew they were sick and sometimes those who never had symptoms at all. Ventilation and air filtration could have kept indoor spaces safer.

Instead of closing parks, activities could have been moved outside weather permitting, since natural ventilation more effectively dissipates the virus. The key role of masks would have been understood earlier, along with the benefits of higher quality masks. Rather than wasting money on plexiglass barriers — which can’t fully block aerosols and can even create dead zones for ventilation, increasing infection risk — schools would have begun updating their ventilation and HVAC systems, and installing HEPA air filters, which can filter viruses. Japan’s cluster-busting strategy could have been adopted.

Also, even though epidemics are easier to suppress with early action, it’s silent spread and superspreading that make a timely response even more important, as shown by South Korea’s early response.

South Korea experienced major superspreading events in February 2020, including one in a secretive church that accounted for more than 5,000 infections, with a single person suspected as the source. The country had the highest number of cases outside of China at that point.

South Korean officials sprang into action, rolling out a mass testing program — they had been readying their testing capacity since January — with drive-through options and vigorous contact tracing.

South Korea beat back that potentially catastrophic outbreak, and continued to greatly limit its cases. They had fewer than 1,000 deaths in all of 2020. In the United States, that would translate to fewer than 7,000 deaths from Covid in 2020. Instead, estimates place the number of deaths at more than 375,000.

What happened: When vaccines were developed, rich countries hoarded them.

The greatest scientific achievement of the pandemic may have been the speedy development of safe, effective vaccines.

In January 2020, the C.E.O. of BioNTech, Ugur Sahin, started designing vaccines as soon as he read The Lancet study noting the case without symptoms, which convinced him that a pandemic was likely. He then persuaded Pfizer, his initially skeptical investor, to back him.
On May 15, 2020, the United States began Operation Warp Speed, which financed the development of six vaccine candidates. Five of them quickly proved to be highly effective — not at all a given. The first to deliver spectacular results was that produced by Pfizer and BioNTech. Moderna’s quickly followed.

Supply was an immediate problem. Pfizer initially estimated it could make as many as 1.35 billion doses in 2021 — enough for about only 8.5 percent of the world’s people to get two doses. Moderna, a much smaller company, wasn’t expected to exceed that. AstraZeneca’s vaccine, too, would not cover the gap quickly enough.

There also was too little commitment to how vaccines could be distributed fairly around the world.

Instead, wealthy countries that had preordered or financed research got most of the initial doses.

Vaccine production grew, but too slowly. There was no consortium or sharing of resources to ramp up supply. Technology wasn’t transferred to lower- and middle-income countries. Patents were left in place. The W.H.O. initiative to get vaccines to poorer countries, known as Covax, was not able to buy enough doses, and what donations were made were insufficient and haphazard.

Then, in a largely unanticipated plot twist, dangerous variants of the coronavirus started emerging in late 2020 — Alpha, Delta and then Omicron.

Widespread earlier vaccination could have helped limit the possibility for these variants emerging. Plus, many variants may have arisen through persistent infections in immunocompromised people — like those who have untreated H.I.V., another terrible legacy of global health inequity.

What could have happened: Vaccine supply ramps up, with sensible distribution.

Political leaders in wealthy countries should have brought together vaccine manufacturers to arrange conditions and deals that can likely be struck only with government prodding: sharing manufacturing facilities, training experts, sharing intellectual property. Technology transfer to poorer countries could have achieved the ultimate goal: a world with many countries that can produce effective vaccines. Existing vaccine manufacturers could still profit handsomely — especially considering they, too, benefit from publicly funded research.

Countries may want to first vaccinate their own citizens, even those at much less risk. But to save the most lives, priorities should have been set globally. Health care workers, the elderly and those at high risk throughout the world should have gotten the first vaccinations.

Trials could have been immediately started to assess whether delaying second doses might work well while allowing doses to be spread more widely geographically. Early results on the protective effect of first doses were encouraging.

A few countries like Canada and Britain did lengthen the interval between doses as a strategy to protect more of their citizens — to great results. More of their vulnerable population got protected quickly. Plus, longer intervals, as some immunologists had predicted earlier, still left people protected — the unusually short three- and four-week period between the two initial shots had been put in place partly to speed up the trials. In the United States, though, such adaptive strategies could not be studied or rolled out.

What needs to happen
When the pandemic is over, the temptation will be to move on and reclaim what had been normal life. For individuals that will be fine. But the cracks revealed in our governments and public health institutions by two years of inertia, mistakes and resistance to evidence make it crucial that a broad, tough dissection of what happened take place if we are to choose the correct course in future challenges.

National and international commissions need to help us see where we went wrong, without scapegoating, and how to respond to future outbreaks, without defensively excusing what public health authorities and national leaders did this time, even if well-meaning. In some countries, it would be easy to focus only on political leaders like President Donald Trump, who severely damaged America’s response. But top public health officials, high-level scientists and state governors made many missteps along the way. At a time of growing international distrust we need to work to increase trust and mutual cooperation. We need to better understand how to rapidly incorporate evidence into scientific policy and to better understand human response to such major, complicated events.

If we can do that, to save lives and ease suffering in the future, it will not make up for all the loss and hardship we have endured in the last two years. But we can at least say we did our best to learn from it, and let that be the one positive legacy of all this.

New Coronavirus News from 11 Mar 2022

Opinion | The Covid-19 Pandemic Didn’t Have to Be This Way [The New York Times, 11 Mar 2022]

By Zeynep Tufekci
Opinion Columnist
This article is part of Times Opinion’s reflection on the two-year mark of the Covid pandemic.

We cannot step into the same river twice, the Greek philosopher Heraclitus is said to have observed. We’ve changed, the river has changed.

That’s very true, but it doesn’t mean we can’t learn from seeing what other course the river could have flowed. As the pandemic enters its third year, we must consider those moments when the river branched, and nations made choices that affected thousands, millions, of lives.

What if China had been open and honest in December 2019? What if the world had reacted as quickly and aggressively in January 2020 as Taiwan did? What if the United States had put appropriate protective measures in place in February 2020, as South Korea did?

To examine these questions is to uncover a brutal truth: Much suffering was avoidable, again and again, if different choices that were available and plausible had been made at crucial turning points. By looking at them, and understanding what went wrong, we can hope to avoid similar mistakes in the future.

What happened in the first weeks: China covered up the outbreak.

Our information about what happened when the coronavirus apparently was first detected in Wuhan, China, in December 2019, remains limited. Reporters working for Western media have been kicked out, and even local citizen journalists who shared information during the early days were jailed. But evidence strongly suggests that China knew the danger long before it told the world the truth.

The South China Morning Post, a newspaper owned by a major Chinese company, reported that Chinese officials found cases that date to Nov. 17, 2019. Several Western scientists said colleagues in China had told them of the outbreak by mid-December. Whistleblower doctors reported being silenced from mid-December on. Toward the end of December, hospitals in Wuhan were known to be quarantining sick patients, and medical staff members were falling sick — clear evidence of human-to-human transmission, the first step toward a pandemic.

