New Coronavirus News from 12 May 2022

WHO says omicron BA.4 and BA.5 subvariants have spread to over a dozen countries [CNBC, 12 May 2022]

By Annika Kim Constantino

Omicron subvariants BA.4 and BA.5 have been detected in more than a dozen countries, helping fuel sporadic Covid outbreaks across the world, but the heavily mutated strains are still circulating at low levels, the World Health Organization said Wednesday.

Less than 700 cases of BA.4 have been detected across at least 16 countries and more than 300 cases of BA.5 have been found across at least 17 countries, WHO's technical lead on Covid Maria Van Kerkhove said during a Q&A on the organization's social media platforms.

While the two sublineages don't make people more sick than the original omicron strain, they appear to be more contagious, Van Kerkhove said. She noted the WHO will monitor BA.4 an BA.5 to determine if they will eventually overtake BA.2 as the dominant strain worldwide.

"We don't know how this variant will behave, how these subvariants will behave in other countries that had a dominant wave of BA.2," Van Kerhkove said. "This is what remains to be seen."

The two subvariants, BA.4 and BA.5, have high rates of detection in South Africa in particular, according to Kerhkove.

South Africa reported 395 cases of BA.4 and 134 cases of BA.5 as of May 6, the highest numbers across all countries, according to a report released by the U.K.'s Health Security Agency last week. Countries aren't sequencing the genetic data for every Covid case so actual infections are likely higher.

Just over 36 cases of BA.4 were found in Austria, 24 in the U.K., 20 in the U.S. and 17 in Denmark, according to the report. Belgium, Israel, Germany, Italy, Canada, France, the Netherlands, Australia, Switzerland and Botswana all reported under 10 cases of BA.4, the report said.

Some 57 cases of BA.5 have been detected in Portugal, 52 in Germany and 17 in the U.K., according to the report. The U.S., Denmark, France, Austria, Belgium, Hong Kong, Australia, Canada, Israel, Norway, Pakistan, Spain and Switzerland all reported less than 10 BA.5 infections, the report said.

The report noted the number of sequences is low, but "the apparent geographic spread suggests that the variant is transmitting successfully."

Tracking BA.2.12.1
Another omicron subvariant called BA.2.12.1 has been detected in 23 countries, according to Van Kerkhove.

She said there are more than 9,000 reported sequences of the subvariant, most of which comes from the U.S.

BA.2.12.1 made up about 42.6% of all sequences new cases in the U.S. during the week that ended on May 7, according to data from the Centers for Disease Control and Prevention. BA.2 was still the dominant subvariant in the country, making up 56.4% of all new sequences cases that week.

But BA.2.12.1 was dominant in New York, New Jersey, Puerto Rico and the Virgin Islands, making up 66.3% of all new sequenced cases in those states and territories, CDC data said.

Van Kerkhove said she expects to see an increase in case detection of BA.2.12.1 worldwide due to its higher growth rate over BA.2. But BA.2.12.1 has shown no difference in hospitalization rates in comparison to BA.2, according to Van Kerkhove.

She urged governments across the world to closely monitor BA.2.12.1, BA.4, BA.5 and other subvariants that could emerge in the future, emphasizing the need to maintain Covid testing and sequencing.

"We talk to government all the time about the need to maintain the surveillance systems so that we can track this, we can trace it, and we can assess it in real time," Van Kerkhove said.

North Korea reports over 200k new coronavirus cases [Axios, 21 May 2022]

by Jacob Knutson

North Korea said Saturday that nearly 220,000 additional people have feverish, COVID-like symptoms around the country, marking its fifth consecutive daily increase over 200,000 likely cases, AP reports.

Why it matters: North Korea has an extremely low vaccination rate against COVID-19, limited health facilities and was already struggling to feed its population before the virus started to spread in late April.

The country has so far reported 2.4 million likely coronavirus infections and at least 66 deaths from the virus.

• The full extent of the country's outbreak is unknown, as experts believe it may be fabricating figures or unable to significantly diagnose a large portion of cases because it lacks testing supplies.
• President Biden, while in Seoul on Saturday meeting South Korea's new president, Yoon Suk-yeol, again offered to send vaccines directly to North Korea or through China to help the country with the massive outbreak.

The big picture: Health experts have long questioned whether North Korea had been unaffected by the virus, despite its strict pandemic border closure at the start of pandemic.

• It did not officially confirm a positive coronavirus case until May 11. North Korean leader Kim Jong-un then declared a "severe emergency incident" and launched a nationwide lockdown.
• Despite Kim's emergency declaration, he has not accepted aid proposals from foreign governments or international organizations, including vaccines offered by the U.N.-backed COVAX initiative.
• Experts fear that the strict national lockdown combined with North Korea's preexisting food insecurity and its unwillingness to accept foreign aid could lead to extremely high levels of civilian suffering.

New Coronavirus News from 16 May 2022

Characterization and antiviral susceptibility of SARS-CoV-2 Omicron/BA.2 [Nature, 16 May 2022]

Authored by • Kiyoko Iwatsuki-Horimoto, Yuri Furusawa, Ryan Wright, Zhenlu Chong, Seiya Ozono, Atsuhiro Yasuhara, Hiroshi Ueki, Yuko Sakai-Tagawa, Rong Li, Yanan Liu, Deanna Larson, Michiko Koga, Takeya Tsutsumi, Eisuke Adachi, Makoto Saito, Shinya Yamamoto, Masao Hagihara, Keiko Mitamura, Tetsuro Sato, Masayuki Hojo, Shin-ichiro Hattori, Kenji M aeda,Riccardo Valdez, IASO study team, Moe Okuda, Jurika Murakami, Calvin Duong, Sucheta Godbole, Daniel C. Douek, Ken Maeda, Shinji Watanabe, Aubree Gordon, Norio Ohmagari, Hiroshi Yotsuyanagi, Michael S. Diamond, Hideki Hasegawa, Hiroaki Mitsuya, Tadaki Suzuki &
Yoshihiro Kawaoka

Abstract
The SARS-CoV-2 B.1.621 (Mu) variant emerged in January 2021 and was categorized as a variant of interest by the World Health Organization in August 2021. This designation prompted us to study the sensitivity of this variant to antibody neutralization. In a live virus neutralization assay with serum samples from individuals vaccinated with the Pfizer/BioNTech or Moderna mRNA vaccines, we measured neutralization antibody titers against B.1.621, an early isolate (spike 614D), and a variant of concern (B.1.351, beta variant). We observed reduced neutralizing antibody titers against the B.1.621 variant (3.4 to 7-fold reduction, depending on the serum sample and time after the second vaccination) compared to the early isolate and a similar reduction when compared to B.1.351. Likewise, convalescent serum from hamsters previously infected with an early isolate neutralized B.1.621 to a lower degree. Despite this antibody titer reduction, hamsters could not be efficiently re-challenged with the B.1.621 variant, suggesting the immune response to the first infection is adequate to provide protection against a subsequent infection with the B.1.621 variant.

New Coronavirus News from 17 May 2022

Characterization of the SARS-CoV-2 B.1.621 (Mu) variant [Science TRANSLATIONAL MEDICINE, 17 May 2022]

Authored by PETER J. HALFMANN , -MAKOTO KURODA, TAMMY ARMBRUST, JAMES THEILER , 84ARIANE BALARAMGAGE, K. MORENO H5318MOLLY, A. ACCOLA, 171KIYOKO IWATSUKI-HORIMOTO, 0XRICCARDO VALDEZ, EMILY STONEMAN , KATARINA BRAUN, SEIYA YAMAYOSHI, ELIZABETH SOMSEN, JOHN J. BACZENAS, KEIKO MITAMURA, MASAO HAGIHARA, EISUKE ADACHI, MICHIKO KOGA, MATTHEW MCLAUGHLIN, WILLIAM REHRAUER, MASAKI IMAI, SHINYA YAMAMOTO, TAKEYA TSUTSUMI, MAKOTO SAITO, THOMAS C. FRIEDRICH , SHELBY L. O’CONNOR, , DAVID H. O’CONNOR, AUBREE GORDON, BETTE KORBER, AND YOSHIHIRO KAWAOKA , FEWER Authors Info & Affiliations
AND YOSHIHIRO KAWAOKA

Abstract
The SARS-CoV-2 B.1.621 (Mu) variant emerged in January 2021 and was categorized as a variant of interest by the World Health Organization in August 2021. This designation prompted us to study the sensitivity of this variant to antibody neutralization. In a live virus neutralization assay with serum samples from individuals vaccinated with the Pfizer/BioNTech or Moderna mRNA vaccines, we measured neutralization antibody titers against B.1.621, an early isolate (spike 614D), and a variant of concern (B.1.351, beta variant). We observed reduced neutralizing antibody titers against the B.1.621 variant (3.4 to 7-fold reduction, depending on the serum sample and time after the second vaccination) compared to the early isolate and a similar reduction when compared to B.1.351. Likewise, convalescent serum from hamsters previously infected with an early isolate neutralized B.1.621 to a lower degree.

Despite this antibody titer reduction, hamsters could not be efficiently re-challenged with the B.1.621 variant, suggesting the immune response to the first infection is adequate to provide protection against a subsequent infection with the B.1.621 variant.

New Coronavirus News from 19 May 2022

Navarro Falsely Links Fauci to Pandemic Origin [FactCheck.org, 19 May 2022]

By Jessica McDonald

SciCheck Digest
The U.S. indirectly funded some bat coronavirus research at a lab in Wuhan, China. But those experiments could not have led to the coronavirus that causes COVID-19, because the viruses used were very different. Yet former White House trade adviser Peter Navarro repeated a false claim that Dr. Anthony Fauci “killed a lot of people” by funding the lab.

What do we know about the origins of SARS-CoV-2?

Full Story
It’s not known how SARS-CoV-2, the coronavirus that causes COVID-19, originated. But many scientists suspect the virus “spilled over” into humans from an animal. There is no evidence the virus was created in a lab, let alone as part of any U.S.-funded research.

For over a year, politicians and others have misleadingly cited certain grants awarded to a group collaborating with a lab in Wuhan to incorrectly suggest that National Institute of Allergy and Infectious Diseases Director Dr. Anthony Fauci is responsible for the COVID-19 pandemic.

While there is a debate about whether some of the research should have been funded or performed, the experiments did not produce SARS-CoV-2, as the National Institutes of Health and others have explained.

The latest iteration of these claims comes from Peter Navarro, former President Donald Trump’s trade adviser, who in a May 16 interview with the conservative outlet Newsmax blamed Fauci for the pandemic and called for his imprisonment.

Navarro began by responding to a clip of Fauci telling CNN on May 15 that he would not serve under Trump if the former president were elected in 2024.

“Tony, you’re fired, dude. There’s no way you’re ever getting back into the Trump White House,” Navarro said, adding that as soon as Republicans take back the House, Fauci would sit in Congress and “confess to creating the virus that’s killed almost a million Americans now.”

“We’re going to fit you for an orange jumpsuit, Tony, you can count on that,” he continued. “So don’t be smug on CNN, dude, okay. You’re fired. And if that’s the only thing that happens to you, Tony, you’ll be lucky because you killed a lot of people by funding this Wuhan lab. You got in bed with the Chinese Communist Party, you lied to the American people.”

Fauci, who has been head of NIAID since 1984 and is one of the most distinguished living scientists, has served under seven presidents, including three Democrats and four Republicans. At age 81, Fauci has said he is thinking of retirement, but has no immediate plans to depart and would not do so until the country is firmly out of danger from COVID-19’s pandemic phase.

Later, Navarro, who has previously misled the public about hydroxychloroquine as a COVID-19 treatment and shared inaccurate information about COVID-19 vaccines, baselessly stated as fact that the pandemic began at the Wuhan Institute of Virology.

“This is where the virus started,” he said, pointing to an image of the facility. “This was funded by Tony Fauci. Gain-of-function research is what he went behind the back of Donald Trump and the White House to get going here in 2017 with the Chinese communists. And now we have a pandemic that’s killed almost a million people. I don’t know how this guy is still in public office, he really ought to have a jumpsuit.”

Newsmax shared its interview with Navarro on Facebook, where it received more than 30,000 views in two days.

Fauci Has No Connection to Pandemic Virus

Navarro’s statements are reminiscent of those from other Republicans, including Florida Rep. Matt Gaetz and Sen. Rand Paul of Kentucky, who have at times also falsely insinuated that NIH-funded research at the Wuhan Institute of Virology could have led to the creation of SARS-CoV-2.

As we have explained before, NIAID did fund some experiments at WIV as part of a multiyear $3.7 million grant that began in 2014 to the U.S.-based nonprofit EcoHealth Alliance. The research was aimed at understanding the risk of the future emergence of coronaviruses from bats, and a small portion of the money — $600,000 — went to an EcoHealth collaborator at the Wuhan Institute of Virology.

But those experiments, which mixed and matched certain elements of bat coronaviruses, couldn’t have produced SARS-CoV-2 because the viruses used were very different.

“Analysis of published genomic data and other documents from the grantee demonstrate that the naturally occurring bat coronaviruses studied under the NIH grant are genetically far distant from SARS-CoV-2 and could not possibly have caused the COVID-19 pandemic,” NIH Director Dr. Francis Collins said in an Oct. 20, 2021, statement, referring to an analysis posted to the NIAID’s website. “Any claims to the contrary are demonstrably false.”

As we’ve written, the NIH analysis shows that the WIV viruses share only about 80% of their genomes with SARS-CoV-2, which is a tremendous difference. Even much more similar viruses — those 96% identical — still differ from SARS-CoV-2 by more than 1,000 nucleotides, and could not have plausibly been the ancestral virus, David Robertson, the head of viral genomics and bioinformatics at the University of Glasgow, told us for a previous story.

There is simply no basis to claim that Fauci, via this NIAID grant, has anything to do with the origin of the coronavirus.

Moreover, there is no evidence that SARS-CoV-2 came from WIV or any lab, and many experts say the virus almost certainly was not bioengineered. Indeed, despite continued speculation, largely because of the proximity of certain research institutions to the city of Wuhan, where the first COVID-19 cases were identified, there is no credible evidence of a lab leak.

In contrast, while there is still no proof, multiple lines of evidence, including geolocation and genetic analyses, suggest the pandemic began with a natural spillover at the Huanan market, which sold a variety of live animals for human consumption.

Much of the debate about the WIV experiments has focused on whether they were so-called gain-of-function experiments and whether NIH should have funded them. Paul has an ongoing feud with Fauci over this issue, and each man has accused the other of lying.

Fauci has said the experiments do not count as gain-of-function, which the agency defines in a specific way and refers to research involving “enhanced pathogens of pandemic potential,” or ePPPs. Paul has insisted they do.

In February, the NIH said it had ordered a review of its ePPP policies, which have been controversial.

Regardless of whether certain potentially risky research should be funded or not, it’s inaccurate for Navarro to claim Fauci had a role in starting the pandemic.

Editor’s note: SciCheck’s COVID-19/Vaccination Project is made possible by a grant from the Robert Wood Johnson Foundation. The foundation has no control over FactCheck.org’s editorial decisions, and the views expressed in our articles do not necessarily reflect the views of the foundation. The goal of the project is to increase exposure to accurate information about COVID-19 and vaccines, while decreasing the impact of misinformation.

Sources
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Holmes, Edward C. et al. “The origins of SARS-CoV-2: A critical review.” Cell. 18 Aug 2021.
Robertson, Lori. “The Wuhan Lab and the Gain-of-Function Disagreement.” FactCheck.org. 21 May 2021.
McDonald, Jessica. “Republicans Spin NIH Letter About Coronavirus Gain-of-Function Research.” FactCheck.org. 26 Oct 2021.
Collins, Francis S. “Statement on Misinformation about SARS-CoV-2 Origins.” 20 Oct 2021.
Stracqualursi, Veronica. “Fauci says ‘no’ to serving under Donald Trump should he win a second term.” CNN. 16 May 2022.
“Anthony S. Fauci, M.D., NIAID Director.” NIAID. Accessed 18 May 2022.
“Anthony S. Fauci, M.D.” NIAID. Accessed 18 May 2022.
“‘This Week’ Transcript 3-20-22: Sen. Dick Durbin, Sen. John Barrasso, Marina Ovsyannikova & Dr. Anthony Fauci.” ABC News. 20 Mar 2022.
Haslett, Cheyenne. “Fauci says COVID-19 cases will likely increase soon, though not necessarily hospitalizations.” ABC News. 18 Mar 2022.
McDonald, Jessica. “Navarro Doesn’t Give Full Picture On Hydroxychloroquine.” FactCheck.org. 9 Jul 2020.
“Washington Times article by Robert Malone and Peter Navarro relies on inaccurate and unsubstantiated claims about virus evolution, vaccine immunity, and COVID-19 vaccine safety.” Health Feedback. 15 Aug 2021.
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“SARS-CoV-2 and NIAID-supported Bat Coronavirus Research.” NIAID. 20 Oct 2021.
Maxmen, Amy. “Wuhan market was epicentre of pandemic’s start, studies suggest.” Nature. 27 Feb 2022.
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Achenbach, Joel. “NIH orders sweeping review of potentially risky experiments on viruses and other pathogens.” Washington Post. 1 Mar 2022.

New Coronavirus News from 23 May 2022

COVID: North Koreans suffer amid surge in cases, food shortages [DW (English), 23 May 2022]

by Julian Ryall

Lockdowns and the rapid spread of COVID-19 are adding to the woes of people in North Korea — on top of food shortages, poor medical facilities and an economic crisis.

The last time Ken Eom managed to speak with his family in North Korea, they did not seem particularly worried about contracting the coronavirus. A far more immediate concern was obtaining enough food or money to buy food, he said. But he said that may have changed in recent weeks.

Eom, who escaped from the North in 2010 and now lives in South Korea, said he has not been able to speak with his family since Pyongyang finally admitted on May 12 that the virus was running virtually unchecked through its population. He cannot contact them regularly as it is dangerous to try to call anyone in the North, but he fears the virus is likely to be widespread in his hometown.

The illness and the strict lockdown imposed on the 26 million people in the country will add to the hardship felt by most, he said. Combined with the worsening food shortages, the situation has become "a disaster."

"The last time I was able to get through to them, they did not even mention the virus," said Eom, an advocate for defectors and a keynote speaker for the Seoul-based Freedom Speakers International organization.

"The government told them there was no coronavirus in North Korea, so they believed that," he told DW. "They just asked me to send them money so they could get some food. But now I am sure they are afraid about the virus as well," he said.

Economic crisis follows border closures
Eom's family used to make a precarious living acting as brokers for smugglers crossing the border between North Korea and China with cargoes of people, cash or consumer goods that could be sold in the North. The government shut the nation's borders in early 2020 with the aim of keeping the virus at bay — also cutting off many people from any sort of income, however illicit.

With limited access to medicines, few doctors or hospitals, and a largely malnourished and unhealthy population, severing all links with the outside world seemed to North Korean leader Kim Jong Un the best solution.

Until May 12, the government consistently reported that its countermeasures had been a complete success and that no cases of the virus had been reported in the country. Medical experts said that claim was extremely unlikely, but all foreign aid agencies had already been ordered to leave the country. There was no way to verify reports in dissident media that people were being diagnosed with unspecified fevers, and that those who died were being hastily buried.

Soaring North Korean caseload
Analysts have said the situation must be dire if the regime has had to admit that its efforts to seal the nation off from the rest of the world have failed, but the numbers appear to back that up. On Sunday alone, state media reported 186,090 new cases of "fever" across the country, putting the total number of apparent infections at 2.65 million — more than 9% of the entire 25.78 million residents of the North, just eight days after it first admitted it had a problem.

Government statistics claim that 2.01 million people have recovered, although the concern is that they have merely been released from hospitals or clinics ill-equipped to treat them and may spread the virus further afield. The actual number of people infected with the illness is almost certainly far higher than the official figures, as the North has virtually no capacity to test people. The experience of other countries shows that many people may have the virus and spread it, even if they do not display any symptoms.

"Perhaps the people believed the government about the virus before, but they don't anymore," Eom said. "And I am very worried for my family. There is effectively no medical system to care for people who are ill, especially those who have a contagious disease like coronavirus, and nothing to help those who are most vulnerable.

"And this comes on top of the food shortages, with people told to stay in their homes," he added.

Youngchang Song, a member of the Seoul-based Worldwide Coalition to Stop Genocide in North Korea, said he is hearing similar stories from more defectors.

"It is like the 'perfect storm' there at the moment," he said. "People were already suffering from shortages of food because the spring months, before the first crops can be harvested, is well-known to be a time of hunger.

"Now people cannot go out to work in the fields to tend their crops, there is nothing to eat and no medicines in the shops, they cannot go to the underground markets and nothing is being smuggled over the border from China," he said. "There is just nothing for them."

"The defectors that I know who have been able to speak with friends or family there are in despair," he said. "There is nothing they can do to help."

Kim ignores offers of assistance
The South Korean government and UN agencies have made it clear that they are ready and willing to help the North, although Pyongyang has ignored those offers and appealed only to China and Russia, its traditional allies, for help. Analysts are not optimistic that Kim will put the needs of his people ahead of the loss of face that would be associated with accepting South Korean or UN aid.

"Considering the terrible human and economic toll COVID can cause in North Korea, one would hope Pyongyang will finally accept international assistance," said Leif-Eric Easley, an associate professor of international studies at Ewha Womans University in Seoul. "But just because North Korea has confirmed infections doesn't mean it will come hat-in-hand to the international community.

"Kim's COVID playbook is probably to rely on more lockdowns, belt-tightening and domestic propaganda while accepting discreet Chinese assistance," he said. "Even if the regime finally prioritizes people's lives over imagined security concerns surrounding international aid, North Korean political and logistical hurdles will make expedited vaccine deliveries difficult."

Kim Jong Un, other North Koreans attend large funeral amid COVID worry [PBS NewsHour, 23 May 2022]

By Hyung-Jin Kim et al.

SEOUL, South Korea (AP) — A huge number of North Koreans including leader Kim Jong Un attended a funeral for a top official, state media reported Monday, as the country maintained the much-disputed claim that its suspected coronavirus outbreak is subsiding.