Finally, on Dec. 31, 2019, as rumors were growing, the Wuhan health officials acknowledged 27 cases of an “unexplained pneumonia” caused by a virus, but claimed there was no evidence of “obvious human to human transmission.” The next day, a Chinese state media outlet announced that authorities had disciplined eight people for spreading rumors about the virus, including Dr. Li Wenliang, who had noted that the mystery pneumonia cases resembled SARS and warned colleagues to wear protective gear, and who would later die of Covid.

Not until Jan. 20, 2020, did Chinese authorities publicly admit that the virus was clearly passing from person to person. Three days later, they shut down the city of Wuhan.

At that point, the virus had had weeks to spread far beyond China’s borders and was beginning to establish outbreaks globally. A pandemic was on its way.

What could have happened: China tells the world the truth and the pandemic is avoided.

China could have notified the World Health Organization sometime in early to mid-December that it had an outbreak of a previously unknown coronavirus similar to the dreaded SARS pathogen, and immediately sequenced the virus and shared the genome, allowing tests to be developed. The rest of the world would have had to act, too. Governments could have made sure tests were immediately developed to find as many cases as possible. Health authorities could have isolated infected people and traced and quarantined their contacts. Travel restrictions and testing could have been put in place to prevent the spread outside China.

It may seem like a fantasy to suggest that the outbreak could have been extinguished before it became a pandemic, but later outbreaks of this virus were contained. This first wave could have been, too, and the pandemic might have been completely avoided, saving millions of lives and much suffering.

What happened after China covered up: The world failed to heed warnings and take action.

On Dec. 30, 2019, ProMED, a service that tracks infectious disease outbreaks globally, warned of “unexplained pneumonia” cases in Wuhan. The veteran infectious disease reporter Helen Branswell shared the news alert on Twitter the next day and said it was giving her “#SARS flashbacks.” That same day, Taiwan’s Centers for Disease Control — with its close contacts on the ground in China — fired off an email to the W.H.O. with its concerns that patients were being isolated in Wuhan — a clear sign of an outbreak with person-to-person spread.

On Jan. 11, 2020, a Chinese scientist bravely allowed an Australian colleague to upload the virus’s genome to a gene bank, without official authorization. This meant that the whole world could now see this was a novel coronavirus, closely related to SARS. The next day, the scientist’s lab was shut down.

Doubts over whether the virus was capable of spreading from person to person should have been swept away in mid-January 2020 by reports that a woman in Thailand and a man in Japan had tested positive without having been to the Wuhan seafood market that Chinese authorities had said was the center of the spread. Meanwhile, despite such clear evidence of the virus’s transmissibility, the number of cases that China reported remained at 44. (We’d later learn that medical professionals weren’t even allowed to report cases that weren’t connected to the seafood market.) Yet the W.H.O. kept repeating China’s line that there was no evidence of human-to-human transmission.

It wasn’t until China shut down Wuhan on Jan. 23, 2020, that the rest of the world could see how serious the threat was — even then, the global response remained feeble.

What could have happened: The world sees through China’s deception and takes action.
How could nations have gotten around China’s smokescreen? They could have done what Taiwan did.

On Dec. 31, 2019, the same day Taiwan officials sent that email to the W.H.O., they started boarding every plane that flew there directly from Wuhan, screening arriving passengers for symptoms like fever.

“We were not able to get satisfactory answers either from the W.H.O. or from the Chinese C.D.C., and we got nervous and we started doing our preparation,” foreign minister Joseph Wu told Time magazine.

Masks were rationed, to ensure there were enough for the entire population, and were distributed to schools. Soldiers were put on production lines at mask factories to increase supply. The country quickly allocated money to businesses that lost customers and revenue.

For most of 2020, Covid was rare in Taiwan. On 253 consecutive days that year there were no locally transmitted cases there, even though there had been extensive travel to China, including Wuhan, before January 2020. With extensive testing and tracing, they squashed two major outbreaks — one that started in March 2020, and more impressively, a major outbreak of the more transmissible Alpha variant in summer 2021 — bringing local cases back to zero. That shows what was possible with an early and robust response.

Taiwan has suffered 853 deaths. If the United States had suffered a similar death rate, we would have lost about 12,000 people, instead of nearly a million.

Taiwan shows that even in early January, there was enough information to be concerned about the virus, and the potential to suppress any outbreak.

What happened after the outbreak went global: The real contagious threat was ignored.
On the precipice of a pandemic, too many important officials failed to understand how the virus was spreading, despite emerging evidence, keeping them from effectively limiting its spread and costing thousands of lives.

On Feb. 3, 2020, the cruise ship Diamond Princess was ordered to stay in Yokohama harbor, in Japan, two days after a passenger who had disembarked in Hong Kong tested positive for Covid. After 10 other people on the ship were found to be infected, the ship was quarantined. Eventually there would be 712 cases, about 19 percent of those on board, with 14 deaths.

Nine public health workers attending to the ship were infected. It seemed quite unlikely, the Japanese virology professor Hitoshi Oshitani noted, that all these professionals with expertise in infection control had failed to take the recommended precautions.

At that point the guidelines from the W.H.O. and the Centers for Disease Control and Prevention were based on the assumption that this virus was spread by large droplets from the nose and mouth that quickly fell to the ground or to surfaces, because of their size. People were advised to keep enough distance from others to stay out of the range of these droplets, and to wash their hands in case they picked them up from surfaces.

If the workers became infected despite those precautions, and if passengers were infected even when they were quarantined, Oshitani suspected that the virus was probably spread by airborne transmission of tiny particles — aerosols — that could spread more widely, float around and concentrate, especially indoors.

This case for aerosol spread strengthened after 61 people attended a choir practice in Skagit, Wash., on March 10, 2020. The church followed droplet-based guidance by propping the door open so nobody would touch the door knob and avoiding handshakes or hugs. No one was six feet in front of the person suspected to have been the single initial source. Nevertheless, 52 people — 85 percent of those present — became infected.

Many Western experts, including in the United States and Europe and at the W.H.O., discounted these and other evidence of airborne transmission. Countries like the United States did not require masks to limit airborne spread but worried instead about germs spreading on people’s mail and groceries.

After more evidence, and organized attempts by hundreds of aerosol scientists, minor course corrections started later in 2020, but they were halting, incomplete and underpublicized. For example, it wasn’t until December 2020 that the W.H.O. started recommending that masks be worn indoors regardless of distance, and even then only if the space was poorly ventilated, and it wasn’t until December 2021 — two years after it all began — that it recommended highly protective masks for health care workers.

It was also assumed that only people with symptoms — like fever — would be infectious, even though evidence to the contrary had emerged early.

On Jan. 26, 2020, the Chinese minister of health gave a news conference warning that people without symptoms could transmit the virus. The same week an article in The Lancet had documented a case in which infection was visible in the lungs of a patient who had shown no symptoms. An article published in the New England Journal of Medicine, also the same week, noted cases presenting only mild symptoms, with the authors stressing that this would make it easy to miss them. Multiple reports from German scientists soon disclosed similar conclusions based on cases there.