Since admitting earlier this month to an outbreak of the highly contagious omicron variant, North Korea has only stated how many people have fevers daily and identified just a fraction of the cases as COVID-19. Its state media said Monday that 2.8 million people have fallen ill due to an unidentified fever but only 68 of them died since late April, an extremely low fatality rate if the illness is COVID-19 as suspected.

North Korea has limited testing capability for that many sick people, but some experts say it is also likely underreporting mortalities to protect Kim from political damage.

The official Korean Central News Agency said Kim attended the funeral Sunday of Hyon Chol Hae, a Korean People’s Army marshal who played a key role in grooming him as the country’s next leader before Kim’s father, Kim Jong Il, died in late 2011.

In what was one of the country’s biggest state funerals since his father’s death, a bare-faced Kim Jong Un carried Hyon’s coffin with other top officials who wore masks before he threw earth to his grave with his hands at the national cemetery. Kim and hundreds of masked soldiers and officials also deeply bowed before Hyon’s grave, state TV footage showed.

State TV earlier showed thousands of other masked soldiers clad in olive-green uniforms gathered at a Pyongyang plaza taking off their hats and paying a silent tribute before a funeral limousine carrying Hyon’s body left for the cemetery. KCNA said “a great many” soldiers and citizens also turned out along streets to express their condolences.

Kim often arranges big funerals for late senior officials loyal to his ruling family and shows a human side in a possible bid to draw the support of the country’s ruling elite and boost internal unity.

KCNA quoted Kim as saying that “the name of Hyon Chol Hae would be always remembered along with the august name of Kim Jong Il.” He wept when he visited a mourning station established for Hyon last week.

During Sunday’s funeral, most people, except for Kim Jong Un and honor guards, wore masks. The Norths’ ongoing outbreak was likely caused by the April 25 military parade and related events that drew large crowds of people who wore no masks.

North Korea maintains a nationwide lockdown and other stringent rules to curb the virus outbreak. Region-to-region movement is banned, but key agricultural, economic and other industrial activities were continuing in an apparent effort to minimize harm to the country’s already moribund economy.

KCNA said Monday that 167,650 new fever cases had been detected in the past 24-hour period, a notable drop from the peak of about 390,000 reported about one week ago. It said one more person died and that the fever’s fatality rate was 0.002 percent.

“All the people of (North Korea) maintain the current favorable turn in the anti-epidemic campaign with maximum awareness, in response to the call of the party central committee for defending their precious life and future with confidence in sure victory and redoubled great efforts,” KCNA said.

Experts question the North’s tally, given North Korea’s 26 million people are mostly unvaccinated and about 40 percent are reportedly undernourished. The public health care system is almost broken and chronically short of medicine and supplies. In South Korea, where most of its 52 million people are fully vaccinated, the fatality rate of COVID-19 was 0.13 percent as of Monday.

South Korea’s spy agency told lawmakers last week that some of the fever cases tallied by North Korea include people suffering from other illnesses like measles, typhoid and pertussis. But some civilian experts believe most of the cases were COVID-19.

Before admitting to the omicron outbreak on May 12, North Korea had insisted it was virus-free throughout the pandemic. It snubbed millions of vaccines offered by the U.N.-backed COVAX distribution program and has not responded to offers of medicine and other aid from South Korea and the United States.

The World Health Organization has also pleaded for more information on the outbreak but not gotten a response.

Some observers say North Korea would only receive assistance from China, its last major ally, because Western aid shipments could hurt Kim’s leadership as he’s repeatedly called for “a self-reliance” to fight against U.S.-led pressure campaigns.

Fauci COVID Criticism May Set Him Up for Failure on Monkeypox [Newsweek, 23 May 2022]

BY ZOE STROZEWSKI

Health authorities are investigating several cases of monkeypox that have recently emerged throughout the world, including in the U.K., Germany and the U.S., where the public's trust in the nation's top infectious disease expert may be hindered by past criticism.

While the U.S. has only confirmed one case of monkeypox so far amid the current rise, previous criticisms of Dr. Anthony Fauci may make it more difficult for him to lead certain segments of the public through a larger monkeypox outbreak, according to one expert.

Fauci, the chief medical adviser to the president and director of the National Institute of Allergy and Infectious Diseases (NIAID), became a household name in 2020 at the onset of the COVID-19 pandemic. But conservative media attacks and other factors, including criticism of masking and vaccination requirements, resulted in a gradual degradation of American confidence in Fauci.

As of April this year, for example, research from the Kaiser Family Foundation (KFF) found that more than half of adults, 53 percent, trust COVID-19 vaccine information from Fauci. But among Republicans, that figure is much lower. Between December 2020 and April 2022, the share of Republicans who said they trusted Fauci to provide reliable COVID-19 vaccine information fell from 47 percent to 25 percent.

Mollyann Brodie is the executive vice president, chief operating officer and director of the Public Opinion and Survey Research Program at the KFF. She told Newsweek that at the start of the pandemic in 2020, Fauci had "a lot of trust" among the American public in general. He maintained a high level of trust among Democrats, but it fell among Republicans "as the pandemic became more and more polarized," she said.

"I think it's just really reflective of the polarized nature that the pandemic has played out over the past few years, even more so than as a direct reflection on Dr. Fauci or any other public health official," Brodie said.

If monkeypox were to become more prevalent in the U.S., there's a possibility that the partisan distrust of Fauci and other public health leaders and institutions during the COVID-19 pandemic could carry over, Brodie said.

When asked whether the divided trust could ultimately cause Fauci to fail in leading the U.S. through a monkeypox outbreak, she said that there is a concern that a segment of the population could potentially not listen to warnings during the emergence of another health crisis. Brodie reiterated that research indicates that the majority of Americans still do trust Fauci and institutions like the Centers for Disease Control and Prevention (CDC) and Food and Drug Administration.

"Even though there's a segment of the population that may be more resistant to hearing public health messages, there's still a fair level of trust in the nation more broadly," Brodie said.

How the public may respond in the future "would just depend on how politically the next public health emergency is portrayed by the media and how effective the government and the public health response is seen by various aspects of the political system," she added.

Conservative media and some Republican figures have repeatedly taken aim at Fauci in the more than two years since the pandemic began. One journalist, for example, compared Fauci to the Nazi doctor Josef Mengele, while Senator Rand Paul has accused him of using his position of power to take aim at scientists he disagreed with.

The one confirmed case of monkeypox in the U.S. is a far cry from the current numbers regarding COVID-19 in America. The U.S. last week surpassed 1 million known COVID deaths, The New York Times reported.

"Transmission of monkeypox virus occurs when a person comes into contact with the virus from an animal, human, or materials contaminated with the virus. The virus enters the body through broken skin (even if not visible), respiratory tract, or the mucous membranes (eyes, nose, or mouth)," the CDC explained, calling monkeypox a "rare disease."

The one confirmed case of monkeypox in the U.S. was discovered in a Massachusetts man. New York City is also investigating another possible case in a patient who tested positive for the virus that causes monkeypox, Axios reported on Saturday.

Newsweek reached out to Fauci via the NIAID and the WHO for comment.

Fauci tells Princeton grads COVID ‘left an indelible mark,’ warns against ‘normalization of untruths’ [NJ.com, 23 May 2022]

By Matt Arco

The nation’s most well-known doctor on Monday gave advice to the latest crop of graduates at Princeton University, urging them to live fulfilling lives while also making it clear “COVID left an indelible mark on you and your entire generation.”

Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases who became the face fighting the coronavirus epidemic since 2020, didn’t mince words about the lasting effects of the pandemic as he delivered the keynote address at the school’s commencement ceremony.

“The profound ways COVID-19 has disrupted your student years are unprecedented,” Fauci said, with the Princeton University’s historic Nassau Hall in the backdrop as up to 5,000 people gathered for the first time in three years to celebrate graduates on “Class Day.” There are 1,234 members of the Class of 2022 who will graduate tomorrow.

Fauci argued the pandemic “has shone a spotlight on one of the greatest failings in our society: the lack of health equity” in the U.S. “As a physician, I feel that I must highlight this for you today,” he said.

Minorities disproportionally bore the brunt of the pandemic because they were more likely to be essential workers who couldn’t isolate themselves at home and are disproportionally at risk for underlying health issues, he said.

“Let us promise ourselves that our ‘corporate memory’ of the tragic reality of the inequities experienced with COVID-19 does not fade after we return to our new normal,” Fauci said. “It will take a decades-long commitment for society to address these disparities. I strongly urge you to be part of that commitment.”
But he also offered words of hope.

“Having said that, I am in awe of you all since each of you deserves enormous credit and respect for your extraordinary adaptability, resilience, and dedication to learning, completing your studies, and graduating despite immense difficulties and uncertainties,” he said.

Fauci first gained some national prominence in the 1980s after “an unusual pneumonia among gay men in Los Angeles” was discovered. He told the students after he graduated from medical school about a decade earlier he originally planned to pursue a “successful” and “comfortable career in investigative medicine.”

The subsequent HIV/AIDS pandemic, though, changed his course.

“I am still not sure what drove me to do this, but I decided right then and there to make an abrupt turn in the direction of my career, abandon my other research pursuits and investigate the pathogenesis of this mysterious disease,” he said. “My mentors were horrified and insisted that I was making a career-ending mistake and that this disease would amount to nothing.”

His critics, of course, were wrong.

About 700,000 people died from complications of AIDS between 1981 and 2018 in the U.S., according to the Kaiser Family Foundation. According to the World Health Organization, 35 million people died worldwide.

Fauci’s message to students was simple.

“Please believe me that you will confront the same types of unprecedented events that I have experienced, regardless of what directions your careers or lives take. And so, expect the unexpected and stay heads up for an unanticipated opportunity should it present itself,” he said. “At the end of the day, go with your own gut.”

Though he urged students to dream big and be on the lookout for opportunities that could shape others’ lives — and, in some cases, save lives — he ended his speech with a stark warning about what the future holds.

He shied away from using the words directly. But what Fauci, who has said he would step down from his position if former President Donald Trump were to win another election, sounded an alarm over fake news.

“What troubles me is that differences of opinion or ideology have in certain situations been reflected by egregious distortions of reality. Sadly, elements of our society have grown increasingly inured to a cacophony of falsehoods and lies that often stand largely unchallenged, ominously leading to an insidious acceptance of ‘what I call the ‘normalization of untruths,’” Fauci said.

“We see this happen daily ... (and) if you take away nothing else from what I say today, I appeal to you, please remember this,” he said. “It is our collective responsibility not to shrug our shoulders and sink to tacit acceptance of the normalization of untruths because if we do, lies become dominant and reality is distorted.”

He added: “Then truth means nothing, integrity means nothing, and facts mean nothing.”

Man Pleads Guilty to Making Threats Against Dr. Anthony Fauci and Other Federal and State Health Officials [Department of Justice, 23 May 2022]

Man Pleads Guilty to Making Threats Against Dr. Anthony Fauci and Other Federal and State Health Officials
Defendant Sent a Series of Emails Sent Over Seven Months Threatening to Kill the Federal Officials and their Families

Greenbelt, Maryland – Thomas Patrick Connally, Jr., age 56, most recently of Snowshoe, West Virginia, pleaded guilty today to making threats against a federal official, specifically for sending emails threatening harm to Dr. Anthony Fauci, the current Director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health (NIH). Connally further admitted threatening Dr. Francis Collins, the former Director of the NIH, Dr. Rachel Levine, currently the Assistant Secretary for Health at the U.S. Department of Health and Human Services, as well as a Massachusetts public health official and a religious leader.

The guilty plea was announced by United States Attorney for the District of Maryland Erek L. Barron and Special Agent in Charge George Adams, Office of Investigations, Office of Inspector General of the Department of Health and Human Services.

According to Connally’s plea agreement, from December 28, 2020 to July 25, 2021, Connally used an anonymous email account from a provider of secure, encrypted email services based in Switzerland, to send a series of emails to Dr. Anthony Fauci, the current Director of the National Institute of Allergy and Infectious Diseases (“NIAID”) and the Chief Medical Advisor to President of the United States, threatening to harm and/or kill Dr. Fauci and members of his family. One of the emails threatened that Dr. Fauci and his family would be “dragged into the street, beaten to death, and set on fire.” On April 24, 2021 alone, Connally sent seven threatening emails starting at 10:05 p.m.

As detailed in Connally’s plea agreement, also on April 24, 2021, beginning at 9:34 p.m., Connally sent Dr. Francis Collins, the then-Director of the NIH, a series of four emails threatening Dr. Collins and his family with physical assault and death if Dr. Collins did not stop speaking about the need for “mandatory” COVID-19 vaccinations.

As stated in his plea agreement, Connally admitted that he sent the threats to Drs. Fauci and Collins with the intent to intimidate or interfere with the performance of their official duties and with the intent to retaliate against Dr. Fauci and Dr. Collins for performing their official duties, including discussing COVID-19 and its testing and prevention.

Connally also admitted sending emails threatening harm to three other individuals. Specifically, on November 24, 2020, Connally sent a series of six threatening emails to Dr. Rachel Levine, then Secretary of Health for the State of Pennsylvania, at Dr. Levine’s email account at the Pennsylvania Department of Health. The subject lines and body of the emails threatened Dr. Levine with physical violence and death. Similarly, on August 31, 2020, Connally sent an email threatening physical violence and death for a public health official in Massachusetts. Finally, on April 21, 2021, Connally sent a series of four threatening emails to four individuals who work for a religious institution in Newark, New Jersey. The four emails threatened physical violence and death to a religious leader at the institution.

Investigation revealed that the anonymous encrypted email account was associated with Connally. On July 27, 2021, law enforcement executed search warrants at Connally’s rental residence in Snowshoe, West Virginia, as well as on his vehicle seizing five Apple laptops and two cellular telephones belonging to Connally.

Connally faces a maximum sentence of 10 years in federal prison for threats against a federal official. U.S. District Judge Paula Xinis has scheduled sentencing for August 4, 2022 at 11:30 a.m.

United States Attorney Erek L. Barron commended the HHS OIG for its work in the investigation. Mr. Barron thanked Assistant U.S. Attorneys Rajeev R. Raghavan and Jessica C. Collins, who are prosecuting the federal case.

Monkeypox cases since 11 Nov 2021

Press Briefing by White House Monkeypox Response Team and Public Health Officials [The White House, 18 Aug 2022]

Via Teleconference

(August 18, 2022)
MR. FENTON: Good morning. I’m Bob Fenton, the White House Monkeypox Response Coordinator. Today, Secretary Becerra, Assistant Secretary O’Connell, and Dr. Walensky and I will provide a brief update and share some key announcements from the Biden administration’s whole-of-government response to the monkeypox outbreak. We’re also joined today by Dr. Peter Marks from FDA and my Deputy Coordinator, Dr. Daskalakis, for questions.

Before I turn it over to Secretary Becerra, I want to provide an update in our response efforts.
Last week, FDA and CDC acted to allow JYNNEOS vaccine to be administered intradermally, increasing the number of doses in each vial of vaccine by up to fivefold.

With the announcement, it increased our existing supply significantly without compromising safety or effectiveness. And as Dawn O’Connell will discuss shortly, we already aggressively are increasing access for jurisdictions to move vac- — to move more vaccine supply.

We’re focused on operationalizing the FDA decision. Since last week’s announcement, CDC has been working hard to provide help to providers and clinicians with training and other resources to administer the intradermal vaccines.

Already we’re seeing some of the country’s largest jurisdictions, big and small, adopt this strategy, including Los Angeles County and Fulton County, Georgia.

Overall, as of today, HHS has delivered nearly 1 million doses of vaccines to states and cities.
We rapidly scaled up supply of vaccine out in the field, and we are working to meet demand wherever we may find it.

In fact, we have the largest JYNNEOS vaccine program of any country in the globe. And we’re not done.

As Assistant Secretary O’Connell will discuss, we have accelerated Phase 4 of our national vaccine strategy. Starting Monday, an additional 1.8 million doses of vaccine will be available to jurisdictions for ordering.

Jurisdictions that are adopting the intradermal administration of vaccine and have used 90 percent of their current supply of vaccines will be able to order more doses. And as always, we’re getting those dors- — doses out the door to places as soon as they’re ordered.

In addition to getting vaccines out quickly to where they’re needed, we’re focused on helping states and local partners turn these doses into vaccinations, because more shots in arms is how we get the outbreak under control.

To that end, today we’re announcing that states and localities will be able to request and receive additional vaccines to support vaccination efforts at large LGBT events in the coming weeks and months.

HHS is launching a pilot program that will provide up to 50,000 doses from the national stockpile to be made available for Pride and other events that will have high attendance of gay and bisexual men. These doses will be on top of jurisdictions’ existing allocations and supply of vaccine.

As Dr. Walensky will discuss in more detail, CDC will also work closely with state and local health departments to ensure they have plans in place for these events, not just around vaccination but also testing and community engagement.

We’re already starting to work with jurisdictions on a number of events taking place in the coming days and weeks.

This is important; it’s innovative — the way that we will bolster local efforts to meet people where they are and mitigate the spread of monkeypox.

Before I turn it over to Secretary Becerra, I want to highlight another step we are taking to make it easier for individuals to access treatment for monkeypox.

Next week, HHS will be pre-positioning 50,000 courses of TPOXX across the country. That’s nearly five times as many treatment courses than confirmed cases in the U.S.

These courses will be made available to jurisdictions where the outbreak is most severe so individuals can get treatment more quickly from their healthcare providers.

In all, we are making a lot of progress on monkeypox. This is because of the hard work across government that is scaling access to vaccines and tests, educating the public, and ensures — ensuring jurisdictions are getting what they need.

This is a whole-of-government response that is built on a strong work by Dr. Panjabi and the National Security Council built that allowed us to rapidly accelerate our tools and resources.
Our feet remain on the gas to do everything we can to end this outbreak.

Let me stop there and turn it over to Secretary Becerra.

SECRETARY BECERRA: Thanks, Bob. Great to be with everyone again.

Let me start by saying: Most Americans still are learning about monkeypox — what it is and what it is not. CDC’s website can answer most of those questions.

Here’s what we do want all American’s to know: It’s important that we all take monkeypox seriously, and it’s critical that we do all we can to keep this dangerous virus from spreading.

Here, this team, we continue building on our efforts from the beginning to secure and make available safe and effective vaccines, treatments, and tests.

For the more than 60 jurisdictions that have reported approximately 13,500 cases of monkeypox across the country, we have, to date, made available more than 1 million doses of vaccine, more than 22,000 courses of TPOXX treatment, and capacity for 80,000 tests per week. And as Coordinator Fenton just mentioned, that number of vaccines will scale up dramatically.

Having declared monkeypox a public health emergency, having safely expanded our supply of effective vaccines, and every day receiving more fertile data about the outbreak from our many state and local partners, we now move into a new phase of our efforts.

The fluid and collaborative allocation of vaccines and treatments to our partners will continue as part of this latest phase, but we will also now surge and target vaccines and treatments when and where that can be most effective, as Administrator O’Connell and Director Walensky will detail.

We know we have more to do to mitigate the spread of this virus and to protect those at risk.
Our work with our state and local partners could be — could not be more critical than at this particular moment. We know that viruses don’t care about state lines. They don’t wait to spread.

And so we will continue to do all we can to work together, communicate, and share information. As I’ve said, we all have a role to play, and working together will lead to our collective success.

So, with that, let me now turn it over to Administrator Dawn O’Connell. Dawn?
MS. O’CONNELL: Secretary, thank you so much.

At ASPR, we continue to partner with our sister agencies, industries, and state and jurisdictional health leaders to accelerate access to vaccines and treatments and strengthen our response.

First, as we have done over the past three months, we continue to work with our manufacturer to accelerate the acquisition and delivery of vaccines to states and jurisdictions.

To date, as been mentioned already, we have shipped more than 700,000 vials of the JYNNEOS vaccine nationwide, including over 60,000 additional vials that have been shipped since the second and final round of ordering under Phase 3 opened on Monday. This represents more than 1 million doses currently delivered and available for use across the country.

On Monday, as Bob said, we will make approximately 360,000 vials, or up to 1.8 million more doses, available to states and jurisdictions.

This rounds out the distribution of the nearly 800,000 vials we received in late July.
In addition, as previously announced, we are accelerating the delivery of another 150,000 doses of vaccine that was initially supposed to come in October; it’ll now be coming in September — which represents up to 750,000 doses under the new FDA EUA.

We are also now receiving administration data from jurisdictions, which helps us ensure we are distributing vaccines equitably across the country while also making sure they get to those who need them most.

And we continue to explore all available options to increase the amount and speed at which we are able to deliver vaccines across the country.

On July 15th, when we announced an order with Bavarian Nordic for an additional 2.5 million vials of the JYNNEOS vaccine, we shared that those doses will be filled at a U.S.-based contract manufacturer using bulk vaccine already manufactured. We continue to work with Bavarian Nordic and the domestic contract manufacturer to advance that goal. We hope to be able to share additional details about that arrangement soon.

And, based on feedback from jurisdictions, the Strategic National Stockpile is making arrangements to deliver more vaccine to more locations, beyond the five in each jurisdiction they already deliver to. More on this as well in the coming weeks, but it represents another example of how this is not a static response. We are continuing to assess where we are, evaluate what we need, and make improvements in real time.

Today, as Bob mentioned, we are also announcing that we will make available 50,000 patient courses of the antiviral, TPOXX, for jurisdictions to begin ordering next week. This is nearly five times, as Bob mentioned, more courses than confirmed cases in the United States.

Starting next week, jurisdictions will be allocated courses of TPOXX using a formula that takes into account both the number of cases in their jurisdiction and the number of individuals who have the highest risk of contracting the virus, including individuals who have HIV or other immunocompromised conditions.

And, of course, this allocation is in addition to the over 22,000 courses ASPR has already deployed from the SNS upon request from jurisdictions.

We believe it is important for states and jurisdictions to be able to order and pre-position these doses for quick and easy access for patients who qualify for them.

As I mentioned at the top, so much of what we do is in partnership with our sister agencies, including the CDC. With that, it’s my pleasure to turn it over to Dr. Walensky.

DR. WALENSKY: Thank you, Administrator. And good morning, everyone.

Today, I’d like to provide the latest information on the current monkeypox outbreak as well as share a few updates on the work we are doing in CDC’s monkeypox response.