However, many health authorities ignored, denied and even belittled evidence of spread without symptoms. It took until well into March for officials in the United States, for example, to accept that people without symptoms could be infectious.

The failure to acknowledge this type of transmission meant that the urgency for mass testing wasn’t realized and the virus spread silently, without critical precautions being taken, until explosive growth occurred in places like New York City. The need to identify and quarantine people who had come in contact with those who were infected was considered unnecessary and alarmist in the United States. The C.D.C. and the W.H.O. initially recommended masks only for the sick.

Another crucial misstep was the failure to recognize the virus’s dominant pattern of spread, in large bursts.

That February, Oshitani and his colleagues concluded that a vast majority of infected people didn’t transmit at all, while a small number of individuals were superspreading, in closed indoor settings like restaurants, night clubs, karaoke bars, gyms and such — especially if the ventilation was poor. They developed new approaches to trace infections to their origin, to find cluster transmission and thus look for other cases.

What could have happened: Officials put in place effective and early mitigation strategies.

The rest of the world could have understood the virus as Japanese officials did. Based on their understanding, which was arrived at in February 2020, that Covid was airborne, spread without symptoms and driven by clusters, by early March they were recommending mask-wearing, emphasizing the need for ventilation and advising the public to avoid the three Cs: closed spaces, crowded places and close-contact settings.

Americans, on the other hand, were disinfecting their groceries, and the W.H.O. kept emphasizing hand-washing and social distancing, or remaining six feet apart. Japan has had about 25,000 Covid deaths, which would be the equivalent of just under 66,000 in a country the size of the United States.

Mass testing could have detected people who were infectious before they even knew they were sick and sometimes those who never had symptoms at all. Ventilation and air filtration could have kept indoor spaces safer.

Instead of closing parks, activities could have been moved outside weather permitting, since natural ventilation more effectively dissipates the virus. The key role of masks would have been understood earlier, along with the benefits of higher quality masks. Rather than wasting money on plexiglass barriers — which can’t fully block aerosols and can even create dead zones for ventilation, increasing infection risk — schools would have begun updating their ventilation and HVAC systems, and installing HEPA air filters, which can filter viruses. Japan’s cluster-busting strategy could have been adopted.

Also, even though epidemics are easier to suppress with early action, it’s silent spread and superspreading that make a timely response even more important, as shown by South Korea’s early response.

South Korea experienced major superspreading events in February 2020, including one in a secretive church that accounted for more than 5,000 infections, with a single person suspected as the source. The country had the highest number of cases outside of China at that point.

South Korean officials sprang into action, rolling out a mass testing program — they had been readying their testing capacity since January — with drive-through options and vigorous contact tracing.

South Korea beat back that potentially catastrophic outbreak, and continued to greatly limit its cases. They had fewer than 1,000 deaths in all of 2020. In the United States, that would translate to fewer than 7,000 deaths from Covid in 2020. Instead, estimates place the number of deaths at more than 375,000.

What happened: When vaccines were developed, rich countries hoarded them.

The greatest scientific achievement of the pandemic may have been the speedy development of safe, effective vaccines.

In January 2020, the C.E.O. of BioNTech, Ugur Sahin, started designing vaccines as soon as he read The Lancet study noting the case without symptoms, which convinced him that a pandemic was likely. He then persuaded Pfizer, his initially skeptical investor, to back him.
On May 15, 2020, the United States began Operation Warp Speed, which financed the development of six vaccine candidates. Five of them quickly proved to be highly effective — not at all a given. The first to deliver spectacular results was that produced by Pfizer and BioNTech. Moderna’s quickly followed.

Supply was an immediate problem. Pfizer initially estimated it could make as many as 1.35 billion doses in 2021 — enough for about only 8.5 percent of the world’s people to get two doses. Moderna, a much smaller company, wasn’t expected to exceed that. AstraZeneca’s vaccine, too, would not cover the gap quickly enough.

There also was too little commitment to how vaccines could be distributed fairly around the world.

Instead, wealthy countries that had preordered or financed research got most of the initial doses.

Vaccine production grew, but too slowly. There was no consortium or sharing of resources to ramp up supply. Technology wasn’t transferred to lower- and middle-income countries. Patents were left in place. The W.H.O. initiative to get vaccines to poorer countries, known as Covax, was not able to buy enough doses, and what donations were made were insufficient and haphazard.

Then, in a largely unanticipated plot twist, dangerous variants of the coronavirus started emerging in late 2020 — Alpha, Delta and then Omicron.

Widespread earlier vaccination could have helped limit the possibility for these variants emerging. Plus, many variants may have arisen through persistent infections in immunocompromised people — like those who have untreated H.I.V., another terrible legacy of global health inequity.

What could have happened: Vaccine supply ramps up, with sensible distribution.

Political leaders in wealthy countries should have brought together vaccine manufacturers to arrange conditions and deals that can likely be struck only with government prodding: sharing manufacturing facilities, training experts, sharing intellectual property. Technology transfer to poorer countries could have achieved the ultimate goal: a world with many countries that can produce effective vaccines. Existing vaccine manufacturers could still profit handsomely — especially considering they, too, benefit from publicly funded research.

Countries may want to first vaccinate their own citizens, even those at much less risk. But to save the most lives, priorities should have been set globally. Health care workers, the elderly and those at high risk throughout the world should have gotten the first vaccinations.

Trials could have been immediately started to assess whether delaying second doses might work well while allowing doses to be spread more widely geographically. Early results on the protective effect of first doses were encouraging.

A few countries like Canada and Britain did lengthen the interval between doses as a strategy to protect more of their citizens — to great results. More of their vulnerable population got protected quickly. Plus, longer intervals, as some immunologists had predicted earlier, still left people protected — the unusually short three- and four-week period between the two initial shots had been put in place partly to speed up the trials. In the United States, though, such adaptive strategies could not be studied or rolled out.

What needs to happen
When the pandemic is over, the temptation will be to move on and reclaim what had been normal life. For individuals that will be fine. But the cracks revealed in our governments and public health institutions by two years of inertia, mistakes and resistance to evidence make it crucial that a broad, tough dissection of what happened take place if we are to choose the correct course in future challenges.

National and international commissions need to help us see where we went wrong, without scapegoating, and how to respond to future outbreaks, without defensively excusing what public health authorities and national leaders did this time, even if well-meaning. In some countries, it would be easy to focus only on political leaders like President Donald Trump, who severely damaged America’s response. But top public health officials, high-level scientists and state governors made many missteps along the way. At a time of growing international distrust we need to work to increase trust and mutual cooperation. We need to better understand how to rapidly incorporate evidence into scientific policy and to better understand human response to such major, complicated events.

If we can do that, to save lives and ease suffering in the future, it will not make up for all the loss and hardship we have endured in the last two years. But we can at least say we did our best to learn from it, and let that be the one positive legacy of all this.

New Coronavirus News from 3 Mar 2022

WHO Responds to Growing Humanitarian Crisis in Ukraine [WebMD, 3 Mar 2022]

By Damian McNamara

March 3, 2022 -- The World Health Organization has called on top-level officials involved in the Russian invasion of Ukraine to ensure access for delivery of essential medical, surgical, and trauma supplies to help the Ukrainian people and refugees in neighboring countries.