So, as of August 17th, over 39,000 cases have been detected globally in 94 countries. Here in the United States, there have been over 13,500 cases of monkeypox identified across 49 states, as well as Washington, D.C. and Puerto Rico.

Monkeypox case data reported to CDC show that 98 percent of cases are occurring in men. Of the more than 6,000 cases for which we have data on race and ethnicity, nearly 35 percent of cases are occurring among those who are white, 33 percent of cases are occurring among those who are Hispanic, and nearly 28 percent are occurring among those who are Black. The median age of cases is 35. And among cases with known recent sexual history and gender, 93 percent of cases were among men who reported recent sexual contact with other men.

Today, HHS is announcing a pilot program for additional vaccine allocations to state and local health departments whose jurisdictions are hosting events that draw a majority of people from the MSM community.

Jurisdictions hosting these events can request to receive additional vaccine allocations based on the size and nature of the event and the ability to reach attendees who are at the highest risk of monkeypox, a lar- — again, largely right now, men who are having sex with men. We’re asking the requests to include a component of how they will promote education and awareness, as well as how they will address health equity in delivery of both messaging as well as vaccine.

CDC and HHS will continue outreach efforts to educate and make resources available to everyone who needs them. As part of this effort, CDC will publish — be publishing a toolkit for health departments to assist with planning of these large events.

This toolkit, which has been developed based on the needs and feedback we’ve received from state and local health departments, includes ready-to-use resources to support local health department efforts when engaging with organizers of large events to provide and promote further monkeypox prevention strategies and key public health messages at large gatherings.

These events are important opportunities for people to connect with their community and to enjoy themselves. And they’re also a chance to provide public health messages and resources to otherwise hard-to-reach publications — populations — otherwise hard-to-reach populations.
That includes providing safer sex guidance that empowers people to make choices that can help them avoid monkeypox exposure, including temporarily limiting sexual partners, and messages about monkeypox symptoms and vaccines. They also provide education opportunities for communities about testing and treatment resources.

Now, I want to emphasize that while we are offering the vaccine at these events to those at high risk, this is a two-dose vaccine series, and receiving the vaccine at these events will not provide protection at the event itself.

Now, much of our work over the last many weeks has been related to the important outreach to clinicians and public health partners, and we have been focused on providing them with the necessary resources and education and tools that they need.

So, related to our announcement last week, some of our recent work has involved answering questions related to intradermal vaccine administration for the JYNNEOS monkeypox vaccine.

Importantly, intradermal administration is not a new vaccination method. Data suggests that the vaccine administration intradermally will produce the same immune response as the standard dose administered subcutaneously.

We also know many intradermal vaccines may require some training for vaccine providers. Now, many healthcare providers already have experience administering allergen testing or tuberculosis skin testing by this route. CDC has resources available to ensure that vaccine providers can receive training and refresh their skills if needed.

To be clear, we’re learning how well these vaccines work against monkeypox and in this specific outbreak. Although we anticipate vaccines will provide protection, temporarily reducing or avoiding behaviors that increase your risk of monkeypox exposure is important, especially between your first and second doses of vaccine. From what we know right now, we expect protection to be the highest two weeks after the second dose of the vaccine.

At CDC, we remain committed to providing the necessary guidance, education, and resources as we continue to respond to current — the current monkeypox outbreak. And we, of course, remain open to feedback on how and where we can provide tailored information to those at highest risk.

So, with that, I’ll say thank you. And I will turn things back to you, Kevin.

MR. MUNOZ: Thanks so much, Dr. Walensky.

We’re going to try to get through as many questions as possible, so keep your questions to one question.

First, let’s go to Chris Johnson at the Washington Blade.

All right. I think, Chris, you might be having some challenge. So, let’s go to the next question, and we’ll go — we’ll come back to you.

Jacqueline Howard at CNN.

Q Yes, thanks for taking my question. We’ve heard from the manufacturer that there are some concerns on the manufacturers’ end, as far as having its manufacturing capacity meet demand. So, my question is: Are you working to help find domestic manufacturing partners to help supply JYNNEOS doses? Or what are you doing to help meet demand just in case the capacity is not there? How would that impact how much vaccine we have? Thank you.

MR. FENTON: Dawn, do you want to start with an answer for that one?

MS. O’CONNELL: Sure, Bob. I’ll be happy to. And then, of course, feel free to jump in.

So, thank you, Jacqueline, for the question. We continue to work closely with Bavarian Nordic, the manufacturer. As you know, they’re a small manufacturer.

So, one of the first things we did as this monkeypox outbreak took hold was begin conversations with them about how they might expand that capacity. They currently have one active line in the Copenhagen area that we’re relying on for 2.5 million doses to be filled and finished. But when we ordered that second 2.5 million to be filled and finished, we made it a requirement that they work with a domestic U.S. contract manufacturing organization. And we continue to partner with Bavarian Nordic as they solidify that relationship.

We are also helping them in other ways consider manufacturing capacity increases — potentially working with a larger pharmaceutical company, for example. We don’t have anything to announce in particular at this time, but we are working very closely in support of Bavarian Nordic’s interest in increasing their capacity.

MR. MUNOZ: Thanks. Let’s try Chris Johnson again.

Q Hi, thank you so much. I just kind of want to build off of that regarding the reported issues that the manufacturer of JYNNEOS vaccine has said with the proposal, the strategy of administration for the vaccines announced last week by the administration.

It seems like we’re having a lot of contradictory information from various health officials. We have the federal government being critical of localities for opting to undergo a one-dose strategy. Now we have the manufacturer of the vaccine being critical of the federal government for the new vaccine implementation.

I mean, with so many, you know, contradictory information, how can the public be trust — be trustful of the information they’re getting from health officials?

MR. FENTON: Yeah, let me start — this is Bob Fenton — and then I’m going to turn it over to Rochelle Walensky at CDC to — and Dr. Peter Marks to talk about the dosing strategy.

I think anytime that you have change, you’re going to have the need to update, educate the community on those changes. And I think, last week, FDA with the EUA did a really good job of doing that, providing scientific data on those changes.

And then, what needs to happen is the training, which CDC is providing, to go to the intradermal shots for those that need help.

As I said in my opening comments, the day that we made that decision — the day that we made that decision, or the FDA made that decision, and we signaled the week before that this was being undertaken by FDA, there already were a number of jurisdictions that started the training in anticipation of that decision. And that day, there were organiza- — jurisdictions actually delivering the intradermal shot that day, and yet five- — up to fivefold the number of shots. And did that to — you know, to areas of high risk and did that to areas that — that, you know, made equity a factor in those decisions of where they vaccinated.

So, it is happening; it is being successful. We’ll continue to work with those that have questions.

But let me turn it over to Dr. Walensky and to Peter Marks to talk about the science behind the decision and any questions they’re getting as they’re providing technical assistance to jurisdictions.

DR. WALENSKY: Thank you very much. Maybe I’ll just add how closely we’re working with state and local health departments through this outbreak, really hand-in-glove, and in really fluid communication through this outbreak.

As articulated, we don’t yet know how well this vaccine will work in this outbreak. And as those data are evolving, as we had some resource constraints early on with vaccine, we were working closely with health departments as a way that they could maximize their coverage.

We’ve met with them to talk about what data might be available for one dose, which are really limited — and, in fact, if anything, concerning — in terms of how well it would work.

And so when the strategy for intradermal dosing, which we anticipate will work just as well as subcutaneous dosing, we again met closely with the health departments — Dr. Marks was on those calls — so that we could provide the data to them.

So, yes, this has been fluid, but we have been in close touch with our state and local health departments, providing them all the data and all the information that we have when we have it.

Dr. Marks, do you have anything to add there?

DR. MARKS: No, I just — I would just very briefly add that, you know, some of this was in response to seeing additional use of a one-dose delayed strategy, which was, as Dr. Walensky noted, very concerning because of the absence of data and the emergence of some data to suggest that that might be a strategy that is not as effective as we would like it to be.

So, this was done very carefully, with a lot of thought, and we are working very actively to make sure the community has the information that we reviewed and can see the thought process that we used to come to the conclusion that giving this intradermally provided the same kind of protection that giving it by the subcutaneous route.

MR. FENTON: And just real quick, let me just ask Dr. Daskalakis if he wants to add anything to what’s been said.

DR. DASKALAKIS: I would just add, just briefly, that it’s really also part of our job, I think from the perspective of governmental public health, to make sure that we’re communicating about the vaccine in a way that makes sense, that actually engenders trust in the population.

So I think our clear, sort of, view that this is equivalent, whether it is the intradermal dose or the subcutaneous dose, and the thorough review of the data that Dr. Marks and Dr. Walensky talk about, really give us the confidence to, I think, signal to folks that this strategy is not only important to protect themselves, but also to allow us to get more vaccines in arms.

So it’s safe, it’s equally effective, and also allows us to expa- — extend vaccine so that we can maximize protection in the community.

MR. MUNOZ: All right, next question. Let’s go to Sheryl Stolberg at the New York Times

Q Hi, thank you for taking my call. Dr. Walensky mentioned some events coming up, and there are two big ones coming on Labor Day weekend: Black Pride in Atlanta and also Southern Decadence in New Orleans, where monkeypox forced the cancellation of a concert. And we also have back to school — college, in particular — coming up.

And I’m wondering if maybe Dr. Walensky, or Dr. Daskalakis — Daskalakis can talk about specifically what are you doing to help officials in Atlanta and New Orleans, and how are you advising colleges and universities in handling the return to campus and dorm life.

DR. WALENSKY: Maybe I’ll start and pass it to Dr. Daskalakis. Thank you for that question, Sheryl.

Part of the motivation for this pilot is for those large events. There were actually a few before those large events. But we’ve been working closely with the jurisdictions, both in Fulton County and New Orleans, in anticipation of these events.

And specifically, we’re asking for plans for how the education will happen; how we can do more outreach; in some cases where they’re testing, we can make testing available, how we can make vaccine available; how we can do this in an equitable fashion so that we get messaging in — out in an equitable fashion but also vaccine out in an equitable fashion.

As I’m sure you can appreciate, these are opportunities for us to reach populations that we might otherwise not be able to reach, which we feel is a really good opportunity to get these messages out there.

So, not only are we working to set up vaccination stands and activities with personnel in the local health departments, but we’re also working hard to ensure that we have the right messaging for the right people during those events. And there are several other events, not just those that we’re closely working with — jurisdictions who are requesting our assistance ahead of time as well.

We do have messaging for our college campuses. We do have — which is very consistent with the messaging that is up on our website. And we’re, of course, carefully monitoring that as well.

Demetre, I don’t know if you — Dr. Daskalakis, I don’t know if you have anything to add.

DR. DASKALAKIS: I would just — I just want to emphasize the importance of really creating more opportunity for vaccine access. It’s really allowing us to do intervention such as this and pilots to try to get vaccine closer to where the people are rather than have people come to always try to find the vaccine.

So I think that also, Dr. Walensky — I think that the point that this is a multidomain intervention, it’s not just about vaccine, but also about clear communication about how the vaccine works, which I think you covered so well with the idea that first dose isn’t enough for protection; second dose is what you need, plus. But then also, there’s so many strategies that folks can use to prevent monkeypox exposure.

And so that package of interventions put in the right place means that it gets to the right people. So we’re really enthusiastic that increasing vaccine availability allows us a bridge to do such events like that.

And again, great, great collaboration with jurisdictions who I think are very enthusiastic about working with CDC and all of us on this topic.

MR. MUNOZ: Thanks both.

Let’s go to Pien Huang at NPR.

Q Hi, thanks for taking my question. I’ve been hearing from some states that the doses being sent this week are being counted using the intradermal dosing regimen. So, I just wanted to confirm how doses are being counted. You know, is every vial sent before this to be considered one dose? Every vial sent this week and after considered five? Just hoping for a clarification on that.

MR. FENTON: Yeah, let me start and then send it over to Dawn to provide some additional detail. So the doses that we provided this week were counted as doses based on the new intradermal strategy and the ability to get up to five doses per vial. That’s how they’ve been sent. And — and with the announcement of going to Phase 4, we’ll continue with that strategy if vaccine administration was at the 90 percent level. So if they’re providing the vaccine, especially to the at-risk community, then they would be able to continue to order.

What we want to do is accelerate this response, which is why we not only provide 3b but 3c at one time this week, and why we’re now moving forward with 4 is because those that are moving forward and vaccinating individuals at risk quickly, we want to be able to continue to provide the vaccine to protect as many people as possible.

Let me turn it over to Dawn from ASPR to add to that.

MS. O’CONNELL: Terrific, Bob. I actually think you covered it very, very well. What’s most important to us is to be able to get as many doses out as quickly as possible to those that need it. And the FDA EUA allowed us to do that with each vial turning into five doses. So we’ve been counting it that way. Since that change — so the beginning of Phase 3, second ordering tranche on Monday — we sent it out according to that new calculation.

We do know there are situations — in a pediatric indication, for example — where a single vial still will equal a single dose. And if a jurisdiction runs into some situations where they’ve administered more of those — and we would certainly hope for in an outbreak like this — you know, we’d be happy to work with them. We do understand that there are some circumstances where we will need to adjust slightly.

But for — you know, as a rule of thumb, it’s been now five doses per vial.

Thanks, Bob.

MR. MUNOZ: A couple more questions. Let’s go to Mike Stobbe at the Associated Press.

Q Hi, thank you for taking my call. I just was hoping for a little more clarity on the pilot project you announced. I heard at one point “50,000 doses.” At another point, I heard “50,000 courses.” “Courses” I take to mean two-dose series. Is it 50,000 courses or doses?
And how will you follow up? Like, if someone goes to an event and they — they are traveling from another place and they come in and then they leave, how will you follow up to make sure that they get that second dose? Thank you.

MR. FENTON: Yeah, so I think two different things announced. One was an announcement with regard to doses available for vaccine, and the ability to go into Phase 4 ordering started Monday for those that have vaccinated 90 percent.

The second thing that was discussed was pre-positioning of TPOXX, which is the treatment for those that are positive with monkeypox, and that’s the 50,000 courses.

So two different — you know, two different things: one vaccine, one medication.

As far as the events in providing one dose, we will work with the jurisdictions to make sure that there’s — that those individuals that were given one dose, if they travel back to their home of origin, that there’s a — that within their allotment, that there’s sufficient vaccine for a second dose.

Let me turn to Dawn or Dr. Walensky and see if they want to add anything to that.

MS. O’CONNELL: Bob, I think you nailed it. Rochelle, I’m not sure if there’s more that you wanted to add, but it is — in the TPOXX pre-positioning, it’s the 50,000 patient courses. In the special events, I believe it is the 50,000 doses. But, Rochelle, you might have more on that.
DR. WALENSKY: Yeah, no. What I was going to add is: We recognize that there are going to be some people who have traveled to large-scale events and that they’re going to have to receive dose one of their vaccine at the event, and then they will necessarily receive dose two at their local jurisdiction. And we anticipate that.

We’ve seen that before when we’ve had to do — when we’ve done mass vaccination, for example, with COVID. So we are prepared to collect the immunization data. And among the messaging that we will convey, as I noted before, is that people will understand that this is a two-dose vaccine and that they are getting their first dose at the event, that they will need to follow up for their second dose.

MR. MUNOZ: All right, two more questions. Let’s go to Cheyenne Haslett at ABC.

Q Hi. Thank you. I was wondering if you had any data on who is doing intradermal injections, if you’re keeping track of what providers are actually performing it that way, and if you can share that with us.

MR. FENTON: Yeah, the information is just coming in this week on that. I’ve been in contact with a number of providers that are doing intradermal doses. Los Angeles is doing a lot. We were just on a call with Philadelphia that’s doing that. Atlanta, there’s a number of them.

But let me turn to Dr. Walensky, who is starting to get a lot of data on that, and see if she wants to add anything. And then I know Dr. Daskalakis has also been on a number of calls with providers.

DR. WALENSKY: Thank you. Really, what I will say: The data are coming in. What we’re doing really — working really hard is to work with jurisdictions so they all get to this intradermal dosing.

As we see the administration come in — the administration data come in, we will also have a better sense. But ultimately, this is a precious resource that we want to be used efficiently and wisely, and that’s the purpose of this, without sacrificing anything on safety and effectiveness, as far as our data show so far. And so we’re really moving to get all jurisdictions to intradermal dosing.

MR. FENTON: Dr. Daskalakis, anything to add?

DR. DASKALAKIS: No, I think it’s covered well. Just, we’re hearing, you know — just, jurisdictions are very enthusiastically starting this. And I think, you know, the training provided by CDC and the technical support has been really important. So, you know, I think it’s exciting from the perspective of access. Thank you.

MR. MUNOZ: Last question. Let’s go to Krista Mahr at Politico.

Q Thanks so much for taking my question and for providing the updated data on the case breakdown of how this is impacting different communities really are. A question about that. You mentioned the events as a particular opportunity to get particularly at-risk communities. Can you please talk a little bit about more specific messaging that is going out to Black and Hispanic communities in particular, which are being disproportionately impacted in the outbreak? Thank you.

MR. FENTON: Yeah, let me start with Dr. Daskalakis and then go over to Dr. Walensky if she wants to add anything.

DR. DASKALAKIS: So I’ll start and say that we know really — working really closely with organizations and trusted messengers for those populations has been really critical. We continue to do the work and go deeper and deeper into engagement to make sure that messages are coming out.

And also, I think it’s important to note that many of the events that we’re focusing on that are coming down the pike, to foreshadow, are really events that do focus on populations who are overrepresented in this outbreak, including the trends that we’re seeing in — among Black and Latino individuals.

So I think it’s really about positioning both messaging and biomedical intervention where people can reach it, but then also making sure that we’re going to the right places and talking to the right people.

Dr. Walensky?

DR. WALENSKY: I don’t have much to add there except to say how closely we’re working and how critically important it is to collaborate with communities and people on the ground. And so we continue to do so and certainly welcome any other ideas of how, where we can do that outreach.

MR. FENTON: With that, I really appreciate everyone participating in today’s call and the questions. This is really a whole-of-community effort.

As you heard today, we’re accelerating our response to ensure that we’re able to vaccinate, provide testing, improve the ability to quickly treat and really focus on educating and communicating a whole of nation through this effort.

So, thank you for tuning in today. I appreciate your questions

How to Protect Against Monkeypox as School Starts [The New York Times, 17 Aug 2022]

How to Protect Against Monkeypox as School Starts
Experts say children are not at a high risk of infection. But they have advice to keep everyone — from toddlers to college kids — safe.

As children around the country head back to school for the third time since the Covid-19 pandemic began, a different infectious disease is now spreading globally: monkeypox. Almost every single state and territory in the United States has reported cases of monkeypox, with more than 11,000 confirmed cases nationwide. And news of a day care worker in Illinois testing positive earlier this month prompted some infectious disease specialists to warn there is potential for spread in group settings like schools and day cares.

But more than 98 percent of those infected with monkeypox are adult men who acquired the virus through intimate contact with other men — and so far, less than a dozen pediatric cases have been recorded in the U.S.

Confirmed Monkeypox Cases in the U.S.

Monkeypox is not spread as easily as Covid-19 or common childhood illnesses, said Dr. Ibukun Kalu, a pediatric infectious diseases specialist at the Duke University School of Medicine. It typically requires direct contact with an infected person’s rash. According to the Centers for Disease Control and Prevention, monkeypox can also spread by touching objects, fabrics and surfaces that have been used by someone with monkeypox and haven’t been cleaned, or by respiratory droplets expelled by an infected person during close face-to-face contact.

However, new data suggests that indirect contact and environmental contamination is not a major source of transmission. If someone with monkeypox comes to shared spaces like offices or schools, scientists have found that they do not leave behind enough live virus that can replicate and infect others.

Additionally, there is a vaccine and a treatment for monkeypox. The vaccine is not publicly available, but an emergency use authorization now allows children under 18 to receive the vaccine if they have been exposed or are at high risk of getting monkeypox.

Parents who are concerned about the virus may also be relieved to know that many pandemic precautions and behaviors can be repurposed to protect children against monkeypox: wearing masks in crowded indoor areas, avoiding sharing personal use items, increasing the frequency of hand washing and isolating at home when you’re sick.

It’s important to pay attention to new rashes and other symptoms, Dr. Kalu said. “Get your child assessed by a doctor if the rash starts spreading or is something you’ve not really seen on your child before.”

What to look out for
A monkeypox rash starts off as red lesions that can become raised and filled with pus. It can appear anywhere on the body, including the face, hands, feet and genitals, and sometimes resembles chickenpox (which is caused by an unrelated virus) or hand, foot and mouth disease, a common childhood rash that tends to circulate during back-to-school season.
Monkeypox cases in adults can also look like acne or sexually transmitted diseases such as herpes or syphilis, particularly if the rash is limited to just a few pustules.

Other symptoms of monkeypox include a fever, headaches, muscle aches, swollen lymph nodes and rectal pain or bleeding. Symptoms can appear up to three weeks after an exposure and last two to four weeks.

How to think about transmission risks
Though monkeypox is unlikely to spread widely in schools and day cares, parents should expect to hear of more cases spilling over to these and other settings if the disease continues to proliferate.

What to Know About the Monkeypox Virus

What is monkeypox? Monkeypox is a virus similar to smallpox, but symptoms are less severe. It was discovered in 1958, after outbreaks occurred in monkeys kept for research. The virus was primarily found in parts of Central and West Africa, but recently it has spread to dozens of countries and infected tens of thousands of people, overwhelmingly men who have sex with men.

What are the symptoms? People who get sick commonly experience a fever, headache, back and muscle aches, swollen lymph nodes, and exhaustion. A few days after getting a fever, most people also develop a rash that starts with flat red marks that become raised and filled with pus. On average, symptoms appear within six to 13 days of exposure, but can take up to three weeks.

How does it spread? The monkeypox virus can spread from person to person through close physical contact with infectious lesions or pustules, by touching items — like clothing or bedding — that previously touched the rash, or via the respiratory droplets produced by coughing or sneezing. Monkeypox can also be transmitted from mother to fetus via the placenta or through close contact during and after birth.

I fear I might have monkeypox. What should I do? There is no way to test for monkeypox if you have only flulike symptoms. But if you start to notice red lesions, you should contact an urgent care center or your primary care physician, who can order a monkeypox test. Isolate at home as soon as you develop symptoms, and wear high-quality masks if you must come in contact with others for medical care.