A shortage of oxygen, insulin, cancer therapies, and other essential supplies will continue to grow more dire in the weeks and months ahead, WHO officials predicted Wednesday. Setting up a secure “corridor” to get these supplies into Ukraine is needed, particularly as pre-positioned supplies placed in 23 hospitals around the country remain largely out of reach at the moment.

The COVID-19 pandemic is making the situation more challenging. Many cities in Ukraine are isolated, and so are their hospitals. At the same time, an estimated 65% of the population in Kyiv is fully vaccinated, but the rate varies considerably, down to only 20% of people in cities of Donetsk and Luhansk.

Add to that an estimated 1 million people who already fled Ukraine into neighboring countries, potentially spreading the coronavirus as they move or find themselves in crowded situations.
The situation inside and around Ukraine means coronavirus transmission is likely to rise, WHO officials said during a media briefing.

"WHO is deeply concerned by the unfolding humanitarian emergency in Ukraine," said WHO Director-General Tedros Adhanom Ghebreyesus, PhD.

The first shipment of trauma kits and other supplies is scheduled to leave Dubai in the United Arab Emirates and land in Poland on March 3. On the plane will be 6 metric tons of supplies for trauma care and emergency surgery to meet the needs of 100,000 patients, as well as enough general health supplies to help 150,000 more.

In addition to 5.2 million in U.S. dollars released from contingency funding so far, the WHO plans on spending another $45 million in Ukraine and $12.5 million in neighboring countries supporting the refugees over the next 3 months.

Attacks on Health Care Workers
"We are also deeply concerned about reports of attacks on health facilities and health workers," Adhanom Ghebreyesus said. "We have received several unconfirmed reports of attacks on hospitals and health infrastructure, and one confirmed incident last week in which a hospital came under heavy weapons attack, killing four people and injuring 10, including six health workers."

"In the past few days, my main discussions with the [Ukrainian] minister of health is how to ensure that health care workers are protected … the health care workers who have gone through last 2 years treating COVID," said Jarno Habicht, MD, from the WHO Head of Country Office in Ukraine.

"Many of them with whom I talked yesterday are working from the shelters or have repurposed their hospitals," he said.

International law protects access to health care during times of conflict, Adhanom Ghebreyesus said. "The sanctity and neutrality of health care, including of health workers, patients, supplies, transport, and facilities, and the right to safe access to care must be respected and protected."

Supporting Ukraine's Health System
The WHO's primary purpose now is to sustain and preserve the health system so it can serve the people of Ukraine, said Michael Ryan, MD, executive director for the WHO Health Emergencies Program. "We will do everything in our power to make that happen."

The WHO engaged in mass casualty management and major surgical training in hospitals all over Ukraine in the months before the military conflict.

"WHO is not going into Ukraine. We have always been in Ukraine," Ryan said. "We've been in Ukraine for years, working with the government on the health system."

But the WHO cannot support the health system unless it can bring in supplies and distribute the supplies already in the country, he said.

"Right now, in the chaos of what's happening there, it's very hard to see how that can be achieved in the coming days," Ryan said. "The tragedy unfolding for the people of Ukraine is so avoidable and so unnecessary."

Don’t Forget the People Behind the Numbers
Many WHO officials are used to addressing humanitarian crises during conflicts, Ryan said. "Some of us have been in this a long time and developed very thick skins. But when you see nurses mechanically ventilating infants in the basements of hospitals, you know even the toughest of us have struggled to watch this."

And it’s hard to carry adults receiving intensive care down to a basement. "So many patients in the ICU are being cared for by doctors and nurses while the bombs fall around them," he said.
Throughout the conflict, it will be important to not just speak in terms of supplies, Ryan said.
"This is people's bodies and people's bones that have been broken. People's lives are being lost, and there isn't a health service available to deliver lifesaving care. So something's got to change."

There is only one simple answer, said Bruce Aylward, MD, senior adviser to the WHO director-general.

"What can we do about it? Number one: Stop the war," he said.

"Second thing you do as it unfolds is you protect your health care system. You've got to protect services. The third thing that is you try and prioritize your vaccinations for your vulnerable people, including for your health care workers," he said.

COVID-19 Concerns Grow
Just before the conflict, Ukraine had a surge of cases of COVID-19, Adhanom Ghebreyesus said.

"There is likely to be significant undetected transmission, coupled with low vaccination coverage, that increases the risk of large numbers of people developing severe disease,” he said.

And it's not just a concern inside Ukraine.

"Anytime you disrupt a society like this and put literally millions of people on the move, infectious diseases will exploit that," Ryan said.

Refugees are highly vulnerable to infection, he said, because they're not eating or sleeping properly, and they are packed together.

This increases their risk for infection and the risk that infection will spread.

"A mild variant could be a very different experience for someone who is in that situation,” Ryan said, adding that refugees should be offered proper vaccination.

The WHO is working on providing antivirals to people in the region.

"This may be one situation where the available therapeutics may be more lifesaving than in other situations," Ryan said. "We've been prioritizing Ukraine over the last 48 to 72 hours for extra supplies of therapeutics for COVID-19, including the newer antivirals."

Not Enough Oxygen
A shortage of oxygen will make it harder to treat patients with COVID-19 and many other conditions. Part of the shortage stems from closure of three major oxygen plants in Ukraine.

In addition, "it's difficult to find drivers who are willing to drive and to bring oxygen from some of the factories, which still have reserves," Habicht said.

An estimated 2,000 people in Ukraine rely on oxygen therapy.

"That's 2,000 people that need oxygen to survive," Ryan said. That number is likely to increase "because we have people with injuries, people undergoing surgery, in addition to the children with pneumonia and women having difficulties during labor."

"And you need it when you need it," he continued. "You can't wait till tomorrow for oxygen. You can't wait till next week. You can't be put on a waiting list for oxygen."

Without enough oxygen or other lifesaving supplies, people will die needlessly, Ryan said.

"In those territories, where the military offensive takes place, and where hospitals are getting isolated and where we don't have access, it's also about electricity, it is also about the medicines," Habicht said.

Addressing Other Health Concerns
The WHO plans to help neighboring countries address key health issues among refugees and forcibly displaced people, including mental health and psychological assistance, as well as treatment for chronic diseases like diabetes, HIV, and cancer.

Insulin, blood pressure medications, and goods and medicines related to sexual and reproductive health and children and maternal health also are needed, Habicht said.

Refugees will also need access to primary health care, said Heather Papowitz, MD, an emergency management specialist for the WHO. Surveillance and vaccination for COVID-19, measles, and polio are paramount, she said.

"But also looking at water sanitation and hygiene to prevent diarrheal diseases.” Everything happening in Ukraine is affecting other countries, Papowitz said.

"It's just a real regional crisis."

What the Future Looks Like
Going forward, it will be important to shift from providing general supplies to supplies specific to wartime injuries, Ryan said. This will include equipment for doing major surgery "and, unfortunately, equipment for doing amputations, bone grafting, and bone wiring."

"I think this gives you the graphic nature of what's happening," he said.

"If the military offensive continues, then the situation that we will see when we meet in a week to weeks, months, or 2 months' time will be much worse that we discussed today," Habicht said.

"Every single life matters, every single life," said Maria Van Kerkhove, PhD, technical lead on COVID-19 for the WHO. "We need to work as hard as we can to not only end the conflict, but to end COVID-19."

Russia-Ukraine crisis replaces coronavirus pandemic as top risk to global supply chains, Moody's says [CNN, 3 Mar 2022]

By Matt Egan

The coronavirus pandemic drove global supply chains to the breaking point, causing shortages and sending prices skyrocketing. Just as the pandemic has calmed down, Russia’s invasion of Ukraine threatens to further scramble fragile supply chains.

Russia is a major producer of commodities, everything from oil and natural gas to palladium and wheat. Ukraine is also a major exporter of wheat as well as neon. The crisis is casting doubt on at least a chunk of those vital supplies.

“The greatest risk facing global supply chains has shifted from the pandemic to the Russia-Ukraine military conflict and the geopolitical and economic uncertainties it has created,” Moody’s Analytics economist Tim Uy wrote in a report on Thursday.

Moody’s warned that the Russia-Ukraine crisis will “only exacerbate the situation for companies in many industries,” especially those reliant on energy resources.

Europe, in particular, will feel the most pain from the energy price spike because it is dependent on Russia for natural gas. Oil prices have surged worldwide, driving up prices for gasoline and raising the cost outlook for airlines and industries like plastics that use petroleum.
The Russia-Ukraine crisis could pile further pressure on the worldwide computer chip shortage, which began during Covid and has been at the heart of the spike in new and used car prices.

Moody’s pointed out that Russia supplies 40% of the world’s supply of palladium, a key resource used in the production of semiconductors. Moreover, Moody’s said Ukraine produces 70% of the world’s supply of neon, a gas used in making computer chips.

“We can expect the global chip shortage to worsen should the military conflict persist,” Uy wrote.

Neon prices skyrocketed during the 2014-2015 conflict in Ukraine. Even though chip-makers have stockpiled resources, Uy said that inventories can only last for so long.

“If a deal is not brokered in the coming months, expect the chip shortage to get worse,” Uy said, adding that this will pose significant risks to automakers, electronics companies, phone makers and other companies.

The combination of high energy prices and more pressure on computer chip supply will complicate the inflation picture. Consumer prices soared in January at the fastest pace in nearly 40 years. Although many economists anticipated inflation would cool off significantly later this year, that is now in doubt.

“The near-term effects on the U.S. economy of the invasion of Ukraine, the ongoing war, the sanctions, and of events to come, remain highly uncertain,” Federal Reserve Chairman Jerome Powell told Congress on Wednesday.

Beyond computer chips, Moody’s pointed out that the Russia-Ukraine crisis has the potential to raise costs in the transportation industry, the most energy-intense of all industries.

The next COVID subvariant is here and may be even more contagious than Omicron [Fortune, 3 Mar 2022]

BY TRISTAN BOVE

Just when we thought we were out, could we be headed back in?

A new variant of the virus that causes COVID-19 has now been detected in every U.S. state. Its high transmissibility has led to it being dubbed “stealth Omicron.”

Stealth Omicron, also known as the Omicron BA.2 variant, was first detected in Europe in late January and has since made its way around the world, becoming the leading strain behind new coronavirus infections in at least 18 countries.

Research is trickling in about just how concerning the new variant is.

How deadly is the new COVID strain?
A study from Denmark, where stealth Omicron rapidly became the dominant lineage of the virus, sampled 263 cases of COVID reinfection from stealth Omicron in the country, and found that reinfections were nearly four times as common for people who had recovered from the Delta variant than those who had come down with Omicron.

The good news from the Danish study is that prior infection with Omicron and vaccination seemed to be enough to provide abundant protection to the new strain.

Other studies have also found that antibodies from the original Omicron strain were able to provide strong protection against stealth Omicron. This survey cataloging COVID reinfections in the U.K. from early February did not identify any cases where a stealth Omicron reinfection followed an Omicron infection.

Eric Topol, a genomicist at Scripps Research in La Jolla, Calif., said the new research was “reassuring” to him. “Instead of thinking that [stealth Omicron] is the new bad variant, I think we can put that aside. I see it as not a worry,” Topol told Nature.

How contagious and transmissible is it?
But while initial data is still spotty on whether stealth Omicron can cause more serious disease than its parent strain, it is very likely more transmissible. A study in Japan released at the end of February found that the BA.2 strain could be as much as 30% more transmissible than the original Omicron variant, which was already the most contagious form of the disease we have encountered so far during the pandemic.

Some scientists have argued that stealth Omicron deserves its own Greek letter name in the coronavirus lexicon. But while BA.2 exhibits some divergent mutations from the original Omicron variant, scientists have been more comfortable calling it a subvariant, as it still has many similar characteristics to its parent strain.

The similarities to Omicron have made it more difficult to sequence and trace BA.2, hence its moniker as stealth Omicron. It was relatively easy to differentiate the Omicron variant from Delta infections through PCR tests and genetic sequencing, but the similarities between Omicron and stealth Omicron have made it much more difficult to trace the latter’s spread.
By the last week of February, the Centers for Disease Control and Prevention estimated that stealth Omicron was causing 8% of all new COVID infections, at a rate doubling every week.

New Coronavirus News from 2 Mar 2022

Why Ukraine's COVID-19 Problem Is Everyone's Problem | Time [TIME, 2 Mar 2022]

BY ALICE PARK

Refugees from Ukraine arrive in Medyka, Poland after crossing the border from Shehyni, Ukraine on Feb. 25, 2022.

Ukraine was struggling to control the COVID-19 pandemic even before Russian troops advanced on the country. It was slower to launch its COVID-19 vaccination campaigns than other European countries, and while the government encouraged citizens to get immunized, most people struggled to find a way to get the shot, didn’t feel the need to get vaccinated, or didn’t trust the safety and efficacy of the vaccine.

Just before the invasion on Feb. 24, only 35% of the Ukrainian population had been vaccinated. That puts it in line with most of its neighboring countries, although some, including Poland and Hungary, have achieved higher vaccination coverage. While different health systems and varying attitudes about vaccination in those countries are contributing to those contrasting rates, Ukraine’s relatively low vaccination rate could have implications for how large additional surges of cases, both in the country and in the region become as a result of the war. Like many other countries, Ukraine experienced a surge in cases due to the Omicron variant in November and another peak in the first week of February—most likely due to its low level of vaccination. By the middle of February, 60% of COVID-19 tests conducted in the country were positive.

Such low vaccine coverage isn’t enough to control a highly transmissible virus like SARS-CoV-2, say public health experts. Add in a war—with the political and social upheaval it causes—and not only are spikes in infections inevitable, but there is also the potential for new variants to emerge, which puts the whole world at risk.