What is the treatment for monkeypox? If you get sick, the treatment for monkeypox generally involves symptom management. Tecovirimat, a hard-to-obtain antiviral drug also known as TPOXX, occasionally can be used for severe cases. The Jynneos vaccine, which protects against smallpox and monkeypox, can also help reduce symptoms, even if taken after exposure.

Who can get the vaccine? Jynneos vaccine is most commonly used to prevent monkeypox infections, and consists of two doses given four weeks apart. It has mostly been offered to health care workers and people who have had a confirmed or suspected exposure due to limited supplies, though new doses should become available in the coming months. A few states, including New York, have also made vaccines available among higher-risk populations.

I live in New York. Can I get the vaccine? Adult men who have sex with men and who have had multiple sexual partners in the past 14 days are eligible for a vaccine in New York City, as well as close contacts of infected people. Eligible people who have conditions that weaken the immune system or who have a history of dermatitis or eczema are also strongly encouraged to get vaccinated. People can book an appointment through this website.

“There will absolutely be cases that will occur in women, in children and in people who are pregnant,” said Dr. Jay Varma, a physician and epidemiologist who specializes in infectious diseases at Weill Cornell Medical School in New York City.

However, for now, children are more likely to pick up monkeypox from people they come into contact with at home than at school, Dr. Varma said. Still, a child who lives with someone with monkeypox could potentially bring the virus to their day care or school.

The activities that may put children at risk and the signs of infection that parents should look out for also differ by age. Here’s what to know.

If your children are in day care
Ages: 0 to 4
Because monkeypox spreads primarily through prolonged close contact, babies and toddlers could theoretically get monkeypox from caregivers who are sick — if they hug or kiss children, change dirty diapers with an exposed rash on their hands — or through contaminated toys, shared utensils and beds. However, most day cares already have policies to disinfect toys and surfaces, as well as avoid shared beds, linens or clothing. After the day care worker in Illinois tested positive for monkeypox, no cases were found in children or other staff members. All were offered the vaccine.

“I think the important thing to know is that monkeypox is extraordinarily rare in children, especially young children,” said Dr. Kristina Bryant, a pediatric infectious diseases specialist with Norton Children’s Hospital in Louisville, Ky., and a member of the American Academy of Pediatrics’ Committee on Infectious Diseases.

That said, parents should take any new rash seriously, particularly if it lasts for more than a few days or if it is accompanied by a fever, Dr. Bryant said. Though experts say it is far more likely to be the result of a common childhood illness such as hand, foot and mouth disease, monkeypox may be more severe in children younger than 8 years old, as well as in those who are immunocompromised or who have certain skin conditions like eczema.

Trust your “spidey sense,” said Dr. Joshua Schaffzin, director of infection prevention and control at Cincinnati Children’s Hospital Medical Center, and contact your child’s pediatrician if you are worried. They may be able to determine what is behind your child’s rash just by looking at a photo or scheduling a phone conversation.

Parents should keep children home if they have any kind of rash. “A child who has a fever and a rash should not be going to day care,” Dr. Schaffzin said.

If there is an exposure, your child’s day care staff should manage it much like they would manage other viruses, like norovirus, that spread via surfaces and person-to-person contact, Dr. Schaffzin said. That entails a thorough cleaning and ensuring any staff or children with symptoms stay home until they are no longer contagious, while carefully monitoring for symptoms in others.

If you have pre- or elementary schoolers
Ages: 4 to 10
As with day care, it is important to keep children with a rash and fever at home and encourage them to frequently wash their hands. “I think the protocols schools have in place have only gotten better since Covid,” Dr. Bryant said. “That’s the good news.”

Children in this age group also have a pretty good understanding of concepts like keeping their hands and bodies to themselves, and not sharing personal items — strategies that can help prevent the spread of more common back-to-school concerns, like head lice, as well as rare cases of monkeypox, Dr. Bryant said.

According to Dr. Bryant, it will also be important for parents and adults at home to be aware of their own health and be open about discussing the disease in an age-appropriate way with their children. If anyone gets infected with monkeypox, they should isolate in a room away from others to the extent it is possible, wear a well-fitting medical mask and cover their rash with long sleeves, pants or gloves.

“The cases in children have been linked to household transmission,” Dr. Bryant said. “So the best way to protect your children from monkeypox is for parents to protect themselves.”

If you have tweens or teens
Ages: 11 to 18
Older children who participate in close-contact sports like wrestling or activities that involve shared costumes or uniforms may be at higher risk for monkeypox compared to their peers.

But that does not mean students should discontinue these activities. As long as school administrators and parents are aware of which activities and areas have potential for virus transmission, and they communicate that clearly to students, monkeypox risks can be contained.

“Athletes are already encouraged to keep up on their personal hygiene and to check their skin for other infections like staph,” Dr. Kalu said. “I’m not really worried that playing sports is going to lead to lots of new monkeypox outbreaks in schools.”

Many schools use disinfectants to clean high-touch surfaces like workout equipment, separate uniforms into dirty or clean piles and handle potential contamination with gloves, all of which can help reduce virus transmission, Dr. Kalu said.

Parents may also start having sex talks with children around this age or earlier. For those who are having conversations about sex, you may want to bring up monkeypox proactively, since one of the main ways it is spreading right now is through intimate contact. Close physical contact during oral, anal or vaginal sex, as well as when kissing or cuddling, can spread the virus.

You can ask if your teen has heard about monkeypox and what they know. Make sure they understand what symptoms to look out for and how to engage in safe sex. (While condoms may reduce monkeypox transmission, they are unlikely to completely eliminate the risk. The Centers for Disease Control and Prevention has some guidance on safe sex for monkeypox, although it is not specific to young adults.)

If your children are in college
A handful of colleges and universities have recently reported monkeypox cases and launched public health campaigns around the disease as students and faculty return to campus in the fall. Although the risk of monkeypox transmission is still fairly low in classrooms, college students are more likely to be sexually active or to come in close contact with others in dorms and at parties, so their risk is more similar to that of other adults, Dr. Kalu said.

Students who are over 18 may be eligible for the monkeypox vaccine before they go to school — if they meet their state’s criteria, such as having had multiple sex partners in the past two weeks or if they are men who have sex with men.

If students develop a suspicious rash, they may be able to access monkeypox tests at their student health center. Concerned parents can also talk to campus officials about medical or emotional support available to students and find out whether there is an isolation protocol for those who test positive.

As Monkeypox Spreads, U.S. Declares a Health Emergency [The New York Times, 4 Aug 2022]

By Sheryl Gay Stolberg and Apoorva Mandavilli

The designation will free up emergency funds and lift some bureaucratic hurdles, but many experts fear containment may no longer be possible.

WASHINGTON — The Biden administration on Thursday declared the growing monkeypox outbreak a national health emergency, a rare designation signaling that the virus now represents a significant risk to Americans and setting in motion new measures aimed at containing the threat.

The declaration by Xavier Becerra, President Biden’s health secretary, marks just the fifth such national emergency since 2001, and comes as the country remains in a state of emergency over the coronavirus pandemic. The World Health Organization declared a global health emergency over the outbreak late last month.

Mr. Becerra’s announcement, at an afternoon news briefing where he was joined by a raft of other top health officials, gives federal agencies power to quickly direct money toward developing and evaluating vaccines and drugs, to gain access to emergency funding and to hire additional workers to help manage the outbreak, which began in May.

“We’re prepared to take our response to the next level in addressing this virus,” Mr. Becerra said, adding that “we urge every American to take monkeypox seriously, and to take responsibility to help us tackle this virus.”

Mr. Biden has faced intense pressure from public health experts and activists to move more aggressively to combat monkeypox, which has infected more than 6,600 people in the United States. Lawrence O. Gostin, a health law expert at Georgetown University, called Thursday’s declaration “a pivotal turning point in the monkeypox response, after a lackluster start.”

Supplies of the monkeypox vaccine, called Jynneos, have been severely constrained, and the administration has been criticized for moving too slowly to expand the number of doses. Less than a decade ago, the United States had 20 million Jynneos doses; by May, the vast majority of them had expired.

In echoes of the early coronavirus response, tests have been difficult to obtain, surveillance has been spotty and it has been challenging to get an accurate count of cases. The administration has also been faulted for not doing enough to educate people in the L.G.B.T.Q. community, who are at high risk, before gay pride celebrations in June.

“We have 5 percent of the world’s population and 25 percent of the world’s cases,” said Dr. Carlos del Rio, an infectious disease physician at Emory University in Atlanta. “That, to me, honestly, is a failure. We were caught sleeping at the wheel.”

To address the vaccine shortage, Dr. Robert Califf, the Food and Drug Administration commissioner, who joined Mr. Becerra on Thursday, said his agency was exploring a strategy that would expand the number of available Jynneos doses by administering the shots differently — into layers of the skin, rather than the fat underneath. If it works, one-fifth of the current dose could be used to protect against the virus.

Dr. Califf said the agency was optimistic about the idea and expected to make a final decision “within the next few days,” adding, “It’s important to note that overall safety and efficacy profile will not be sacrificed for this approach.”

What to Know About the Monkeypox Virus

Card 1 of 7
What is monkeypox? Monkeypox is a virus similar to smallpox, but symptoms are less severe. It was discovered in 1958, after outbreaks occurred in monkeys kept for research. The virus was primarily found in parts of Central and West Africa, but in recent weeks it has spread to dozens of countries and infected tens of thousands of people, overwhelmingly men who have sex with men. On July 23, the World Health Organization declared monkeypox a global health emergency.

What are the symptoms? People who get sick commonly experience a fever, headache, back and muscle aches, swollen lymph nodes, and exhaustion. A few days after getting a fever, most people also develop a rash that starts with flat red marks that become raised and filled with pus. On average, symptoms appear within six to 13 days of exposure, but can take up to three weeks.

How does it spread? The monkeypox virus can spread from person to person through close physical contact with infectious lesions or pustules, by touching items — like clothing or bedding — that previously touched the rash, or via the respiratory droplets produced by coughing or sneezing. Monkeypox can also be transmitted from mother to fetus via the placenta or through close contact during and after birth.

I fear I might have monkeypox. What should I do? There is no way to test for monkeypox if you have only flulike symptoms. But if you start to notice red lesions, you should contact an urgent care center or your primary care physician, who can order a monkeypox test. Isolate at home as soon as you develop symptoms, and wear high-quality masks if you must come in contact with others for medical care.

What is the treatment for monkeypox? If you get sick, the treatment for monkeypox generally involves symptom management. Tecovirimat, an antiviral drug also known as TPOXX, occasionally can be used for severe cases. The Jynneos vaccine, which protects against smallpox and monkeypox, can also help reduce symptoms, even if taken after exposure.

Who can get the vaccine? Jynneos vaccine is most commonly used to prevent monkeypox infections, and consists of two doses given four weeks apart. It has mostly been offered to health care workers and people who have had a confirmed or suspected monkeypox exposure due to limited supplies, though new doses should become available in the coming months. A few states, including New York, have also made vaccines available among higher-risk populations.

I live in New York. Can I get the vaccine? Adult men who have sex with men and who have had multiple sexual partners in the past 14 days are eligible for a vaccine in New York City, as well as close contacts of infected people. Eligible people who have conditions that weaken the immune system or who have a history of dermatitis or eczema are also strongly encouraged to get vaccinated. People can book an appointment through this website.

Under current regulations, doctors have to navigate byzantine rules to request tecovirimat, the drug recommended for treating the disease, for their patients. The declaration does not change those rules, and federal officials have said they believe the regulations are necessary to ensure that the drug is safe and effective in patients.

Monkeypox, a virus similar to smallpox but with symptoms that are less severe, has in the past primarily been found in parts of Central and West Africa. But in the current outbreak, the United States has the world’s largest number of monkeypox cases, and the virus is spreading fast. Less than a month ago, there were about 700 cases; now there are nearly 10 times that many.

More than 99 percent of people infected with monkeypox in this country are men who have sex with men, which has posed a delicate task for public health officials communicating with the public about the threat. They do not want to stigmatize gay people, as happened in the early days of the H.I.V./AIDS epidemic, but neither do they want to downplay their particular risk.

This week, Mr. Biden named a veteran emergency response official, Robert Fenton, and an infectious disease specialist, Dr. Demetre Daskalakis, to coordinate the response from the White House — a sign that the administration was stepping up its attention to the outbreak. Dr. Daskalakis, who is gay, has built deep credibility in the L.G.B.T.Q. community over his career. Both he and Mr. Fenton were on Thursday’s call.

Monkeypox is transmitted mostly during close physical contact. The infection is rarely fatal — no deaths have been reported in the United States — but it can be very painful. The number of cases is expected to rise as the virus continues to spread and as surveillance and testing improve, Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said on Thursday.

“Two things are happening at once that I think can account for the rise in cases that we’re seeing: One is more widely available testing, and two, potentially more infections that are actually happening,” Dr. Walensky said, adding that “it’s hard to disentangle those right now.”

The emergency declaration that Mr. Becerra issued on Thursday falls under a specific section of federal law that allows the health secretary to declare an emergency that generally lasts for 90 days, but may be extended. But it does not grant the F.D.A. authority to give emergency authorization to vaccines, tests and treatments; that requires a separate declaration.

“It should help galvanize more testing and more health care provider awareness, especially in places outside the big cities where the level of attention to this has been far less,” said Tom Inglesby, the director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health, who has helped the Biden administration with its coronavirus response.

Anne Rimoin, an epidemiologist at the University of California, Los Angeles, and a member of the W.H.O.’s advisory panel on monkeypox, said the declaration would send “a strong message that this is important, that it must be dealt with now.”

Dr. Rimoin is one of the scientific advisers who urged the W.H.O. to categorize monkeypox as a “public health emergency of international concern,” a designation the organization has used only seven times since 2007. With panelists divided on the matter, Dr. Tedros Adhanom Ghebreyesus, the W.H.O.’s director general, overruled the advisers to declare monkeypox a global emergency, a status currently held by only two other diseases, Covid-19 and polio.

In the United States, demands for stronger action against monkeypox have intensified recently and several states — California, Illinois and New York — have declared their own health emergencies. Recently, Representative Adam B. Schiff, Democrat of California, called on the Biden administration to step up the manufacturing and distribution of vaccines, and develop a long-term strategy for combating the virus.

Senator Patty Murray, Democrat of Washington and the chairwoman of the Senate health committee, pushed the Department of Health and Human Services to provide a detailed account of the steps it is taking the contain the outbreak.

Gay rights activists, who have been sharply critical of the administration, have been demanding an emergency declaration for weeks. “This is all too late,” said James Krellenstein, a founder of PrEP4All, an advocacy group that works to expand treatment for people with H.I.V. “I don’t really understand why they didn’t do this weeks ago.”

The F.D.A.’s plan to consider fractional doses of Jynneos took some federal scientists by surprise.
There is some data to suggest that injecting one-fifth of a regular dose of Jynneos between skin layers would be just as effective as the approach being used now, administering a full dose under the skin. The skin is rich in immune cells that mediate the response to vaccines, so this approach is sometimes used, especially with vaccines in short supply, although it requires more skill.

Researchers at the National Institutes of Health had planned to test the strategy for Jynneos in a clinical trial that was set to begin in a few weeks, with results expected later in the fall.

“That was our plan, so we’ll have to see how it fits into the new landscape, which has changed,” said Dr. Emily Erbelding, who directs the N.I.H.’s division of microbiology and infectious diseases. “We thought that there was a desire to get a more robust data set, but if it’s a race against time, then this is a different situation.”

“Things are moving fast,” she added.

Declaring an emergency gives the C.D.C. more access to information from health care providers and from states.

During the outbreak, federal health officials have regularly shared information on testing capacity or on the number of vaccines shipped to states. But the C.D.C.’s data on the number of cases lags that of local public health departments, and the number of people vaccinated, or their demographic information, is mostly unavailable.

“We are again really challenged by the fact that we at the agency have no authority to receive those data,” Dr. Walensky, the C.D.C.’s director, said recently at an event hosted by The Washington Post.

The agency is working to broaden its access to state data, but in the meantime, the information is spotty and unreliable. Local health departments are underfunded, understaffed and exhausted after more than two years of grappling with the Covid-19 pandemic.

“A declaration of this monkeypox outbreak as a public health emergency is important, but more important is to step up the level of federal, state and local coordination, fill our gaps in vaccine supply and get money appropriated from Congress to address this crisis,” said Gregg Gonsalves, an epidemiologist at the Yale School of Public Health and an adviser to the W.H.O. on monkeypox.

“Otherwise,” he said, “we’re talking about a new endemic virus sinking its roots into this country.”

Portugal records five monkeypox infections [Northern Beaches Review, 19 May 2022]

Portuguese authorities say they have identified five cases of the rare monkeypox infection and Spain's health services are testing 23 potential cases after the United Kingdom put Europe on alert for the virus.

The five Portuguese patients, out of 20 suspected cases, are all stable.

They are all men and they all live in the region of Lisbon and the Tagus Valley, the Portuguese health authorities said.

European health authorities are monitoring any outbreak of the disease since the UK has reported its first case of monkeypox on May 7 and found six more in the country since then.

Spain issued an alert earlier on Tuesday morning saying it had eight suspected cases under testing.

The figure rose to 23 cases by late afternoon, Madrid region health authorities said in a statement.

All cases remain unconfirmed.

In the US on Wednesday, state health officials in Massachusetts reported a case of monkeypox in a resident who had travelled to Canada, and investigators are looking into whether it is connected to the European outbreaks.

Monkeypox is a rare viral infection similar to human smallpox, although milder, first recorded in the Democratic Republic of Congo in the 1970s.

The number of cases in west Africa has increased in the last decade.

Symptoms include fever, headaches and skin rashes starting on the face and spreading to the rest of the body.

It is not particularly infectious between people, Spanish health authorities said, and most people infected recover within a few weeks although severe cases have been reported.

Four of the cases detected in the UK self-identified as gay, bi-sexual or other men who have sex with men, the UK Health Security Agency said, adding evidence suggested there may be a transmission in the community.

The agency in the UK urged men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.

The newspaper El Pais quoted the head of public health in the Madrid region, Elena Andradas, as saying, "22 of the 23 suspected cases have reported having had sex with other men in recent weeks".

Portugal's DGS health authority did not release any information on the sexual orientation of the monkeypox patients or suspected patients.

The two countries sent out alerts to health professionals in order to identify more possible cases.

Massachusetts public health officials confirm case of monkeypox [Mass.gov, 18 May 2022]

The confirmed case poses no risk to the general public

BOSTON — The Massachusetts Department of Public Health (DPH) today confirmed a single case of monkeypox virus infection in an adult male with recent travel to Canada. Initial testing was completed late Tuesday at the State Public Health Laboratory in Jamaica Plain and confirmatory testing was completed today at the US Centers for Disease Control and Prevention (CDC). DPH is working closely with the CDC, relevant local boards of health, and the patient’s health care providers to identify individuals who may have been in contact with the patient while he was infectious. This contact tracing approach is the most appropriate given the nature and transmission of the virus. The case poses no risk to the public, and the individual is hospitalized and in good condition.

Monkeypox is a rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a rash on the face and body. Most infections last 2-to-4 weeks. In parts of central and west Africa where monkeypox occurs, people can be exposed through bites or scratches from rodents and small mammals, preparing wild game, or having contact with an infected animal or possibly animal products.
The virus does not spread easily between people; transmission can occur through contact with body fluids, monkeypox sores, items that have been contaminated with fluids or sores (clothing, bedding, etc.), or through respiratory droplets following prolonged face-to-face contact.

No monkeypox cases have previously been identified in the United States in 2022; Texas and Maryland each reported a case in 2021 in people with recent travel to Nigeria. Since early May 2022, the United Kingdom has identified 9 cases of monkeypox; the first case had recently traveled to Nigeria. None of the other cases have reported recent travel. UK health officials report that the most recent cases in the UK are in men who have sex with men.

Based on findings of the Massachusetts case and the recent cases in the UK, clinicians should consider a diagnosis of monkeypox in people who present with an otherwise unexplained rash and 1) traveled, in the last 30 days, to a country that has recently had confirmed or suspected cases of monkeypox 2) report contact with a person or people with confirmed or suspected monkeypox, or 3) is a man who reports sexual contact with other men. This clinical guidance is consistent with recommendations from UK health officials and US federal health officials, based on identified cases.

Suspected cases may present with early flu-like symptoms and progress to lesions that may begin on one site on the body and spread to other parts. Illness could be clinically confused with a sexually transmitted infection like syphilis or herpes, or with varicella zoster virus. The CDC plans to issue public information soon on poxvirus infections which, when available, will be found here.

Rare monkeypox case confirmed in Massachusetts [The Washington Post, 18 May 2022]

By Meryl Kornfield and Hannah Knowles

Massachusetts health authorities confirmed a case of monkeypox Wednesday after the Centers for Disease Control and Prevention said it was monitoring the possible spread of the rare but potentially serious viral illness.

A man who recently traveled to Canada was tested for the virus Tuesday, and the infection was confirmed by the CDC on Wednesday, the Massachusetts Department of Public Health said in a statement. The news comes the same day that British and Portuguese health authorities reported clusters of cases, heightening concerns that monkeypox is spreading undetected outside of central and West Africa, where it is typically found.

The CDC is monitoring six Americans after they sat on a plane near a British patient, CDC medical officer Agam Rao told The Post on Wednesday. None of the patients have shown signs of monkeypox symptoms.

What is monkeypox, the rare virus now confirmed in the U.S. and Europe?
U.S. officials said clinicians should consider a diagnosis of monkeypox in people with an otherwise unexplained rash who traveled to a country that had a confirmed case, had contact with someone who may be infected or is a man who had sexual contact with other men.

Experts are trying to determine how the virus is spreading and how the cases may be connected. Past outbreaks of monkeypox have typically been limited to small groups, said Tom Inglesby, director of the Johns Hopkins Center for Health Security.

“So I think the risk to the general public at this point, from the information we have, is very, very low,” he said.

Still, the latest outbreak is unusual, Inglesby said, with cases popping up in several countries simultaneously.

“We don’t really have the sense yet of what’s driving it. … There isn’t a travel link that’s identified that brings these cases all together,” he said.