Vaccination and mitigation measures such as mask-wearing, social distancing, and basic hygiene are critical for curbing spread of SARS-CoV-2, but are impossible to maintain when a country is under siege. The humanitarian group Doctors Without Borders has been distributing trauma kits and training health care providers in Mariupol, Ukraine—a target of the Russian attack—as well as providing shelter and basic health needs for those crossing the border into other countries like Poland. But it’s not enough.

“War is an infectious disease’s best friend,” says Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “It challenges every public health program you can possibly have. It limits the medical care available for those who might be seriously ill, and often fosters transmission when so many people are crowded into bomb shelter locations and on trains. This is going to be the perfect storm of one serious challenge after another.”

A decade and a half ago, World Health Organization researchers found that 65% of major infectious disease outbreaks occurring in the 1990s were among refugee populations or in conflict zones. Les Roberts, professor emeritus of Columbia University’s Mailman School of Public Health who has spent time in war zones addressing outbreaks, notes that these populations are especially vulnerable to viral diseases like COVID-19. “It turns out when you are under stress, your immune system does not work as well. You are not eating as well, and you cannot fight disease as well,” he says. “And in times of conflict, you move around a lot, and end up in bomb shelters or basements or on trucks that are way more crowded than normal and have bad air circulation. I don’t think people fully understand how war is like the breeding ground of disease.”

More than 670,000 people have left Ukraine since the war began, and this increased travel will almost certainly lead to a spike in cases in the country and those bordering it—like Poland, Hungary, Slovakia, Romania, and Moldova—while straining their health care systems. Health experts are particularly concerned about the situation in Poland, where almost half of the Ukrainians have fled, according to the U.N. High Commissioner for Refugees. “SARS-CoV-2 spreads like lightning right now,” says Jeffrey Shaman, professor of epidemiology at Columbia University Mailman School of Public Health. “For places like Poland and places in western Ukraine where people are fleeing, there is enormous opportunity for this virus to do damage that it wouldn’t have had the opportunity to do otherwise.” Prior to the influx, nearly 60% of Poland’s population was vaccinated, which will help protect it against a surge, but new infections will likely spike there as well, increasing demand for health care services.

“We have warned for years about the potential convergence of conflict and epidemiology—bad things happen when those things converge,” says Dr. Eric Toner, senior scholar at the Johns Hopkins Center for Health Security. “Certainly, in the dire circumstances in which the population is right now, mask-wearing, distancing, and quarantine are not going to be possible. As people flee the affected parts of the country, crowding on buses, trains, and cars and ending up in hotels or living with relatives or in refugee settlements—those are not conditions for good control of a transmissible disease like COVID-19.”

Hospitals will likely be hit hardest by the influx of refugees during the pandemic, say public health experts. War-related injuries will take precedence over COVID-19 care, which will only make it easier for the virus to spread. That disruption will in turn lead to more health care workers who will get infected, and won’t be able to perform their duties.

“There will be runs on hospitals and facilities and resources because of injuries associated with the conflict,” says Shaman. “In the longer term, I imagine it will result in deterioration of the ability to deliver health care at the level that people in the Ukraine are used to having.” And if surges occur in neighboring countries as well, that puts additional pressure on health care services in the entire region. “The world community would be advised to provide supplies and facilities to buffer the displaced Ukrainians and Polish populations from those consequences.”

Shaman and other public health experts are also concerned about longer term effects of the conflict on COVID-19 control. Studies consistently show that vaccine-based immunity starts to wane after about five to six months. Booster shots are essential to maintaining protection against disease so severe that it requires hospital care; if the conflict in Ukraine continues, that would mean even vaccinated citizens will not be able to get boosted as trauma care and war-related injuries will take priority over vaccination efforts.

The situation exposes the weaknesses in the global biodefense network against threats like highly infectious coronaviruses. Even without a military conflict, stark inequities in health resources have led to profound differences in countries’ ability to control COVID-19; developed nations have been able to purchase and distribute vaccines, while poorer countries, mostly in Africa and parts of Asia, still struggle to contain the virus since they lack access to the shots.
When a conflict like that occurring in Ukraine right now hits during a pandemic, the lack of global coordination of public health resources becomes more tragically obvious. “I can’t begin to tell you where the solution is,” says Shaman. “The World Health Organization doesn’t have the authority or the resources in terms of money to deal with this. This is a very large issue that involves development, nation sovereignty, and the ability of nation states to get along and support one another in a trusting way rather than in ways that we’ve seen the world devolve into over the last 20 years.”

What’s truly needed is a global coordinating body for public health, Toner says, which isn’t likely, given challenges posed by issues of national sovereignty. But the principles behind global coordination might still be implemented in more limited ways.

The global vaccination distribution program COVAX, through which developed nations purchase vaccines in order to drive prices down for developing countries, represented such an effort, but is falling short of meeting its promise. It failed to deliver the 2 billion doses it had guaranteed by the end of 2021, and the group estimates that it will take until well into 2023 to provide enough vaccines to immunize the world. “After the pandemic is over, I think we need to take a real look into COVAX and why it didn’t work as well as we had hoped, and what we could have done to make it better,” says Toner.

Some public health experts have proposed alternatives, like supporting vaccine makers to set up manufacturing facilities in countries that have historically struggled to get the latest vaccines, as well as encouraging more shared intellectual property to enable poorer countries to access the technology they need to produce shots on their own.

Roberts points out that there are also ways to control and reduce the likelihood of viral spread as Ukrainians gather in shelters and flee to other countries. Vaccinating and boosting people who enter these communal settings—especially those who are particularly vulnerable, such as the elderly or people with underlying health conditions—is an important start.

However, that’s still mostly out of reach. The World Health Organization doesn’t have enough resources to quickly direct vaccine supplies and personnel to crisis zones such as Ukraine, and lacks political authority to address questions of national sovereignty. Organizations such as Doctors Without Borders and other humanitarian groups also play critical roles, but are equally restricted to more localized aid efforts. “If we continue to be reactive in crisis after crisis, then we will not get at the systemic, underlying issues that need to be solved,” says Shaman.

Antigenic differences between Omicron BA.1 and BA.2 SARS-CoV-2 variants [News-Medical.Net, 2 Mar 2022]

By Dr. Priyom Bose

The global healthcare system and economy have suffered massively throughout the ongoing coronavirus disease 2019 (COVID-19) pandemic, which emerged as a result of the rapid spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Owing to the evolution of the virus due to mutations, several SARS-CoV-2 variants have emerged, some of which are more virulent and transmissible than the original strain.

SARS-CoV-2 variants have been classified as variants of concern (VOC) and variants of interest (VOI) by the World Health Organization (WHO) based on their increased virulence, changes in epidemiology and/or clinical presentation, increased transmissibility and decreased effectiveness of social measures or COVID-19 diagnostics. Recently, the SARS-CoV-2 Omicron variant has become the dominantly circulating strain that replaced the previously dominant Delta variant in many countries across the world.

Background
To date, all available COVID-19 vaccines and therapeutics have been developed against the spike (S) protein of the original SARS-CoV-2 strain. Therefore, mutations in the S domain could pose a threat to the effectiveness of current COVID-19 vaccines.