Two newly confirmed cases in Britain, one in London and one in southeast England, have no travel links to a country where monkeypox is endemic, indicating possible community transmission, according to the British Health Security Agency.

British health authorities said Wednesday that nine infections have been confirmed in England since May 6, “with recent cases predominantly in gay, bisexual or men who have sex with men.” Two cases that were confirmed Saturday were found among a family unit with no connection to others who later become infected.

The agency is advising people in those groups to be especially “alert to any unusual rashes or lesions on any part of their body.” Monkeypox could transmit through physical contact during sex, the agency said, as well as other close contact with someone infected, such as touching clothing and linens the person has used.

Portuguese health officials also announced confirmed cases of monkeypox Wednesday. Portugal’s Directorate-General of Health said more than 20 “suspected cases” were identified this month, five of which were confirmed.

The number of cases detected in such a short period is unprecedented, said Jamie Lloyd-Smith, a University of California at Los Angeles professor who has studied zoonotic viruses, or infections transmissible from animals to humans, for 20 years.

“It is surprising to see monkeypox appearing to spread internationally like this,” Lloyd-Smith said, adding that it is also “not impossible under the existing paradigm for how monkeypox spreads.”
Monkeypox does not have epidemic-causing transmission potential, such as that of the coronavirus. Also, unlike covid-19, the disease is more noticeable, making detection easier.
Monkeypox causes a milder infection than smallpox. The viral illness most often begins with flu-like symptoms and swelling of the lymph nodes. Eventually, “pox,” fluid-filled blisters, spread across a person’s body.

The Massachusetts case is the first in the United States this year. The other most recent case was confirmed in November, when a Maryland resident who had recently returned from Nigeria contracted the infection and had mild symptoms. Another case was detected in July after a Dallas resident traveling from Nigeria flew through two U.S. airports. No other cases were found at the time.

In 2003, U.S. health authorities identified 47 confirmed and probable cases in six states in the first outbreak of monkeypox in the Western Hemisphere that was later linked to a shipment of infected rodents from Africa.

Rare case of monkeypox reported in England, UKHSA says [CNN, 8 May 2022]

By Martin Goillandeau

(CNN)A rare case of monkeypox has been diagnosed in a patient in England, the UK Health Security Agency said in a statement Saturday.

Monkeypox is a rare viral infection which does not spread easily between people, the agency said, qualifying the overall risk to the general public as "very low."

"The infection can be spread when someone is in close contact with an infected person; however, there is a very low risk of transmission to the general population," the statement read.
The patient is believed to have contracted the infection in Nigeria, the UKHSA said, before recently traveling to the UK. He or she is receiving treatment in London at the expert infectious disease and isolation unit at the Guy's and St Thomas' NHS Foundation Trust.

Per the UKHSA, initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion.

The UKHSA said it would contact people "who might have been in close contact with the individual to provide information and health advice," as a precautionary measure.

Monkeypox is a relative of smallpox, which was eradicated in 1979, but is less transmissible and less deadly. According to the US Centers for Disease Control and Prevention, "The main difference between symptoms of smallpox and monkeypox is that monkeypox causes lymph nodes to swell while smallpox does not."

Rodents, including animals kept as pets, and monkeys can carry monkeypox and transmit it to people. The CDC investigated one case in a traveler to Dallas last year.

Forty-seven people in the US were infected with the virus in 2003 in an outbreak traced to a shipment of small mammals from Ghana sold as pets. There was a smaller outbreak in Britain in 2018.

Monkeypox - United States of America [World Health Organization, 25 Nov 2021]

On 16 November 2021, the IHR National Focal Point of the United States of America (USA) notified PAHO/WHO of an imported case of human monkeypox in Maryland, USA. The patient is an adult, resident of the USA, with recent travel history to Nigeria.

The individual was in Lagos, Nigeria when they developed a rash. On 6 November, they travelled from Lagos, Nigeria to Istanbul, Turkey and, on 7 November, from Istanbul to Washington, D.C, USA. The patient has not been vaccinated against smallpox in the past and is currently in isolation in Maryland.

Samples of skin lesions were positive on 13 November by real-time polymerase chain reaction (RT-PCR) assays for orthopoxvirus-generic and non-variola orthopoxvirus at the Maryland laboratory of the Laboratory Response Network (LRN). On 16 November, the USA Centers for Disease Control and Prevention (US CDC) confirmed the diagnosis on the same two lesion specimens by PCR assays for monkeypox, and also, specifically for the West African clade of monkeypox, the strain that re-emerged in Nigeria since 2017.

At this time, while the patient had remained in Lagos throughout the stay in Nigeria, the source of infection for this case is unknown.

This is the second time that an imported human monkeypox case has been detected in a traveler to the USA. The first imported human case in a traveler from Nigeria was reported on 15 July 2021 (for more information on the first case, please see the Disease Outbreak News published on 27 July 2021). In addition to these two cases, since 2018, six importations of human cases of monkeypox have been reported in non-endemic countries in travelers from Nigeria to Israel (one case), Singapore (one case) and the United Kingdom of Great Britain and Northern Ireland (four cases). The frequency of global travel indicates that further exported cases may be expected among travelers from endemic areas / countries. Additionally, there may be cases that are undetected, misdiagnosed, or not reported.

Public health response
The USA CDC is working with their international health counterparts, state, and local health officials to assess potential risks and to contact airline passengers and others who may have had contact with the patient on flights from Nigeria to Turkey and onwards to the USA, in transit, or after arrival in the USA. Travelers on these flights were required to wear masks due to the ongoing COVID-19 pandemic, the risk of spread of monkeypox via respiratory droplets to others on these flights is therefore considered low.

Public health measures are being taken, including isolation and continued monitoring of the patient’s clinical recovery. Possible contacts are being notified for assessment and monitoring by their local or state health department. Post-exposure vaccination with a smallpox vaccine within 14 days of the last contact with the case may be recommended for cases who are at intermediate and high risk.

Healthcare providers have been advised to be vigilant to poxvirus-like lesions, particularly among travelers returning from Nigeria. Because of the public health risks associated with a single case of monkeypox, clinicians should report suspected cases immediately to state or local public health authorities regardless of whether they are also exploring other potential diagnoses.

WHO risk assessment
Monkeypox is a sylvatic zoonosis with incidental human infections that usually occur sporadically in forested parts of Central and West Africa. It is caused by the monkeypox virus (MPXV) that belongs to the Orthopoxvirus family. Genomic sequencing shows there are two monkeypox clades – Congo Basin and West African and there have been observed differences in human pathogenicity and mortality in the two geographic areas. Both clades can be transmitted by contact and droplet exposure via exhaled large droplets or contact with fomites such as bedding; infection can be fatal in humans.

The incubation period for monkeypox is usually from 6 to 13 days but can range from 5 to 21 days. The disease is often self-limiting with signs and symptoms usually resolving spontaneously within two to four weeks. Signs and symptoms can be mild or severe, and lesions can be painful. Immune deficiency, young age, and pregnancy appear to be risk factors for severe disease. The case fatality ratio (CFR) for the West African clade has been reported to be around 1%. The recent outbreak in Nigeria recorded a higher CFR related to underlying conditions which may lead to immunodeficiency. A case fatality ratio of up to 11% (in individuals without prior smallpox vaccination) has been reported for the Congo basin clade.

Since 2017, a monkeypox outbreak has been occurring in Nigeria with 218 cases confirmed to date. In addition to Nigeria, outbreaks have also been reported in nine other countries in central and western Africa since 1970. These include Cameroon, Central African Republic, Cote d'Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Republic of Congo, Sierra Leone, and Sudan. Sporadic small outbreaks continue to occur in some of these countries including Cameroon and the Central African Republic. However, the vast majority of cases continue to be reported in the Democratic Republic of the Congo, with 2780 cases and 72 deaths (CFR 2.6%) reported between 1 January through 31 October 2021.

While a new vaccine has been approved for the prevention of monkeypox, and traditional smallpox vaccine has been demonstrated to provide protection, these vaccines are not widely available. Increased susceptibility of humans to monkeypox is thought to be related to waning immunity due to cessation of smallpox immunization. Contact with live and dead animals through hunting and consumption of wild game or use of animal-derived products are presumed sources of human infection. Milder cases of monkeypox in adults could go undetected, misdiagnosed, or unreported and represent a risk of human-to-human transmission.

There is likely to be little immunity to infection in those exposed as endemic disease is geographically limited to West and Central Africa and populations worldwide under the age of 40 or 50 years no longer benefit from the protection afforded by prior smallpox vaccination programmes. There is no specific treatment for monkeypox disease, and care is symptom-based optimal care. In some circumstances, treatment approved for smallpox may be offered on a compassionate or emergency use basis.

WHO advice
Any illness during travel in an endemic area or upon return should be reported to a health professional, including information about all recent travel and immunization history. Residents and travelers to endemic countries should avoid contact with sick, dead, or live animals that could harbor monkeypox virus (mammals including rodents, primates) and should refrain from eating or handling wild game or use of products derived from animals. The importance of hand hygiene using soap and water, or alcohol-based sanitizer should be emphasized.

A patient with monkeypox should be isolated during the infectious period, just prior to and including the rash stage of the infection and until all lesions have crusted and fallen off. Timely contact tracing, surveillance measures and raising awareness of endemic and imported emerging diseases among health care providers are essential parts of preventing secondary cases and effective management of monkeypox outbreaks.

Treatment for monkeypox is optimal care based on the patient’s symptoms and clinical condition.

Health care workers caring for patients with suspected or confirmed monkeypox should implement standard, contact and droplet infection control precautions. Samples taken from people and animals with suspected monkeypox virus infection should be handled by trained staff working in suitably equipped laboratories.

WHO does not recommend any restriction for travel to or trade with Nigeria, Turkey or the USA based on available information at this point in time.

5 things to know about monkeypox after a new case appeared in US [STAT, 11 Nov 2021]

By Helen Branswell

F or the second time this year, the United States has an imported case of monkeypox. A traveler from Maryland who had recently returned from Nigeria has been diagnosed with the dangerous illness, the Centers for Disease Control and Prevention said Wednesday.

The unidentified person is in isolation in Maryland, the CDC said in a statement. The Maryland Department of Health said in a statement that the individual has mild symptoms and is not in the hospital.

The earlier U.S. case this year occurred in Texas in July, also in a person who had traveled to Nigeria. There were no secondary cases from the Texas patient, though more than 200 people who had contact with the individual were monitored.

The CDC said it is working with the airline on which the passenger traveled, as well as state and local health authorities in the Washington, D.C., area to identify other passengers and people who may have been in contact with the infected person.

But the agency said it believes the risk of transmission during travel will have been lowered because people on flights are currently required to wear masks.

In recent years there have been a number of reports of exported monkeypox cases cropping up around the globe. Here are some facts about this rare disease:
The virus
Monkeypox is caused by a virus that is related to smallpox; both are Orthopox viruses.
Smallpox, once a common scourge, was declared eradicated in 1980.

Its name suggests it comes from monkeys, but that in fact is not the case. While the first time the virus was seen to cause an outbreak was in 1958, in a colony of research monkeys, the true reservoir of the virus remains unknown. A number of African rodent species are known to be susceptible to the virus and have been seen to be involved in its transmission. (More on this in a bit.)

The disease in humans
The incubation period for the disease — the time from exposure to the onset of illness — ranges from five to 21 days. People who are infected initially develop mild, flu-like illness — headache, fever, chills, and swollen lymph nodes. But a few days later, a rash will appear, often starting on the face. The rash will typically spread to other parts of the body, though mainly the extremities. Palms of the hands and soles of the feet are frequently affected.

Scarring lesions will form in a stage of the disease that can last between two and six weeks.
The disease can be deadly. In Africa, monkeypox has been fatal in about 1 in 10 cases, with severe disease and death more likely among children.

Spread to and among people
The virus transmits to people from infected animals, entering through cuts in the skin, the respiratory tract, or the mucous membranes around the eyes or in the nose and mouth.

A large outbreak in the United States in 2003 — the first time monkeypox was reported outside of Africa — saw 47 confirmed and probable cases reported from six different states.

The outbreak was linked to infected exotic pets imported from Ghana, which in turn infected some prairie dogs sold as pets.

Person-to-person transmission can occur, and is thought to occur mainly through virus-laced droplets. But direct contact with lesions or bodily fluids from an infected person, or indirect contact via contaminated clothing or linens, can also result in transmission.

Where it is found
The virus appears to be present in a belt of countries in West and Central Africa, with locally acquired cases reported from Sierra Leone, Liberia, Côte d’Ivoire, Nigeria, Cameroon, Gabon, Central African Republic, the Republic of Congo, and the Democratic Republic of the Congo.

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The United States, the United Kingdom, Israel, Benin, South Sudan, and Singapore have reported imported cases of monkeypox.

An unintended consequence of smallpox eradication
The WHO suggests that the risk of contracting monkeypox in countries where it is found may be greater in people middle-aged and younger — people who were not vaccinated against smallpox in childhood.

The eradication of smallpox led to the termination of routine smallpox vaccination around the world, which may have contributed to the increase in human cases in Nigeria that has been observed since 2017, Australian scientists suggested in a paper published earlier this year.

New Coronavirus News from 14 May 2022

This Activist Group Tapped Into Partisan COVID Politics To Make Big Trouble For Anthony Fauci And The NIH [BuzzFeed News, 14 May 2022]

by Peter Aldhous

The White Coat Waste Project has pulled the “lab leak” strings and channeled right-wing anger over COVID to pursue its goal of defunding animal experiments backed by the federal government.
As much of the United States entered COVID lockdowns in April 2020, a tiny group that campaigns against federal funding for animal experiments spotted an opportunity.

Speculation was swirling in right-leaning media that the virus behind the pandemic had emerged from a lab in Wuhan, China, rather than from wildlife sold for food in the city’s markets. As it happened, the White Coat Waste Project had been looking into taxpayer money going to labs in China, including in Wuhan. The group’s founder had strong contacts with Republican politicians and had launched the group with the mission of getting conservatives into animal activism.

The White Coat Waste Project sprung into action, persuading DailyMail.com to run a story saying the US government had funded the lab. Then all hell broke loose.

Then-president Donald Trump, keen to blame China for the pandemic, was soon involved. After prodding from the conservative outlet Newsmax at a press conference, his administration terminated the grant from the National Institutes of Health, which had been awarded to a New York–based nonprofit called the EcoHealth Alliance.

Since then, the controversy over whether the COVID pandemic started with a “lab leak” has escalated into a ferocious fight, with conflicting narratives that paint EcoHealth and the Wuhan Institute of Virology either as out-of-control scientists who may have caused the pandemic through inherently risky research or as the victims of politically motivated conspiracy theories, unfairly vilified as the architects of a catastrophe that they worked for years to prevent by studying the risks posed by bat coronaviruses.

Two years on, and with the scientific trail going cold, it’s possible that the mystery of the origins of SARS-CoV-2, the virus that causes COVID-19, may never be conclusively solved. But thousands of pages of NIH emails and other documents released to BuzzFeed News through a Freedom of Information Act lawsuit show how the White Coat Waste Project rode the wave of partisan pandemic politics to serve its cause, and in the process triggered a storm that engulfed EcoHealth, one of the world’s largest groups studying potentially dangerous animal viruses. They also show how the NIH, a behemoth that spends more than $40 billion annually on biomedical research, stumbled under the political pressure the White Coat Waste Project brought to bear.

The White Coat Waste Project has subsequently channeled right-wing anger toward Anthony Fauci, the public face of COVID policies including mask and vaccine mandates, accusing his National Institute of Allergy and Infectious Diseases, which is part of the NIH, of funding “beagle torture.” The White Coat Waste Project is writing a controversial new activist playbook — and it’s unclear whether anyone can control the forces that it has helped to unleash.

“They jumped on the bandwagon of how I have become public enemy number one of the far right,” Fauci told BuzzFeed News. “If you engage and try and push back on that, it very often only gives it legs. And then it becomes even worse of a problem.”

The White Coat Waste Project was formed in 2013 by Anthony Bellotti, a campaign consultant who over the years had worked for Republican candidates including Arnold Schwarzenegger and Lisa Murkowski, and on efforts to defund Planned Parenthood and Obamacare. But Bellotti’s real passion had long been animal protection, he told BuzzFeed News — an interest forged at the age of 17 when he worked as a summer intern in a lab doing research on pigs, studying ways to extend the time they could be kept under anesthesia during heart surgery.
Bellotti said he was struck both by the animals’ suffering and the “repugnant and callous attitude” of the experimenters. “It really made a mark on me,” he said.

Poring over polling data, Bellotti could see that there was a big gap between Democrats and Republicans on the issue. Democrats were much more likely to support campaigns against animal experiments, which had often focused on corporate labs, and Republicans tended to back the research. So Bellotti crafted a message calculated to bring the missing Republicans on board, focusing on government spending. He avoids the label “animal rights,” and has cast the White Coat Waste Project as a “taxpayer watchdog uniting liberty-lovers and animal-lovers.”

In addition to mobilizing support from the political right, there was another reason to target government spending: Congress has the power to shut it down. “The goal isn’t to change hearts and minds, it’s to win the fight,” Bellotti told BuzzFeed News. “We had to get to the root cause of the problem, which was the government spending.”

The group didn’t really take off until 2016, when Bellotti hired Justin Goodman, a former director of laboratory investigations with People for the Ethical Treatment of Animals, to head the White Coat Waste Project’s advocacy efforts. Goodman started digging into government databases and filing FOIA requests to identify projects that the group could campaign to defund.

Even before the pandemic, the White Coat Waste Project scored some victories. An early campaign, launched in a report called “Spending to Death,” highlighted experiments involving dogs in federal labs, including one studying the effects of blood transfusions in dogs with pneumonia in which some of the animals died. The group then turned up the heat on the Department of Veterans Affairs Medical Center in Richmond, Virginia, focusing on experiments into heart disease in which dogs were run on treadmills after their heart rhythms were disrupted using implanted pacemaker devices. The White Coast Waste Project’s multiyear effort to shut down Veterans Affairs dog research eventually led Congress to restrict spending on the work and demand explicit approval from the secretary for veterans affairs for new dog experiments by the agency.

White Coat Waste
The cover of the White Coat Waste Project’s 2019 report titled “USDA Kitten Cannibalism”
But it was another campaign that sowed the seeds for the attack on EcoHealth and its collaboration with the Wuhan Institute of Virology. In 2018, the White Coat Waste Project began to target the US Department of Agriculture’s Animal Parasitic Diseases Laboratory in Beltsville, Maryland, zeroing in on its research into toxoplasmosis, which can infect people exposed to cat feces and can cause brain or eye damage in those with compromised immune systems. The campaign culminated in a March 2019 White Coat Waste Project report called “USDA Kitten Cannibalism.” Its cover featured the Chinese flag superimposed over a photo of USDA’s headquarters in Washington, DC.

That framing drew on an experiment published in 2007 in which cats at the Maryland facility were fed meat from other cats purchased at a market in China to gauge its infectivity.
Although the full report noted that these experiments were no longer being run, the association between this gruesome-sounding research and a nation seen as a major adversary to the US resonated with members of Congress from both parties and with the media. Within a couple of weeks, the USDA announced that the cat toxoplasmosis research would be shut down, stating that it had “reached its maturity.”

After that win, Bellotti said that the White Coat Waste Project started to wonder about what else was being funded with taxpayer dollars outside of the US: “This is horrible stuff. What else is going on?” So Goodman started to look at research in foreign labs funded by the NIH, turning to a list of those given an “animal welfare assurance” needed to receive federal dollars for animal experiments. He focused particularly on labs in the US’s two main geopolitical rivals.
“One of the things that struck us was that there were at the time 31 labs in Russia and China,” Goodman told BuzzFeed News.

Dr. Fauci Just Said Something Every American Should Hear — Eat This Not That [Eat This, Not That, 14 May 2022]

By Michael Martin

Listen to what the nation's top infectious-disease expert has to say.
Right now, the CDC recommends that people over age 50 or who are immunocompromised get a second booster of the COVID vaccine. But what about everyone else? During testimony before a House budget panel on Wednesday, Dr. Anthony Fauci, the nation's top infectious-disease expert, talked about why second boosters are important for certain groups, and how long it may be before everyone is advised to get one. Read on to find out more—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

1 Vaccination Still Important
"If you look at the hospitalizations and the deaths of those who are unvaccinated compared to those who are vaccinated and boosted, the data are stunning, they're striking, the difference," said Fauci.

2 Boosters Are Needed
"In the era of Omicon, it is very clear that a boost is needed, a third shot," said Fauci. "If you look at both the durability of protection, there's no doubt—not only to natural infection from which you recover, but also from vaccination over a period of time—there's a waning of immunity."

"Other countries like Israel have really good data that when you get X number of months out, even from the third shot, you then get an increased risk, particularly among the elderly, and particularly among those with underlying conditions, of hospitalizations and death."

3 Who Should Get Boosted?
"The FDA and the CDC have said that people 50 years of age or older, are eligible for a fourth shot of an mRNA vaccine, not only the third boost, but the fourth shot right now," said Fauci.

Those recommendations may expand this fall. "The advisory committee to the FDA met and are looking at what the recommendations are going to be as we get to the fall, namely, what's going to happen when we get to September and October," he said. "It is very likely that all of us who've been vaccinated will have a diminution of the level of protection after a certain number of months. And it is likely that there will be recommended for everyone to get a boost then."

4 What About After That?
"Does that got to be every year, the way we do with flu? We don't know that right now," said Fauci. "Because of the fact that we're having different variants. But right now we're in an Omicron era, and the vaccines that we all got work pretty well … I think sometime in the middle of the summer, we're going to know what the cadence is going to be about how often we're going to have to vaccinate people."

5 How to Stay Safe Out There
Follow the fundamentals and help end this pandemic, no matter where you live—get vaccinated ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Reversing COVID-free claim, North Korea reports 'explosive' outbreak [Nikkei Asia News, 14 May 2022]

by JUNNOSUKE KOBARA

Pyongyang sounds out potential for help from abroad, with as many as 187,800 isolated
SEOUL -- Abandoning past boasts of no COVID-19 cases, North Korea reported Friday that up to 187,800 people are "being isolated and treated," spurring speculation of a severe outbreak and a desire for international assistance.