Previous studies have reported that the efficacy of existing COVID-19 vaccines is reduced against some SARS-CoV-2 variants, such as the Omicron variant. Furthermore, several reports have also found that the Omicron BA.1 variant almost completely escapes neutralizing antibodies, which has resulted in a high number of breakthrough infections. However, the BA.1 lineage has been determined to be less virulent as compared to other SARS-CoV-2 variants.

According to recent studies, Omicron variants BA.2 and BA.1 are genetically different. In many countries, BA.1 has already been replaced by the new BA.2 strain. To date, no study on the antigenic characteristics of BA.2 and BA.1 is available.

A new study published on the bioRxiv* preprint server identifies the antigenic differences that exist between the Omicron BA.2 and BA.1 variants. Herein, the researchers also quantified the extent to which human post-BNT162b2 immunization sera neutralized Omicron BA.2.

Study findings
In this study, researchers used antigenic cartography to estimate and visualize antigenic differences between SARS-CoV-2 variants using hamster sera, which was collected after primary infection. Scientists found it difficult to obtain human sera post-primary Omicron infection; therefore, they selected Syrian golden hamsters’ sera for this study.

Hamsters are highly susceptible to SARS-CoV-2 infection and are ideal for collecting well-defined sera. Furthermore, previous studies have reported that human and hamster serum responses to SARS-CoV-2 infection are similar, as they develop similar topological maps.

In the current study, scientists inoculated hamsters with several SARS-CoV-2 variants including 614G, Alpha, Beta, Gamma, Zeta, Delta, Mu, and Omicron (BA.1) to generate antisera.

Antigenic cartography allows for the quantitative analysis of antigenic drift and visualization of new antigenic clusters. Utilizing this technique, early SARS-CoV-2 variants have been found to be antigenically similar, as they were found to cluster closer to each other in antigenic space.

This is comparable to Omicron BA.1 and BA.2, which have evolved as two distinct antigenic outliers.

Plaque reduction neutralization titers resulted in a 50% reduction in infected cells associated with authentic SARS-CoV-2, as well as pseudotyped viral infection. The researchers reported that sera from Omicron BA.1-infected hamsters poorly neutralized all other variants, which implies that this variant induces different antibody responses as compared to other SARS-CoV-2 variants.

Antigenic maps were developed by a multidimensional scaling algorithm. To this end, the scientists reported that the map constructed by Calu-3 cells was highly similar to the VeroE6 map because the same antigens were plotted within one two-fold dilution from each other in the two maps. This finding demonstrates that the choice of the cell line for the neutralization assay had no substantial effect on the topology of the map.

The Omicron BA.1 formed a distinct antigenic outlier in the map that was 10- to 38-fold dilutions away from the nearest virus.

The researchers also reported that a single BNT162b2 vaccination exhibited a low neutralizing titer against all variants with an addition 13-fold and 8-fold reduction in neutralizing titers observed against Omicron BA.1 and BA.2, respectively. Both Omicron variants were also found to evade vaccine-induced antibody responses as a result of their unique antigenic characteristics.

Conclusions
The emergence and rapid spread of the highly mutated BA.1 and BA.2 variants was an indicator that population immunity is employing robust selective pressure on SARS-CoV-2 in favor of the emergence of new antigenic variants.

The researchers of the current study anticipate that SARS-CoV-2 will eventually attain endemicity and is likely to cause annual or biannual infection waves, similar to influenza and seasonal coronaviruses. Therefore, it is imperative to monitor the antigenic changes of SARS-CoV-2, as this information will be important in the selection of future vaccine strains.

*Important notice
bioRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
• Mykytyn, Z. A., Rissmann, M., Kok, A., et al. (2022) Omicron BA.1 and BA.2 are antigenically distinct SARS-CoV-2 variants. bioRxiv. doi:10.1101/2022.02.23.481644. https://www.biorxiv.org/content/10.1101/2022.02.23.481644v1.

New Coronavirus News from 1 Mar 2022

Ukraine conflict could spark surges of covid, polio, other diseases, say experts [The Washington Post, 1 Mar 2022]

By Loveday Morris and Dan Diamond

Hospitals are running out of supplies. Health workers and patients are hiding in makeshift shelters. And some fear the flight of millions of people could worsen pandemic.

Victoria, 33, as she holds her three month old baby boy named Mark in an underground shelter for sick children a hospital in Kiev on March 1. (Heidi Levine for The Washington Post)
LVIV, Ukraine — At the main train station in this western Ukrainian city, where the internally displaced jostle to get on trains to Poland or change for other destinations in Europe, few among the heaving crowd wore masks. As night fell, hundreds bedded down across crowded stone floors or curled up on the stairs, inhaling thick, muggy air.

FAQ: What to know about the omicron variant of the coronavirus
For these Ukrainians, the focus is escaping the Russian invasion bearing down on their country — not on dodging diseases such as covid-19.

But as more than half a million people have fled Ukraine to neighboring countries, global health officials fear that Russia’s invasion of Ukraine will be the latest reminder of a grim lesson — that war and disease are close companions, and the humanitarian and refugee crises now unfolding in Eastern Europe will lead to long-lasting health consequences, exacerbated by the coronavirus pandemic.

As Russia’s military campaign accelerates, Ukraine’s hospitals are running out of critical medical supplies as travel is increasingly choked off by the conflict. The country’s health workers and patients are relocating to makeshift shelters, seeking to escape explosions.
Meanwhile, officials at the World Health Organization, United Nations, U.S. State Department and other organizations warn of rising civilian casualties and new pressures on the region’s fragile health-care systems.

“What we’re dealing with now in Ukraine is a double crisis,” said Máire Connolly, a global health professor at the National University of Ireland Galway who has studied the link between conflict and disease. In an interview, Connolly said she was worried not just about threats from the coronavirus pandemic but also those from Ukraine’s polio outbreak, which global experts had sought to quell for months. She also said she fears the potential resurgence of tuberculosis during the current conflict.

“As we’ve seen in wars over the years, viruses and bacteria are happy to exploit those situations where human beings are put under pressure,” Connolly added, citing how refugees fleeing armed conflict can end up in overcrowded conditions and without sufficient water, food and sanitation. “These factors increase the risk of outbreaks among a population that are already dealing with the trauma of forced displacement.”

While covid cases in Eastern Europe have plunged in recent weeks, experts such as Connolly say they’re worried that the regional conflict will trigger new spikes. Ukraine experienced some of the world’s highest rates of coronavirus late last year, and is flanked by countries with some of the lowest vaccination rates in Europe — raising the prospect that the movement of thousands if not millions of refugees could lead to surges of illness in neighboring countries.

“I am heartbroken and gravely concerned for the health of the people in Ukraine in the escalating crisis,” Tedros Adhanom Ghebreyesus, director general of the WHO, said in a statement as the conflict began last week. The WHO leader also shared a video on Twitter of newborns in Ukraine being cared for in a makeshift bomb shelter, calling the images “beyond heartbreaking.” On Sunday, he warned that Ukraine is now dealing with a dangerous shortage of oxygen supplies needed to treat covid and other conditions.

“The majority of hospitals could exhaust their oxygen reserves within the next 24 hours. Some have already run out,” the WHO said in a statement. “This puts thousands of lives at risk.”

U.S. officials, Ukraine’s health minister and others have also accused Russian military forces of firing on the country’s ambulances and hospitals, and experts remain concerned the conflict could disturb radioactive waste being stored at the Chernobyl nuclear plant, sparking additional health and environmental disasters.

Global humanitarian organizations have moved to shore up Ukraine’s health safety net. The WHO, which began positioning additional medical supplies in Ukraine in November after Russian military forces began to mass on its borders, on Thursday made $3.5 million available in additional emergency funding. The U.S. Agency for International Development deployed a disaster response team to nearby Poland, intended to help coordinate the regional humanitarian response, and along with the State Department, will provide nearly $54 million in additional assistance. The White House also is seeking $6.4 billion for emergency aid to the region, much of which would go toward humanitarian assistance.

U.S. officials and outside experts say they’re bracing for further shocks. “Despite the immense, multinational efforts to prepare for this scenario, we know that many Ukrainians will needlessly suffer at the hands of Russian aggression,” USAID Administrator Samantha Power said in a statement on Friday.

Power, who spent time at the Poland-Ukraine border this weekend, said Monday that as many as 5 million refugees could flee Ukraine in coming weeks.

Humanitarian and health groups also had not anticipated an invasion from multiple directions; they expected it to be concentrated on the country’s eastern border, where they had positioned emergency supplies in advance, said Simon Pánek, CEO of People in Need, a humanitarian organization working to deliver aid.

“Until a few days before the war started, my colleagues and I didn’t talk about the possibility that there would be a direct offensive on Kyiv from the north, for example,” Pánek said in an interview from Prague, where he is based. “What we need most is safe transport to central and eastern Ukraine, but no one from outside can provide it,” Pánek added, saying his group had sent five trucks filled with supplies on Sunday and had planned to send more aid on Tuesday.

Meanwhile, the accelerating Russian military campaign has posed mounting challenges, with explosions across Ukraine’s major cities and more military forces pouring into the country.

A “health system cannot function during an active bombing campaign,” Rachel Silverman, a policy fellow at the Center for Global Development, wrote in a series of text messages from Germany. “They must evacuate patients from hospitals, all routine services will be put on hold, many facilities will be damaged and health workers will flee.”

Russia’s invasion of Ukraine also comes on the heels of a coronavirus outbreak that skyrocketed late last year and saw the region become a global hot spot. While Ukraine’s case numbers have fallen sharply, public health experts say large movements of people could spark new infections in Eastern Europe, where vaccination rates trail countries to the west. Only one-third of Ukrainians have received at least one dose of a coronavirus vaccine, according to the University of Oxford’s Our World in Data tracking project, compared with more than three-quarters of people in countries like France, Germany and Britain.

“Covid is understandably not top of mind for anyone” during an armed conflict, Silverman wrote in a message. “But having people in crowded subways, with no real access to health services, is a terrible situation. Even the mildest covid cases can be very problematic if you have no place to isolate/get care, and/or if you need to flee on foot.”

Many Ukrainians are now seeking shelter in neighboring Poland, which has waived its standard coronavirus quarantine and testing requirements for those refugees.

.@a_niedzielski: Persons crossing the border of the Republic of Poland with Ukraine in connection with an armed conflict on the territory of this country are exempt from the quarantine obligation and showing covid test results. https://t.co/8HILs1IDn9
— US Embassy Warsaw (@USEmbassyWarsaw) February 25, 2022

Poland’s health minister also announced free coronavirus vaccinations for Ukrainians on Friday.

But like Ukraine, Poland has had a severe covid outbreak in recent weeks, and officials say its health system is dealing with a significant workforce shortage that has sparked walkouts and protests. About 59 percent of Poland’s population has received at least one vaccine shot.
Poland is set to lift many of its remaining coronavirus restrictions on Tuesday.

Jarno Habicht, the WHO’s representative to Ukraine, told reporters that he was worried that the conflict would set back months of progress to vaccinate Ukrainians while escalating other regional health crises, such as the polio outbreak.

Russia’s invasion “will have implications across the whole country,” he said, adding that his team was rapidly pivoting to address a brand-new set of health challenges. “Our priorities have shifted to trauma care, ensure access to services, continuity of care, mental health and psychosocial support.”

The rapid spread of Omicron BA.2: What studies say [Medical News Today, 1 Mar 2022]

The Omicron variant, which researchers first sequenced in South Africa and Botswana in November 2021, was found to be more transmissible but cause less severe disease than its predecessor — the Delta variant.

Owing to being more contagious, Omicron rapidly supplanted Delta as the dominant variant worldwide. Currently, it accounts for 99%Trusted Source of all sequenced cases.

Moreover, since it emerged, scientists have categorized Omicron’s subvariants or lineages into three groups: BA.1, BA.2, and BA.3.

Although the BA.1 subvariant started as the dominant Omicron lineage across the globe, since December 2021, the proportion of COVID-19 cases linked to the BA.2 variant has been rapidly increasing.

This has raised concerns about the severity and transmissibility of BA.2. Here’s what researchers have found so far:
Omicron subvariant BA.2 overtakes BA.1

BA.2 has been especially prominent in countries in Southeast Asia, Africa, and Europe. Recent analyses have indicated that it has displaced BA.1 as the dominant Omicron sublineage in Denmark, Singapore, India, South Africa, and Austria. The rapid ascent of BA.2 is illustrated by the increaseTrusted Source in its prevalence from 20% in the last week of December 2021 to 66% by the third week of January 2022 in Denmark.

The proportion of BA.2 cases in the United States remains low at 3.8% so far, but health experts expect it to rise.

Preprint studies that are yet to be peer reviewed have characterized differences between the BA.1 and BA.2 subvariants, which may explain why the latter is outcompeting its sibling variant.
Although BA.2 shares many of BA.1’s mutations, the two subvariants differ by 28 mutations, some of which are responsible for the rapid surge in BA.2 cases.

Notably, the mutations unique to these subvariants are also present in the spike protein, which mediates the entry of SARS-CoV-2 into cells and is the target of COVID-19 vaccines.
Specifically, BA.2 carries eight new mutations in the spike protein but lacks 13 mutations that the BA.1 spike protein harbors.

BA.2 seems to be more transmissible
The rapid surge in the prevalence of BA.2 in multiple countries suggests that this variant is more contagious than BA.1. One study estimates that BA.2 is up to 33% more transmissible than BA.1 and considers that its spread could be a serious issue for global health in the near future.

Moreover, a nationwide study comparing the spread of the BA.1 and BA.2 variants in Danish households in late December 2021 and January 2022 suggested that the latter was more contagious. The study found that the secondary attack rate, which measures the probability of transmission of the virus to household members, was 39% for BA.2 and 29% for BA.1.

The study also reported that fully vaccinatedTrusted Source and booster-vaccinated individuals were less likely to pass on or contract an infection due to either subvariant compared with unvaccinated individuals.

In addition, unvaccinated individuals were more likely to spread the BA.2 subvariant to their household members than BA.1.