"A fever whose cause couldn't be identified explosively spread nationwide from late April" to affect more than 350,000 people, the official Korean Central News Agency reported Friday in a story acknowledging "the nationwide spread of COVID-19." At least 162,200 of them have fully recovered, KCNA said.

The country had long said it had zero cases.

Thursday alone saw around 18,000 cases of fever, according to the story. It said six people have died so far, with one of them testing positive for the highly contagious BA.2 subvariant of omicron.

"The situation is more dire than we had expected," a source in the South Korean president's office said Friday. The new president, Yoon Suk-yeol, has expressed interest in discussing potential assistance in vaccines with Pyongyang.

North Korea had never published detailed case numbers before. "It likely changed its policy in response to a rapid increase in infections across the entire country," said Yang Moo-jin, a professor at the University of North Korean Studies in Seoul.

"It's a message that it may ask international organizations for help with vaccines," said Yang, whose areas of interest include North Korean foreign policy.

Most North Koreans remain unvaccinated. In 2021, the country turned down a UNICEF offer to send shots developed by China's Sinovac Biotech. The U.S. also sounded out the North on potential vaccine assistance this January, though no shipments have been made.

The current outbreak is expected to further hurt North Korea's struggling economy. The country closed its border with China in 2020 in an attempt to keep out the virus, leading to a roughly 80% drop in bilateral goods trade. It reopened to freight trains this January, pushing goods trade up over 11-fold on the year to nearly $197 million in the first quarter, though it suspended traffic again in April.

North Korean leader Kim Jong Un has ordered a national lockdown in response to the spread of COVID-19 -- a step only expected to further squeeze economic activity.

Sanctions by the United Nations Security Council already heavily restrict North Korean imports of oil and electronics. Rainfall in the country was roughly 40% of the average in April, sparking concern of a drought.

"If the impact from the coronavirus continues to spread, North Korea will have no choice but to consider receiving aid from China, the U.S. and Europe," said Cheong Seong-chang, senior research fellow in the Department of Unification Strategy Studies at South Korea's Sejong Institute.

"The new government in South Korea is hawkish on Pyongyang, so cooperation between the two Koreas will not be easy, but assistance on vaccines could create an opening for dialogue," Cheong said.

Yoon will meet with U.S. President Joe Biden on May 21, while North Korea is scheduled to hold a key policymaking meeting for its Workers' Party Central Committee in June. COVID-19 could have a major impact on North Korean foreign and military policy in the coming months.

Kim Jong Un admits North Korea's COVID-19 outbreak is a 'great disaster' [Yahoo News, 14 May 2022]

by Alia Shoaib

North Korean leader Kim Jong Un said that the country's COVID-19 outbreak is a "great disaster," the BBC reported, citing state media.

"The spread of the malignant epidemic is [the greatest] turmoil to fall on our country since the founding," in 1948, Kim said during an emergency meeting on Saturday, according to state news agency KCNA.

North Korea said on Saturday that there had been over half a million cases of "fever" in recent weeks, just two days after claiming to have found its first ever COVID case and imposing a national lockdown.

The new figure marked an increase from the estimated 350,000 cases reported on Friday.
The country is especially at risk due to its under-resourced health system, limited testing capabilities, and an unvaccinated, poorly-fed population.

Kim called for an all-out battle to slow the spread of the virus during the meeting on Saturday, and urged the country to have faith in overcoming the crisis, per KCNA.

"If we don't lose focus in implementing epidemic policy and maintain strong organization power and control based on single-minded unity of the party and the people and strengthen our epidemic battle, we can more than overcome the crisis," Kim said.

The North Korean leader blamed the outbreak on bureaucratic incompetence, and said that lessons could be learned from China's response to the virus, Reuters reported.

Experts have warned that the numbers of cases in North Korea are likely to be much higher than the reported figures.

It is one of only two countries in the world not to have had a known COVID-19 vaccination program, and has previously refused offers of vaccines from China.

The country of 26 million people ranks last in the world for its ability to rapidly respond to and mitigate the spread of an epidemic, according to the latest Global Health Security Index in December, Reuters said.

New Coronavirus News from 15 May 2022

Over 1 million North Koreans mobilized to fight COVID-19 as outbreak continues [NK News, 15 May 2022]

by Ifang Bremer

'Fever' cases in the hundreds of thousands as Kim Jong Un attends funeral for Pyongyang elite Yang Hyong Sop

Fifteen more North Koreans have died after suffering from “fever,” state media reported on Sunday, while another 260,000 are afflicted by fever symptoms as the country battles a nationwide COVID-19 outbreak.

North Korea does not likely have the testing capacity to confirm positive COVID cases at a nationwide level, and appears to be using “fever” as a euphemism.

Over three dozen deaths and hundreds of thousands of cases have been attributed to fever since state media said last week that the omicron strain of COVID-19 spread from Pyongyang in late April.

The Rodong Sinmun reported on Sunday that some 1.3 million North Koreans have been mobilized to fight the spread of the virus, while the Korean Central News Agency said that “epidemic prevention posts” have been erected to “totally check the inroads and spread of the malignant virus.”

State media also continued to suggest that most deaths since the omicron outbreak began were not due to the virus but “careless” drug use due to “lack of knowledge and understanding of stealth omicron variant virus infection disease and its correct treatment method.”

The DPRK’s healthy ministry has started to compile “treatment guidelines, methods and tactics,” according to the state newspaper, while emergency meetings were held in Okryu Children’s Hospital and the Pyongyang Maternity Hospital.

Party officials have reportedly started donating “spare medicine” amid efforts to supply all parts of the country with sufficient medication. North Korea likely lacks the medical supplies to treat its population for COVID-19 symptoms, particularly after two and a half years of austere trade restrictions.

The Rodong Sinmun did not make any mention of a vaccine drive in the country, however, even though no North Koreans in the country are known to be vaccinated. South Korean President Yoon Suk-yeol has offered to help the North procure vaccines and other medical supplies.

North Korea first reported the outbreak of COVID-19 on May 12, after the highly contagious omicron variant had been detected a few days before.

Meanwhile, North Korean leader Kim Jong Un visited the bier of Yang Hyong Sop, one of the oldest members of the North Korean elite who died at the age of 96. State media did not mention COVID-19 in his obituary, but claimed the former vice president of the presidium of the Supreme People’s Assembly died of a stroke on May 13.

In a single photo carried by the Rodong Sinmun, Kim can be seen wearing what appears to be a black, 3D style mask of a seemingly higher grade than the mask he wore during a politburo meeting earlier this week.

What we know (and don't know) about North Korea's Covid outbreak [CNN, 15 May 2022]

By Nectar Gan, Gawon Bae and Helen Regan

(CNN)North Korea's first-reported Covid-19 outbreak is the "greatest turmoil" to befall the country since its founding more than 70 years ago, according to its leader Kim Jong Un, as the isolated and impoverished nation scrambles to curb the spread of a highly transmissible virus that risks causing a major humanitarian crisis.

North Korea reported 15 more deaths and 296,180 new "fever cases" between Friday and Saturday evening, according to state media KCNA, though it did not specify how many of the deaths and cases were linked to Covid, likely due to the country's extremely limited testing capacity.

The climbing death toll and surging "fever cases" come after North Korea said Thursday it had identified its first ever case of Covid-19 -- an alarming development for a country with one of the world's most fragile public health systems and a largely unvaccinated population.

But given the opaque nature of the regime and the country's isolation from the world -- a trend that has only exacerbated since the pandemic -- it is extremely difficult to assess the real situation on the ground.

Foreign diplomats and aid workers had fled North Korea en masse in 2021 due to shortages of goods and "unprecedented" restrictions on daily life, making it all the more impossible to obtain information from the country other than through official state media.

But North Korean state media reports have been vague, and many important questions remain unanswered, including the country's vaccine coverage and the lockdown's impact on the livelihood of its 25 million people.

Here is what we know, and what we don't know about the outbreak:
How did the outbreak emerge?

North Korean authorities have not announced the cause of the outbreak.

North Korea's borders have been tightly sealed since January 2020 to keep the virus at bay, making the so-called "hermit nation" even more isolated from the world. It even declined invitations to send teams to compete at the Tokyo and Beijing Olympics, citing the threat of Covid-19.

And as new variants began to emerge, it stepped-up those efforts, cutting off nearly all trade with China -- the country's biggest trading partner and economic lifeline for the Kim regime -- with imports from Beijing dropping 99% from September to October 2020.

It remains unclear how the virus slipped through the country's tightly-sealed borders.
When KCNA reported on the first identification of Covid-19 in the country on Thursday, it did not even specify how many infections had been defected. It simply said samples collected from a group of people experiencing fevers on May 8 had tested positive for the highly contagious Omicron variant.

By Friday, KCNA was reporting that 18,000 new "fever cases" and six deaths were recorded on Thursday, including one who tested positive for the BA.2 sub-variant of Omicron.

"A fever whose cause couldn't be identified explosively spread nationwide since late April," the newspaper said. "As of now up to 187,800 people are being isolated."

On Saturday, KCNA said a total of 524,440 people had reported "fever" symptoms between late April and May 13. Among them, 280,810 people were still being treated in quarantine, while the rest had recovered.

Can North Korea cope with a large-scale outbreak?
An outbreak of Covid-19 could prove disastrous for North Korea. The country's dilapidated health care infrastructure and lack of testing equipment is unlikely to be up to the task of treating a large number of patients with a highly infectious disease.

North Korea's lack of transparency and unwillingness to share information also poses a challenge.

North Korea has never formally acknowledged how many died during a devastating famine in the 1990s that experts suggest killed as many as 2 million. Those who fled the country at the time shared horrific stories of death and survival, and a country in chaos.

"North Korea has such a limited supply of basic medicine that public health officials need to focus on preventative medicine. They would be ill-equipped to deal with any kind of epidemic," Jean Lee, director off the Hyundai Motor-Korea Foundation Center for Korean History at the Washington-based Woodrow Wilson Center, told CNN at the outset of the pandemic.

Doctors who have defected in recent years often speak of poor working conditions and shortages of everything from medicine to basic healthcare supplies.

Choi Jung-hun, a former physician in North Korea who fled the country in 2011, said when he was helping to combat a measles outbreak in 2006 to 2007, North Korea did not have the resources to operate round-the-clock quarantine and isolation facilities.

He recalled that after identifying suspicious cases, manuals for doctors said patients were supposed to be transferred to a hospital or a quarantine facility for monitoring.

"The problem in North Korea is that manuals are not followed. When there wasn't enough food provided for the people at hospitals and quarantine facilities, people escaped to look for food," Choi said during an interview with CNN in 2020.

How is North Korea responding so far?
North Korean state media declared the situation a "major national emergency" upon admitting the first officially reported Covid infection.

On Thursday, Kim placed all cities into lockdown and ordered "people with fever or abnormal symptoms" into quarantine; he also directed the distribution of medical supplies the government had reportedly stocked in case of a Covid emergency, according to KCNA.

Kim later chaired a meeting of the country's powerful politburo, which agreed to implement "maximum" emergency anti-epidemic measures. The measures include isolating work units and pro-actively conducting medical checkups to find and isolate people with "fever and abnormal symptoms," the KCNA reported Friday.

"Practical measures are being taken to keep the production going at a high rate in the major sectors of the national economy and to stabilize the life of the people to the maximum," KCNA said.

According to KCNA, the politburo criticized the country's anti-epidemic sector for "carelessness, laxity, irresponsibility and incompetence," saying it "failed to respond sensitively" to increasing Covid-19 cases across the world, including in neighboring regions.

A reporter for Chinese state media CGTN released a rare video from Pyongyang on Friday, recounting his experience on the ground.

"As far as we know, not many people in Pyongyang have been vaccinated, and the medical and epidemic prevention facilities are in short supply," reporter Zang Qing said in a Weibo post.

"Because the capital is in lockdown, the food I have at home is only enough for a week. We are still awaiting what policy the government will announce next."

At a meeting Saturday, Kim inspected the country's emergency epidemic measures and medical supplies. He also urged North Korean officials to learn from China's "advanced and rich quarantine results and experience they have already achieved in their fight against the malicious infectious disease," according to KCNA.

What about North Korea's vaccine coverage?
North Korea is not known to have imported any coronavirus vaccines -- despite being eligible for the global Covid-19 vaccine sharing program, Covax.

Assuming most North Koreans are unvaccinated, an outbreak in the country -- which has limited testing capabilities, inadequate medical infrastructure and which has isolated itself from the outside world -- could quickly become deadly.

Calls are mounting on the country's leadership to provide access to vaccines.

"There is no evidence to show that North Korea has access to enough vaccines to protect its population from Covid-19. Yet, it has rejected millions of doses of AstraZeneca and Sinovac vaccines offered by the WHO-led Covax program," said Amnesty International's East Asia researcher Boram Jang, in a statement.

"With the first official news of a Covid-19 outbreak in the country, continuing on this path could cost many lives and would be an unconscionable dereliction of upholding the right to health."

In February, Covax reportedly scaled back the number of doses allocated to North Korea because the country failed to arrange for any shipments, according to Reuters.

A spokesperson for Gavi, the Vaccine Alliance, said Covax has moved to "needs-based vaccine allocations" and "has currently not committed any volume" for North Korea.

"In case the country decides to start a Covid-19 immunization program, vaccines could be made available based on criteria of Covax objectives and technical considerations to enable the country to catch up with international immunization targets," the spokesperson said.

New Coronavirus News from 13 May 2022

Omicron subvariants BA.4, BA.5 confirmed for 1st time in Japan at airport quarantine [The Mainichi, 13 May 2022]

TOKYO -- A total of three people infected with the BA.4 and BA.5 subvariants of the coronavirus's omicron strain have been confirmed at airport quarantine in Japan, the health ministry announced on May 12, the first time their existence has been confirmed in the country.

These strains had previously been detected mainly in South Africa, Europe, and the United States, and are more likely to spread than the BA.2 subvariant that is currently the mainstream in Japan.

BA. 4 was detected in a man in his 50s who arrived from South Africa on April 22, and BA. 5 was found in two men in their 60s who arrived from Spain and Zambia, respectively, on April 29. All three were asymptomatic at the time of arrival.

As for the omicron variant, BA.1, which sparked the sixth wave of coronavirus infections, and BA.2, which is now the mainstream, have been confirmed in Japan.

Hiroshi Nishiura, a professor of theoretical epidemiology at Kyoto University, presented data on the "effective reproduction number," which indicates how many people one person can spread the infection to, at a Ministry of Health, Labor and Welfare advisory board meeting on April 20.
According to this data, in South Africa, the effective reproduction number was found to be 1.49 times higher for BA.4 than for BA.1 and 1.4 times higher for BA.5 than for BA.1, and the spread of these subvariants is proceeding in that country.

(Japanese original by Sooryeon Kim, Lifestyle and Medical News Department)

Anthony Fauci at a Loss When Asked About Biden's COVID Vaccine Claim [Newsweek, 13 May 2022]

BY JAKE THOMAS

A nthony Fauci, the president's chief medical advisor, says he "just can't explain" a White House tweet stating the COVID-19 vaccine wasn't available when President Joe Biden took office.

Fauci made the remarks Friday to CNN's Jake Tapper, who asked him about the since corrected tweet that seemed to falsely give credit to Biden for the vaccine's development. The exchange comes as the Biden administration seeks to defend its record against withering criticism from political opponents.

During the segment, Tapper pointed to a Thursday tweet from the White House stating that "when President Biden took office, millions were unemployed and there was no vaccine available."

"But as you know, that's not true," said Tapper. "There was a vaccine available, it might not have been widely available, but it was available."

Tapper said that CNN fact-checker Daniel Dale found that more than 3 million Americans had been fully vaccinated and more than 18 million had at least one shot as of Biden's inauguration on January 20, 2021.

"Why is the White House politicizing the pandemic by tweeting out that there was no vaccine available until Joe Biden became president?" asked Tapper. "It's not true."

"So you're talking to the wrong person," deflected Fauci. "I wasn't involved in the tweet. I just can't explain it. Sorry."

Tapper responded by asking Fauci if he agreed it was important to have facts about the vaccine, "whether it's from the Trump White House or the Biden White House," and that the vaccine became available before Biden was sworn in.

Fauci agreed, adding, "I think from a pure accuracy, that's not a correct statement."

By Friday afternoon, the White House had corrected the tweet.

"We previously misstated that vaccines were unavailable in January 2021. We should have said that they were not widely available," the White House said in a follow-up tweet. "Vaccines became available shortly before the President came into office. Since then, he's responsible for fully vaccinating over 200 million people."

The U.S. Food and Drug Administration (FDA) first authorized the Pfizer-BioNTech COVID-19 vaccine on December 11, 2020. Developing a vaccine was a priority for then-President Donald Trump.

The vaccine was initially only available to people particularly vulnerable to the virus because of a medical condition, their age or occupation.

Currently, 66.4 percent of the U.S. population, 220 million people, is fully vaccinated, according to numbers from the Centers for Disease Control and Prevention (CDC).

Biden has seen sagging poll numbers going into the 2022 midterm elections amid high inflation and gas prices. Seeking to stem possible losses, the president and his allies have played up his administration's handling of the pandemic and how the U.S. has seen record-low unemployment numbers since he took office.

North Korea and Eritrea are the only two countries without vaccines [The Washington Post, 13 May 2022]

By Adam Taylor

North Korea admitted the inevitable this week — that covid-19 had finally reached its population. But for global health experts, there’s a particularly worrying detail: It is one of just two countries without any vaccines.

Are you on Telegram? Subscribe to our channel for the latest updates on Russia's war in Ukraine.

North Korea and Eritrea — both poor and led by brutal governments — have refused to join global vaccine-sharing initiatives, leaving their populations vulnerable to fast-spreading variants of the virus.

In Pyongyang, authorities Thursday attributed the outbreak to the highly contagious BA.2 omicron subvariant. On Friday, state media reported that one person had died and some 350,000 people had shown symptoms of fever.

Many health experts were already skeptical that North Korea had yet to report a single coronavirus case — more than two years into the pandemic. For its part, Eritrea has admitted about 10,000 confirmed coronavirus cases and 103 deaths, figures that are far lower than those of its neighbors.

North Korea admits to coronavirus outbreak for the first time
“North Korea, with a huge immunity gap — no protection acquired with vaccines or prior infections — is an open field for uncontrolled transmission, which maximizes the odds of new variants,” said J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies.

John P. Moore, professor of microbiology and immunology at Cornell University’s Weill Cornell Medicine, said in an email that unless North Korea was able to limit transmission through a lockdown, “a very high percentage of the population” would soon be infected.

“The carnage could be awful,” he said. “To the extent that it might affect the regime’s hold over the population.”

In both countries, rumors have swirled that the political elites are already vaccinated — and that their dismissal of foreign-made vaccines is just for show.

Eritrea, under longtime president and strongman Isaias Afwerki, has ignored requests by other African nations to join Covax, the global vaccination effort backed by the World Health Organization. Some activists say the country is rife with propaganda that paints Covax as a Western tool to destroy Africa.

In December, the head of the African Centers for Disease Control, John Nkengasong, said Eritrea was the only member of the African Union that had not “joined the family of 55 member states that are moving forward with vaccination, but we are not giving up.”

As world reopens, North Korea is one of two countries without vaccines
In North Korea, the government rejected doses of the AstraZeneca vaccine out of apparent concerns about potential side effects. It also turned down the delivery of nearly 3 million doses of China’s Sinovac vaccine, saying the shipments should go to other countries suffering more severe outbreaks.

Last month, a panel of experts convened by the Center for Strategic and International Studies recommended that North Korea be offered a high-volume donation of mRNA vaccines. But the vaccines previously allocated for North Korea under the Covax plan are no longer available.

Morrison said Covax and other donors had “grown weary” of North Korea’s nonresponsive nature during the pandemic. “That does not rule out revisiting the issues of what to do on a crash basis,” he added.

A spokesperson for Gavi, a nonprofit that helps coordinate Covax, said the initiative had “currently not committed any volume for” North Korea. But, the spokesperson said, if Pyongyang moves forward with a national vaccination program, Gavi could work with Covax to help North Korea catch up with immunization targets.

Pyongyang might not have a choice. Even in partially vaccinated places such as China or Hong Kong, omicron subvariants have spread incredibly fast among pockets of unvaccinated people — with deadly consequences similar in scale to the first wave of cases in other parts of the world.

China, North Korea’s most important ally, is battling a BA.2 outbreak and has imposed a severe lockdown on its commercial hub, Shanghai.

“China is itself struggling with the spread of the omicron variant, so I am not sure whether it has strong incentives to help North Korea battle covid,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.

A model released as a preprint this week estimated that if China relaxed what it calls its “zero covid” policy, the virus could kill up to 1.5 million people.

In North Korea, it would be “far worse,” Moore said, “because of the minimal vaccine uptake there.”

COVID-19 Finally Slipped Through North Korea’s Borders. Here’s What to Know About the ‘Explosive’ Outbreak [TIME, 13 May 2022]

BY CHAD DE GUZMAN

North Korea on Friday went public with its first “explosive” COVID-19 outbreak, reporting six fatalities and raising concerns about the hermit state’s defenses against the coronavirus after two years of claiming to have warded off infections.

The state-run Korea Central News Agency (KCNA) says that one of the six people who died had tested positive for the BA.2 subvariant of Omicron.

Up to 187,000 North Koreans are now reportedly being “isolated and treated” after some 18,000 developed a fever on Thursday. KCNA adds that a fever “whose cause couldn’t be identified explosively spread” since late April, appearing in some 350,000 people. It says that leader Kim Jong Un visited “the state emergency epidemic prevention headquarters” on May 12 and “learned about the nationwide spread of COVID-19.”

The situation may be worse than what is reported, says Leif-Eric Easley, associate professor of international studies at Ewha Womans University in Seoul. “People desperately need coronavirus vaccines and therapeutics,” Easley tells TIME.

According to the Yonhap news agency, South Korea plans to donate COVID-19 vaccines to the North. “We will hold discussions with the North Korean side about details,” a spokesperson for President Yoon Suk-yeol told the agency.

Until today, North Korea was among a handful of countries, including Turkmenistan and Tuvalu, that have not reported a case of COVID-19. Its borders have been closed since the start of the pandemic in early 2020.

It is also believed that the country has not administered COVID-19 vaccines to its 25 million people, having refused COVID-19 vaccines from global vaccine sharing program COVAX. In February, the WHO-led program scaled back North Korea’s allotment after millions of doses were rejected last year.

“There is no evidence that North Korea has access to enough vaccines to protect its population from COVID-19. Yet it has rejected millions of doses of AstraZeneca and Sinovac vaccines offered by the WHO-led COVAX program, which requires transparent distribution and monitoring,” says Amnesty International’s East Asia researcher Boram Jang.

North Korea shares a border with ally China, which is trying to stamp out infections with a stringent zero-COVID policy. Beijing on Thursday said it was “ready to go all out” to assist Pyongyang in combating the outbreak.

How COVID-19 could break North Korea
A COVID-19 outbreak may prove disastrous for North Korea. The country has poor medical infrastructure; a 2021 index assessing the epidemic and pandemic preparedness of 195 countries ranked North Korea at 193rd. Its seeming lack of a vaccination program makes its people more vulnerable to severe infections and death.

Jang says that if North Korea continues to pursue an isolationist strategy, it “could cost many lives” and would be an “unconscionable dereliction” of its duty to citizens. “It is vital that the North Korean government acts now to protect the right to health of one of the world’s populations with lowest access to vaccines and one of the most fragile health systems.”

There is no evidence that North Korea has access to enough vaccines to protect its population from COVID-19

Acording to the KCNA, Kim has criticized the spread of the disease in the capital Pyongyang, highlighting a vulnerable point in the epidemic prevention system. He has also ordered a swift lockdown and isolation of infected cases, but added that residents should be “provided with every convenience” in their attempt to curb the spread of COVID-19, the agency says.

North Korea’s two-year border closure has battered its economy, on top of the U.S.-led sanctions over the nuclear-armed country’s ballistic missile tests.

But the hermit state may be welcoming more outside help now. Ahn Kyung-su of Seoul-based research center dprkhealth.org said North Korea’s announcement signals its need for international support and that it needs COVID-19 medication more than vaccines. “This is because drugs are much simpler in terms of transportation, distribution and management personnel than vaccines.”

But according to Easley, engagement with Pyongyang won’t be easy. Says the international studies professor: “Even international humanitarian assistance has to navigate Pyongyang’s political pathologies.”

North Korea: 'First' Covid cases prompt strict national lockdown [BBC News, 13 May 2022]

By Frances Mao

North Korea has ordered a strict national lockdown after confirming its first official Covid infections.

State media have reported an Omicron outbreak in the capital, Pyongyang, but did not state the number of cases.

North Korea has rejected any kind of vaccine programme, even when offered a supply by other countries.

Instead, it controlled Covid by sealing its borders - and had never recorded a case, despite experts believing the virus has long been present.

Outsiders say the nation's 25 million population is vulnerable due to the lack of a Covid-19 vaccine programme, even rejecting offers from the international community to supply millions of AstraZeneca and Chinese-made Sinovac jabs last year.

There have also been concerns about North Korea's impoverished healthcare system.

KCNA said leader Kim Jong-un had vowed to eradicate the outbreak, which it called a "severe national emergency" that had breached the country's "quarantine front".

At the meeting outlining the new Covid rules, Mr Kim was seen wearing a face mask on television for what is believed to be the first time. He soon removed it, while other officials present kept theirs on.

North Korea's strategy of sealing its foreign borders - one of the first countries to do so, in January 2020 - has also stopped essential supplies from entering the country, leading to food shortages and a faltering economy.

On Thursday, KCNA said Mr Kim had ordered "maximum emergency" virus controls, which appeared to include orders for localised lockdowns and gathering restrictions in workplaces.

The North Korean news outlet added that the first case of the Omicron variant had been reportedly detected in the capital four days ago.

Residents in some areas of Pyongyang had been subjected to lockdown for at least two days before the latest announcement, according to NK News, a Seoul-based monitoring site.
South Korea's government said it has renewed its offer of humanitarian assistance to the North in response to the news of the outbreak. Pyongyang has yet to respond.

For more than two years, North Korea has, rather dubiously, claimed not to have a single case of Covid-19. So why admit to it now?

Most likely it is because this outbreak is too serious and too difficult to hide.

North Korea has been consistent in its public commitment to fighting the virus. This is how it has justified closing its borders for so long. Now that Omicron has entered the country, the challenge is to limit its spread.

With no vaccines, poor healthcare and a limited capacity to test people, North Korea's options are very limited right now.

Authorities have clearly decided they have no choice but to put the country into lockdown. In order to do this, they simply have to tell people and the rest of the world.

It does not necessarily mean they will be any more willing to accept outside help.

Analysts initially said Pyongyang's disclosure of the Covid cases at this time was significant and could hamper the state's nuclear ambitions, which have been on show this year.

But hours after the Covid announcement on Thursday, North Korea fired three short-range ballistic missiles about 360km (224 miles) towards the Sea of Japan/ East Sea, South Korea's military said.

North Korea has claimed to have conducted more than a dozen banned missile tests, including one of an intercontinental ballistic missile, a weapon it hadn't tested in more than four years.

Yang Moo-jin, a professor at the University of North Korean Studies, told AFP that North Korea might shelve plans for a nuclear test to focus on battling the outbreak, though if public fears escalated, Mr Kim may go ahead with a test "to divert this fear to another place".

But Leif-Eric Easley, a professor at Ewha University, said that North Koreans "may be less interested in nuclear or missile tests when the urgent threat involves coronavirus rather than a foreign military".

He added that he believed Pyongyang would "likely double down" on its lockdowns, given that it was entering a "period of uncertainty in managing its domestic challenges and international isolation".

Despite North Korea's claims that it had "shining success" in keeping out Covid, there have been signs throughout the pandemic of the virus' potential presence in the country. There were several unconfirmed reports of Covid cases previously.

In June last year, state media reported that Mr Kim had punished officials over a "grave incident" related to Covid, but did not specify details.

Then in September, the state held a military parade featuring lines of soldiers wearing hazmat suits and masks, which some analysts saw as a sign that a special force was created to help prevent the spread of Covid.

North Korea shares land borders with South Korea and China, which have battled outbreaks.
China is now struggling to contain an Omicron wave with lockdowns in its biggest cities.

California coronavirus updates: US may be vulnerable to COVID-19 come this fall and winter season [Capital Public Radio News, 13 May 2022]

Friday, May 13
11:23 a.m.: US may be vulnerable to COVID-19 come this fall and winter season
The new White House COVID-19 coordinator is issuing a dire warning.

Dr. Ashish Jha said in an Associated Press interview that the U.S. will be increasingly vulnerable to the coronavirus this fall and winter if Congress doesn’t swiftly approve new funding for more vaccines and treatments.

Jha said in the interview that America’s immune protection from the virus is waning, and with the virus adapting to be more contagious, booster doses will be necessary for most people.

He predicted that the next generation of vaccines, which are likely to be targeted at the currently prevailing omicron strain, “are going to provide a much, much higher degree of protection against the virus that we will encounter in the fall and winter.”

But he warned that the U.S. is at risk of losing its place in the global vaccination line to other countries if Congress doesn’t act in the next several weeks.

11:16 a.m.: This is what may be behind N. Korea’s COVID-19 admission
North Korea’s recent admission of its first domestic COVID-19 cases has surprised many outsiders and prompted speculation about how back the outbreak is and whether it could handle a major humanitarian crisis in a country where public medical infrastructure is terrible.

As reported by the Associated Press, some experts say North Korea may face one of the world’s worst per-capita fatality and infection rates if it doesn’t get outside aid shipments soon.
Others argue that North Korea may just want to use the outbreak to tighten public vigilance against the virus and boost its control of its people.

11:05 a.m.: N. Korea reports six deaths attributed to COVID-19
North Korea says six people have died and 350,000 have been treated for a fever that has spread explosively across the country.

According to the Associated Press, the announcement came a day after it acknowledged its first COVID-19 cases of the pandemic.

The hermitic country likely doesn’t have enough testing supplies and said the cause of the fevers was unclear. Experts have warned a COVID0-19 outbreak could be devastating in a country with a broken health care system and an unvaccinated, malnourished population.

Leader Kim Jong Un was shown on state TV at a pandemic response meeting, where he took off his face mask and smoked a cigarette while talking with officials.

Thursday, May 12
9:33 a.m.: Biden marks 1 million US COVID deaths in a global summit
President Joe Biden has appealed to world leaders for a renewed international commitment to attacking COVID-19 as he leads the U.S. in marketing the “tragic milestone” of 1 million deaths in America.

Biden told the second global coronavirus summit Thursday: “This pandemic isn’t over,” as reported by the Associated Press.

The virtual meeting comes as a lack of resolve at home reflects the global response. Biden ordered the U.S. flags to be flown at half-staff to honor the dead in America.

He used last year’s first summit to pledge to donate 1.2 billion vaccine doses worldwide.

There are a few official death totals floating around. According to figures complied by Johns Hopkins University, the coronavirus has killed more than 999,000 people in the U.S.

Other counts, including the American Hospital Association, American Medical Association and American Nurses Association, have the toll at 1 million.

9:26 a.m.: Creeping COVID-19 cases still result in very few mask mandates at school
U.S. coronavirus cases are up, leading a smattering of school districts, especially in the Northeast, to bring back mask recommendations and requirements.

As reported by the Associated Press, their return comes for the first time since the omicron winter surge ebbed and the United States approaches 1 million deaths from the virus.

Districts in Maine, New Jersey and Pennsylvania have brought masks back in schools, with a few in Massachusetts also recommending them.

The uptick in cases is a vast undercount because testing has dropped considerably and most tests are being taken at home and are not reported to health departments.

9:08 a.m.: North Korea confirms first COVID-19 outbreak, orders countrywide lockdown
North Korea has imposed a nationwide lockdown to control its first acknowledged COVID-19 outbreak of the pandemic, according to the Associated Press.

It had held for more than two years to a widely doubted claim of a perfect record keeping out the virus that has spread to nearly every place in the world.

The outbreak forced leader Kim Jong Un to wear a mask in public, likely for the first time since the start of the pandemic.

The size of the outbreak isn’t immediately known, but it could have serious consequences because the country has a poor health care system and its 26 million people are believed to be mostly unvaccinated.

Some experts say the North, by its rare admission of an outbreak, may be seeking outside aid such as vaccines and COVID-19 treatment pills.

Wednesday, May 11
10:05 a.m.: Los Angeles School District to postpone COVID-19 mandate
A COVID-19 vaccination mandate for students 12 and older in the Los Angeles Unified School District has been postponed from this fall to next year, as reported by the Associated Press.

The Board of Education voted Tuesday to delay the mandate to no sooner than July 1, 2023, aligning the district with the state.

Last year, California announced that it would require all schoolchildren to receive the coronavirus vaccine, and Gov. Gavin Newsom estimated it would take effect for the 2022-23 school year.

However, last month the Newsom administration put off the requirements to at least summer 2023 because school administrators worried they would not have enough time to implement the mandate.

9:53 a.m.: Pandemic infections are harder to track due to official testing plummeting
Testing for COVID-19 has plummeted globally, making it tougher for scientists to track the course of the pandemic and spot worrisome viral mutants as they emerge and spread.

Experts say testing has dropped by 70-90% worldwide from the first to the second quarter of this year, as reported by the Associated Press.

Rates are particularly low in low-income countries, however, that’s the opposite of what experts say should be happening with new omicron variants on the rise in places such as the U.S. and South Africa.

In the U.S., a shift toward home testing has also obscured efforts to track the virus.

9:43 a.m.: China defends their ‘zero-COVID’ approach
China on Wednesday defended sticking to its strict “zero-COVID” approach, calling critical remarks from the World Health Organization “irresponsible.”

According to the Associated Press, the response from the Foreign Ministry came after WHO Director-General Tedros Adhanom Ghebreyesus said he had been discussing with Chinese experts the need for a different approach in light of new knowledge about the virus.

Tedros said the policy characterized by strict lockdowns, mass testing and compulsory quarantining for anyone who tests positive or has contact with someone infected was not sustainable and urged China to change strategies.

Earlier Wednesday, a Shanghai health official said that while China’s largest city has seen progress, any relaxation in anti-virus measures could allow the outbreak to rebound.

Tuesday, May 10
9:38 a.m.: In rare cases, some who took Pfizer’s COVID-19 pill have gotten infected again
A small number of COVID-19 patients are relapsing after taking Pfizer’s antiviral pill, raising questions about the drug at the center of the U.S.' response effort.

Paxlovid has become the go-to option against COVID-19 because of its at-home convenience and impressive results in heading off severe disease.

According to the Associated Press, the U.S. government has presented more than $10 billion to purchase enough pills for 20 million people.

However, doctors have begun reporting cases of patients who see their symptoms return several days after treatment — making it one of the several questions about how the drug is holding up against a changing virus.

Pfizer mainly studied the drug in unvaccinated patients during the delta variant wave, but most Americans now have had at least one shot as omicron variants dominate the outbreak.

8:56 a.m.: Here’s how COVID-19 pills work

COVID-19 patients have two treatment options that can be taken at home, but that convenience comes with a catch — the pills have to be taken as soon as possible once symptoms appear.

The challenge for patients is getting tested, getting a prescription and then starting the pills within five days of the start of symptoms, according to the Associated Press.

U.S. regulators authorized the pills from Pfizer and Merck late last year. Both were shown to reduce the chances of hospitalization or death from COVID-19 in high-risk patients.
The pills are intended for those with mild or moderate COVID-19 who are more likely to become seriously ill.

8:52 a.m.: Norway discards excess COVID-19 vaccines as demand declines in low-income countries

Norwegian health authorities say the country has a surplus of COVID-19 vaccines and has already discarded more than 137,000 doses because there is declining demand in low-income countries.

According to the Associated Press, the Norwegian Institute of Public Health said that it plans a further disposal of doses if global demand does not change.

In Norway, there’s high vaccine coverage, while globally a demand for donations has fallen.
Earlier this month, health officials in neighboring Denmark said that 1.1 million excess COVID-19 vaccines would be discarded because their expiration date is near, and efforts to donate them to developing countries have failed.

Monday, May 9
10:16 a.m.: Employers added nearly 430,000 jobs last month despite inflation
America’s employers added 428,000 jobs in April, extending a streak of solid hiring that has defied punishing inflation, chronic supply shortages, the Russian war against Ukraine and much higher borrowing costs.

According to the Associated Press, last month’s hiring kept the unemployment rate at 3.6%, just above the lowest level in a half-century.

Employers have added at least 400,000 jobs for 12 straight months. Still, the job growth, along with steady wage gains, will help fuel consumer spending and likely keep the Federal Reserve on track to raise borrowing rates sharply to fight inflation.

That would lead to increasingly heavy borrowing costs for consumers and businesses. Higher loan rates could also weigh down corporate profits.

10:11 a.m.: New York City plans to continue some outdoor car-free areas set up during pandemic

As New York City forges ahead with its recovery, the pandemic is leaving lasting imprints, especially on city roadways — less room and for cars and more space for people, as reported by the Associated Press.

As the COVID-19 outbreak ravaged New York City two years ago, the bustling metropolis found itself transformed into grids of mostly deserted streets and sidewalks as businesses shuttered and virus-wary denizens shut themselves in.

Now the city is drafting new rules that would allow eateries to make outdoor dining permanent, although the policy is being challenged in court. The city is also announcing plans to close off even more streets to vehicles on Sundays, so pedestrians have more room to roam in warmer months.

9:44 a.m.: Italy and Greece welcome back tourists after relaxing pandemic restrictions
For travelers going to southern Europe, summer vacations just got a lot easier.

According to the Associated Press, Italy and Greece have relaxed some COVID-19 restrictions before Europe’s peak summer tourist season as life increasingly returns to normal after the pandemic.

Greece’s civil aviation authority announced Sunday it was lifting all COVID-19 rules for international and domestic flights except for wearing face masks during flights and at airports.

Air travelers were previously required to show proof of vaccination, a negative test, or a recent recovery. Italy did away with the health pass that had been required to enter restaurants, cinemas, gyms and other venues.

Visitors to Italy also no longer have to fill out the EU passenger locator form, a complicated ordeal.

Sunday, May 8
10:13 a.m.: FDA restricts J&J COVID-19 vaccine due to rare blood clotting risk
U.S. regulators strictly limit who can receive Johnson & Johnson’s OVID-19 vaccine due to a rare but serious risk of blood clots.

According to the Associated Press, the Food and Drug Administration said Thursday the shot should only be given to adults who cannot receive a different vaccine or specifically request J&J’s vaccine.

The decision is the latest restriction to hit the company’s vaccine, which has long been overshadowed in the U.S. by the more effective shots from Pfizer and Moderna.

In December, the Centers for Disease Control and Prevention recommended using the Moderna and Pfizer shots over J&J’s because of its safety issues.

Saturday, May 7
10:59 a.m.: Nevada governor sets May 20 date to lift state of emergency
Nevada Gov. Steve Sisolak says that in two weeks, he’ll lift the state of emergency he declared during the early days of the coronavirus pandemic more than two years ago, according to the Associated Press.

In a statement on Friday, the Democrat who is running for a second term credited the declaration with giving the state flexibility to respond to challenges as they arose.

He put a May 20 end date to the statewide emergency he declared on March 12, 2020. Most measures, including business restrictions and mask mandates, have already been lifted.
As of the end of this week, state health officials have reported just over 665,000 known cases of COVID-10 and almost 10,800 deaths.

Friday, May 6
9:38 a.m.: Californian bill to allow preteens to get vaccinated without parental consent advances

A California measure that would allow children age 12 and up to be vaccinated without their parents’ consent, including against the coronavirus, has cleared its first legislative committee.

According to the Associated Press, if the proposal that advanced Thursday becomes law, California would allow the young people of any state to be vaccinated without parental permission.

Minors aged 12 to 17 in California currently cannot be vaccinated without permission from their parents or guardians unless the vaccine is to prevent a sexually transmitted disease.

Democratic Sen. Scott Wiener’s proposal is perhaps the most continuous measure remaining from lawmakers’ once-ambitious agenda after several other proposals lost momentum as the winter pandemic wave eased.

9:19 a.m.: A look at the nearly 1 million COVID-19 deaths in the US

The count of U.S. deaths from COVID-19 is nearly 1 million, and there’s a wealth of data that clarifies which groups have been hit the hardest.

According to the Associated Press, more than 700,000 people 65 and older died. Men died at higher rates than women, and white people made up most of the deaths overall.

Despite this, an unequal burden fell on Black, Hispanic and Native American people considering the younger average age of minority communities.

Racial gaps narrowed between surges and then widened again with each new wave. Most deaths happened in urban counties, but rural areas also paid a high price.

9:12 a.m.: China cancels the Asian Games due to omicron spreading
The Asian Games in China are being postponed because of concerns about the spreading omicron variant of COVID-19, as reported by the Associated Press.

The decision comes less than three months after the country hosted the Winter Olympics and Paralympics.

The World University Games have also been postponed. The Asian Games were to take place from Sept. 10-25 in the eastern city of Hangzhou and would involve more than 11,000 athletes — that’s more than the Summer Olympics.

The World University Games had been scheduled for June 26 - July 7 in the western city of Chengdu.

Thursday, May 5
10:13 a.m.: WHO estimates nearly 15 million excess deaths during with COVID-19 pandemic
The World Health Organization is estimating that nearly 15 million people were killed either by the coronavirus or by its impact on overwhelmed health systems in the first two years of the pandemic.

According to the Associated Press, that’s more than double the current official death toll.
In a report released on Thursday, the U.N. health agency said that most of the fatalities were in Southeast Asia, Europe, and the Americas.

Accurately counting COVID-19 deaths have been problematic as reports of confirmed cases represent only a fraction of the devastation wrought by the virus. This could be attributed to limited testing and global differences in how countries count COVID-19 deaths.

9:56 a.m.: Pfizer is trying to get their young children's vaccine approved by the FDA
Pfizer now hopes to tell U.S. regulators how well its COVID-19 vaccine works in children under 5 by early June, according to the Associated Press.

Currently, only children ages 5 or older can be vaccinated in the U.S. using Pfizer's vaccine.

Rival Moderna hopes to be the first to offer vaccinations to the youngest children and began filling its own data with the Food and Drug Administration last week.

The FDA has set tentative meetings in June to review data from one or both companies.
9:47 a.m.: COVID-19 health care coverage dries up despite US still being in the pandemic phase

For the first time, the U.S. came close to providing health care for alll for the first time during the coronavirus pandemic, but just for one condition — COVID-19.

Now, things are reverting to how they were as federal money for the uninsured dries up, as reported by the Associated Press.

Lack of an insurance card could become a barrier to timely care for COVID. A $20 billion government program that paid the pandemic bills of uninsured people has been shut down.

Special Medicaid COVID coverage likely faces its last months, even though the virus is not yet contained. To exacerbate matters, safety-net hospitals and clinics are seeing sharply higher operating costs. They fear they won’t be prepared if there’s another surge.

Wednesday, May 4
9:52 a.m.: Shasta County Board of Supervisors fires county health officer
The Shasta County Board of Supervisors voted to terminate county Health Officer Dr. Karen Ramstrom by a 3-2 vote during its closed session on Tuesday, and the announcement was made public soon after.

In a letter addressed to the community and published in A News Cafe on Friday, Ramstrom wrote that she believed the board would consider her termination during this week’s meeting but that she had been given no notice that her performance was unsatisfactory.

“My performance review did not mention anything suggesting that my job was in jeopardy, and I have no specific information from the Board that my job performance was unsatisfactory in any way,” she wrote.

Ramstrom has frequently come under fire by some members of the community during board meetings for upholding COVID-19 safety measures and mandates. In her letter, she wrote that she and her colleagues had been no more restrictive than the state required.

9:37 a.m.: CDC restates recommendation for masks on public transportation
Despite a court ruling last month that struck down a national mask mandate on public transportation, U.S. health officials are restarting their recommendation that Americans wear masks on planes, trains, and buses.

As reported by the Associated Press, the Centers for Disease Control and Prevention on Tuesday issued a statement saying people age 2 and older should wear a well-fitting mask when traveling in public spaces, like buses.

Last month, a federal judge in Florida struck down a government requirement for masking in public transportation. The Justice Department is appealing the decision.

9:25 a.m.: Despite COVID-19 cases increasing, mask mandates still seem off the table
As mask mandates and vaccination rules kept falling across the U.S., infections from the latest COVID variants have quietly taken hold in some places, sparking concern among public health officials.

According to the Associated Press, more cities are now in a new high-risk category that is supposed to trigger indoor mask-wearing, but there’s been little appetite to do so.

Nationally, hospitalizations are up slightly but still as low as at any point in the pandemic.
Deaths have steadily decreased to nearly the lowest numbers in the last three months.
The muted response reflects the country's exhaustion after two years of restrictions and the new challenges that health leaders are facing at this phase of the pandemic.

An abundance of at-home virus test kits has led to a steep undercount of COVID-19 cases, which is an important benchmark.

Tuesday, May 3
9:39 a.m.: Kamala Harris tests negative for COVID-19 six days after testing positive
Vice President Kamala Harris tested negative on Monday for COVID-19, six days after she tested positive for the virus, according to the Associated Press.

She has been cleared to return to the White House on Tuesday. Harris press secretary Kirsten Allen said Harris, who was prescribed the antiviral treatment Paxlovid last week, was negative on a rapid antigen test.

Allen said Harris would continue to wear a “well-fitting mask while around others” in accordance with the Centers for Disease Control and Prevention guidelines until her tenth day after her positive test.

9:31 a.m.: California’s population shrank second year in a row
Officials have announced that California’s population shrank in 2021 for the second year in a row, according to a new estimate from the California Department of Finance.

As reported by the Associated Press, state officials say California lost 117,552 people in 2021, giving it a population of just over 39 million residents.

California is still far ahead of Texas, which is No. 2 for population size in the U.S.

State officials blame the loss on a declining birth rate and more deaths because of the pandemic. Also, fewer people are moving from other states to California.

9:13 a.m.: Beijing shuts indoor dining during holiday to stem COVID-19 infections
Restaurants in Beijing have been ordered to close dine-in services over the May holidays as the Chinese capital grapples with a COVID-19 outbreak, according to the Associated Press.

Authorities said at a recent news conference that dining in restaurants has become an infection risk, cting virus transmissions between diners and staff.

Restaurants have been ordered to only provide takeout services from Sunday to Wednesday, during China’s Labor Day holidays.

Beijing began mass testing millions of residents earlier this week. Parks and entertainment venue are allowed to operate only at half capacity.

The stakes are high as the ruling Communist Party prepares for a major congress this fall at which President XI Jinping is seeking a third five-year term as the country’s leader.

Monday, May 2
9:22 a.m.: CDC says 60% of US adults have previously been infected with COVID-19
Most people in the U.S., including most children, have now been infected with COVID-19 during the omicron surge, according to a new study from the Centers for Disease Control and Prevention.

NPR reports that at a briefing for reporters last Tuesday, the CDC’s Dr. Kristie Clarke said so many people caught omicron over the winter that almost 60% of everyone in the country now has antibodies to the virus in their blood.

That number is even higher for children — almost 75% of kids 11 and younger have antibodies to the virus.

Clarke said the finding means many people have at least some immunity to the virus but stresses that people should still get vaccinated since it still provides the strongest, broadest protection against getting seriously ill.

Immunity provided solely by a previous infection may or may not be as protective against severe disease.

9:18 a.m.: Here’s what to do if you test positive for COVID-19 while traveling
COVID-19 rules for travelers will vary depending on the destination, but testing positive for the virus could result in an unexpected change in plans, such as being required to stay isolated in a hotel.

As reported by the Associated Press, the U.S. Centers for Disease Control and Prevention warns that travelers going overseas should make contingency plans since they may have to stay longer than planned if they test positive.

Travel companies suggest getting insurance that covers the cost of recovery or isolation.

Those who do end up needing medical treatment are advised to check with their embassy for suggested health care providers.

8:55 a.m.: COVID-19 pandemic has changed office fashion
After working remotely in sweats and yoga pants for two years, many Americans are rethinking their wardrobes to balance comfort and professionalism as some offices reopen.

According to the Associated Press, they’re dropping structured suits, zip-front pants and pencil skirts worn before the pandemic and are experimenting with new looks.

Retailers and brands are rushing to meet workers’ fashion needs for the future of work with blazers in knit fabrics, pants with drawstrings or elastic bands, and casual twists on the button-down dress shirt.

The New York Times Explainer-How N.Korea's COVID-19 outbreak could ignite a major health crisis [Reuters, 13 May 2022]

By Soo-Hyang Choi and Josh Smith

SEOUL, May 13 (Reuters) - North Korea's admission that it is battling an "explosive" COVID-19 outbreak has raised concerns that the virus could devastate a country with an under-resourced health system, limited testing capabilities, and no vaccine programme.

The isolated North confirmed on Thursday its first COVID-19 infections since the pandemic emerged more than two years ago, shifting to the "maximum emergency epidemic prevention system" and imposing a national lockdown. On Friday it reported its first COVID-related death.

State media have not confirmed the total number of COVID-19 cases so far, but said that more than 350,000 people have shown fever symptoms since late April.

NO VACCINATION, LIMITED TESTING Along with Eritrea, North Korea is one of only two countries that have not started a vaccination campaign against COVID-19, according to the World Health Organization (WHO).

The COVAX global COVID-19 vaccine-sharing programme cut the number of doses allocated for North Korea as the country has so far failed to arrange for any shipments, reportedly over international monitoring requirements.

Pyongyang also declined offers of vaccines from China.

The latest reported assessment of whether leader Kim Jong Un was vaccinated was from July 2021, when South Korea's spy agency said there were no signs he had received a shot.
North Korea said last year it had developed its own polymerase chain reaction (PCR) equipment to conduct coronavirus tests, and Russia has said it had delivered small numbers of test kits.

But North Korea is heavily sanctioned over its nuclear weapons programme, and since 2020 has maintained strict border lockdowns that have blocked many supplies.

Experts said that so far the pace of testing suggests North Korea cannot handle the number of symptomatic cases it has reported.

As of the end of March, only 64,207 of North Korea's 25 million people had been tested for COVID, and all the results were negative, the latest WHO data shows.

"North Korea has been testing around 1,400 people each week. Assuming they were at their peak capacity, then they can perform 400 tests per day max - not nearly enough to test 350,000 people with symptoms," said Harvard Medical School’s Kee Park, who has worked on health care projects in North Korea.

It's unclear whether North Korea has imposed any mask mandates since the pandemic began. Citizens were at times seen wearing masks, but also going mask-free at some major political events that mobilized tens of thousands of people.

Kim was shown for the first time wearing a mask at the COVID response meeting on Thursday.

MEDICAL SYSTEM LACKS SUPPLIES
North Korea ranks last in the world for its ability to rapidly respond to and mitigate the spread of an epidemic, according to the latest Global Health Security Index in December.

Although it has a high number of trained doctors and the ability to rapidly deploy and organise staff in the face of emergencies, North Korea's health care system is chronically under-resourced.

Every North Korean village has one or two clinics or hospitals, and most county hospitals are equipped with X-ray facilities, "though not necessarily functional ones," the WHO said in its 2014-2019 Country Cooperation Strategy report.

Kwon Young-se, South Korea's new nominee to be the unification minister, responsible for inter-Korean ties, said at his confirmation hearing on Thursday the North is believed to lack even the most basic medical supplies such as painkillers and disinfectants.

An independent U.N. human rights investigator reported in March that the North's COVID-19 restrictions, including the border closings, could have prevented massive outbreaks "though likely at considerable cost to the wider health situation."

"Chronic issues plague the country’s healthcare system, including under-investment in infrastructure, medical personnel, equipment and medicine, irregular power supplies and inadequate water and sanitation facilities," the report said.

POTENTIAL 'NIGHTMARE'
The outbreak could pose a political challenge for the North's authoritarian leader, North Koreans who had defected to the South said.

"Kim ordered the mobilization of reserve medical supplies, which means in North Korea they will now use war reserves and that general hospitals have ran out of medicines," said Thae Young-ho, a former North Korean diplomat who defected to the South in 2016 and is now a lawmaker.

Ji Seong-ho, another South Korean lawmaker who left the North in 2006, said the virus could spread rapidly, due partly to the lack of a working medical system.

"An enormous number of people died during the (1990s) famine after typhoid broke out. It was a nightmare for the North Korean regime, and for the North Korean people," Ji told a parliamentary session.

The New York Times Surge in Virus Cases Puts Most of New York State on High Alert [The New York Times, 13 May 2022]

By Lola Fadulu

How Long Covid Exhausts the Body

New coronavirus cases surged in most counties in New York State this week, putting them on “high” alert under Centers for Disease Control and Prevention guidelines and triggering recommendations for indoor masking, including inside schools.

The state refrained from imposing an indoor mask mandate, but health officials on Friday afternoon did urge residents living in counties that have been placed on “medium” or “high” alert to wear masks in indoor spaces, regardless of vaccination status.

“These public health measures, as well as ensuring proper air ventilation when gathering, will help reduce Covid-19 transmission in communities and lower the risk of serious illness and hospitalization for individuals,” the state health commissioner, Dr. Mary T. Bassett, said in a statement.

As of Thursday, the average of new cases stood at more than 10,000 a day, according to a New York Times database. New cases have increased 47 percent over the past two weeks, and hospitalizations have increased 28 percent over that time period, to an average of more than 2,600 a day.

As of Thursday, the seven-day average of daily deaths stood at 20, up from 15 two weeks ago, according to the Times database.

How cases, hospitalizations and deaths are trending in New York

New York City was one of the few places in the state where transmission rates have not risen high enough to trigger a higher alert level, according to the C.D.C.’s data. But new virus cases have increased 82 percent in New York City over the past 14 days, with the daily average standing at over 4,300, according to the Times database. Hospitalizations have increased 30 percent in the city over the same time period, to a daily average of 835.

Mayor Adams, who has focused on rolling back a number of pandemic policies in an effort to reopen the city, called the rise a “slow uptick.”

“Our hospitals and deaths — those numbers are really at a solid place,” he said at a news conference on Friday. “We’re going to be prepared and not panicked.”

Case counts in New York City’s school system have moved steadily upward, too. The daily average of new cases reported last week in the public school system was 1,216, raising alarm among some parents.

“The health and safety of our students and staff is our top priority,” Jenna Lyle, a spokeswoman for the Department of Education, said in a statement. “We will continue to follow the science and adjust if needed, putting the health and safety of our students and staff first.”

Known cases are far lower than they were during the winter, when the state was first struck by the highly contagious variant of the virus, Omicron, and cases in city schools reached around 14,000 in January.

However, Denis Nash, an epidemiologist at the CUNY Graduate School of Public Health, noted that testing is much lower than it once was. And widely used home tests are not usually reported. Both factors mean that case numbers could be much higher than the official counts.

About 77 percent of people are fully vaccinated in the state, a figure that rises to 79 percent in New York City. Covid-19 treatments available to certain at-risk populations may also be reducing the number of serious cases and keeping hospitalization rates relatively low.
“We have very good vaccination coverage and, although booster coverage hasn’t been so great, it’s been stable for a while,” said Dr. Nash.

“I think that we don’t yet know if we could absorb a big surge in transmission without seeing a substantial increase in hospitalizations and deaths,” he added.

If hospitalizations and deaths begin to rise quickly, government officials should consider “some reinstatement of measures to protect New Yorkers,” Dr. Nash said.

North Korea COVID-19 Cases Surge To 350,000 From 1 In Single Day - Benzinga [Benzinga, 13 May 2022]

byNavdeep Yadav,
North Korea Reports COVID-19 Cases Surging To 350,000 From 1 In Single Day Ahead Of Biden Asia Visit

At least six people have died due to COVID-19, and more than 350,000 are infected in North Korea as an "explosive" coronavirus outbreak takes a toll on the isolated nation, the country's state media KCNA confirmed, according to CNN.

This comes a day after North Korean leader Kim Jong-un confirmed the first-ever COVID-19 case in the hermit kingdom.

What Happened: North Korea is reporting COVID-19 cases for the first time since the pandemic started in 2020.

Experts believe that given North Korea's limited testing capabilities, the numbers it is reporting represent a small fraction of the infections, Reuters reported.

They also reportedly predicted that this could lead to thousands of deaths in one of only two countries without a COVID-19 vaccination campaign.

Why It Matters: For more than two years, North Korea claimed to have kept the situation at bay by imposing a rigid COVID-19 blockade of its borders.

North Korea fired three short-range ballistic missiles toward the sea in the middle of this reported outbreak, according to the Associated Press. The Biden administration has said the country could be preparing for a nuclear test ahead of the U.S. president's Asia visit.

Joe Biden is expected to be in Japan and South Korea from May 20-24.

N.Korea reports first COVID-19 death after 350000 sickened with fever [Reuters.com, 13 May 2022]

By Hyonhee Shin and Josh Smith

SEOUL, May 13 (Reuters) - At least one person confirmed to have COVID-19 has died in North Korea and hundreds of thousands have shown fever symptoms, state media said on Friday, offering hints at the potentially dire scale of country's first confirmed outbreak of the pandemic.

About 187,800 people are being treated in isolation after a fever of unidentified origin has "explosively spread nationwide" since late April, the official KCNA news agency reported.

Roughly 350,000 people have shown signs of that fever, including 18,000 who newly reported such symptoms on Thursday, KCNA said. About 162,200 have been treated, but it did not specify how many had tested positive for COVID-19.

At least six people who showed fever symptoms died, with one of those case confirmed to have contracted the Omicron variant of the virus, KCNA said.

North Korean leader Kim Jong Un visited the anti-virus command centre on Thursday to check the situation and responses after declaring a "gravest state of emergency" and ordering a national lockdown on Thursday.

North Korea has said the outbreak began in the capital of Pyongyang in April. State media did not elaborate on the cause of the outbreak, but the city hosted several massive public events on April 15 and 25, including a military parade and large gatherings where most people did not wear masks.

Kim "criticised that the simultaneous spread of fever with the capital area as a centre shows that there is a vulnerable point in the epidemic prevention system we have already established," KCNA said.

Kim said actively isolating and treating people with fevers a top priority, while calling for scientific treatment methods and tactics "at a lightning tempo" and bolstering measures to supply medication.

In another dispatch, KCNA said health authorities were trying to organise testing and treatment systems and bolster disinfection work.

The rapid spread of the virus highlights the potential for a major crisis in a country that lacks medical resources, has refused international help with vaccinations and has kept its borders shut.

Analysts said the outbreak could threaten to deepen the isolated country's already tough food situation this year, as the lockdown would hamper its "all-out fight" against drought and the mobilisation of labour.

North Korea had declined vaccine supplies from the COVAX global sharing programme and China, possibly leaving the vast majority of people in a relatively young society at higher risk of infection.

Kwon Young-se, South Korea's new nominee to be the unification minister, responsible for inter-Korean ties, said at his confirmation hearing on Thursday that he was willing to push for humanitarian assistance for the North, including COVID treatment, syringes and other medical supplies.

A U.S. State Department spokesperson said it had no plans to send vaccines to North Korea but supported international efforts to provide aid to vulnerable people there, urging Pyongyang to facilitate that work.

New Coronavirus News from 12 May 2022b

Full interview: Dr. Anthony Fauci shares what he’s learned throughout the COVID pandemic [WDIV ClickOnDetroit, 12 May 2022]

by Kayla Clarke

Local 4′s Dr. Frank McGeorge sat down with Fauci

Before Dr. Anthony Fauci delivered the commencement address to the University of Michigan class of 2020 and 2021, he sat down with Local 4′s Dr. Frank McGeorge.
Their conversation about the COVID pandemic was very candid. They had a wide-ranging discussion at the University of Michigan School of Public Health.

They talked about what he felt was important to press on new graduations, to being accused of flip-flopping on his recommendations and a controversial comment he recently made.

How do we avoid public health and medicine being so heavily politicized in any future pandemic or public health emergency?

One of the ways to avoid that, if we possibly can, is to try and feed into the system as much correct information as we possibly can, because it’s very interesting that the people that tweet falsities seem to have more energy of tweeting falsities than the people who are talking about true things.

You’ve basically been accused of flip-flopping on your positions. Can you clarify why some of those nuanced opinions are really important?

Yeah, what I can say, it’s a good thing. I have flip-flopped and the reason is because science and the evolution of this outbreak changes.

If you are being true to the facts and true to the data, you’re going to have to change. That’s not flip-flopping, that’s getting moving along with the science the way this outbreak is moving along. And it’s understandable how the general public doesn’t fully understand that.

You recently said on PBS News, that we were out of the pandemic phase and then you essentially updated that to save the data out of the full-blown pandemic right now. You received a fair amount of pushback on that statement. It feels to me like there are many people that are reasonably afraid to be optimistic going forward. What are your thoughts on that?

Well, I was being quite realistic and I could still stand by what I said. I mean, I probably could’ve used the better wording so that it would not be misunderstood by some people.

So, what I meant, is that we’re not in . . . in that explosive phase of the pandemic, we’re at a phase where it’s much, much lower. And I hope we stay at that level and continue go down. I wasn’t saying the pandemic is over by no means is it over. Not in the United States and certainly not globally.
________________________________________
In his full interview (available above), Fauci gave many other interesting answers -- including his thoughts on why children may be less affected by COVID.

Eritrea: Announcement From the Ministry of Health [AllAfrica - Top Africa News, 12 May 2022]

Four patients have been diagnosed positive for COVID-19 in tests carried out today at Testing Stations in the Central Region.

Accordingly, the total number of confirmed cases in the country to date has risen to 9,744.

The total number of recovered patients stands at 9,632 while the number of deaths stands at 103.

Ministry of Health
Asmara

North Korea faces its first covid outbreak without any vaccines [The Washington Post, 12 May 2022]

By Adam Taylor

North Korea admitted the inevitable this week — that covid-19 had finally reached its population. But for global health experts, there’s a particularly worrying detail: It is one of just two countries without any vaccines.

North Korea and Eritrea — both poor and led by brutal governments — have refused to join global vaccine-sharing initiatives, leaving their populations vulnerable to fast-spreading variants of the virus.

In Pyongyang, authorities Thursday attributed the outbreak to the highly contagious BA.2 omicron subvariant. On Friday, state media reported that one person had died and some 350,000 people had shown symptoms of fever.

Many health experts were already skeptical that North Korea had yet to report a single coronavirus case — more than two years into the pandemic. For its part, Eritrea has admitted about 10,000 confirmed coronavirus cases and 103 deaths, figures that are far lower than those of its neighbors.

North Korea admits to coronavirus outbreak for the first time
“North Korea, with a huge immunity gap — no protection acquired with vaccines or prior infections — is an open field for uncontrolled transmission, which maximizes the odds of new variants,” said J. Stephen Morrison, director of the Global Health Policy Center at the Center for Strategic and International Studies.

John P. Moore, professor of microbiology and immunology at Cornell University’s Weill Cornell Medicine, said in an email that unless North Korea was able to limit transmission through a lockdown, “a very high percentage of the population” would soon be infected.

“The carnage could be awful,” he said. “To the extent that it might affect the regime’s hold over the population.”

In both countries, rumors have swirled that the political elites are already vaccinated — and that their dismissal of foreign-made vaccines is just for show.

Eritrea, under longtime president and strongman Isaias Afwerki, has ignored requests by other African nations to join Covax, the global vaccination effort backed by the World Health Organization. Some activists say the country is rife with propaganda that paints Covax as a Western tool to destroy Africa.

In December, the head of the African Centers for Disease Control, John Nkengasong, said Eritrea was the only member of the African Union that had not “joined the family of 55 member states that are moving forward with vaccination, but we are not giving up.”

As world reopens, North Korea is one of two countries without vaccines In North Korea, the government rejected doses of the AstraZeneca vaccine out of apparent concerns about potential side effects. It also turned down the delivery of nearly 3 million doses of China’s Sinovac vaccine, saying the shipments should go to other countries suffering more severe outbreaks.

Last month, a panel of experts convened by the Center for Strategic and International Studies recommended that North Korea be offered a high-volume donation of mRNA vaccines. But the vaccines previously allocated for North Korea under the Covax plan are no longer available.

Morrison said Covax and other donors had “grown weary” of North Korea’s nonresponsive nature during the pandemic. “That does not rule out revisiting the issues of what to do on a crash basis,” he added.

A spokesperson for Gavi, a nonprofit that helps coordinate Covax, said the initiative had “currently not committed any volume for” North Korea. But, the spokesperson said, if Pyongyang moves forward with a national vaccination program, Gavi could work with Covax to help North Korea catch up with immunization targets.

Pyongyang might not have a choice. Even in partially vaccinated places such as China or Hong Kong, omicron subvariants have spread incredibly fast among pockets of unvaccinated people — with deadly consequences similar in scale to the first wave of cases in other parts of the world.

China, North Korea’s most important ally, is battling a BA.2 outbreak and has imposed a severe lockdown on its commercial hub, Shanghai.

“China is itself struggling with the spread of the omicron variant, so I am not sure whether it has strong incentives to help North Korea battle covid,” said Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.

A model released as a preprint this week estimated that if China relaxed what it calls its “zero covid” policy, the virus could kill up to 1.5 million people.

In North Korea, it would be “far worse,” Moore said, “because of the minimal vaccine uptake there.”

North Korea Did an Amazing Job of Keeping Covid Out. Or It Lied. [Bloomberg, 12 May 2022]

By Jon Herskovitz

Few health experts believe North Korea managed to keep out Covid-19 since early 2020. So when Kim Jong Un officially confirmed the nation’s first case on Thursday, the question was more: “Why now?”

Kim has long trumpeted his virus-control measures as evidence of his nation’s superiority, calling the efforts as a “shining success.” He sealed the border, crippling an already anemic economy, and banned athletes from two Olympics. To keep the disease out, his troops even shot, killed and burned the body of a South Korean government employee who drifted near a nautical border.

All along, outsiders speculated that Covid was already in North Korea, despite its isolation. The commander of US Forces Korea said as early as July 2020 the virus had almost certainly made its way into the country, and both China and Russia had reported outbreaks near their borders with North Korea.

Now, after 520 million cases have been reported around the world, North Korea has acknowledged that Covid indeed has arrived -- leaving Turkmenistan as the only nation still claiming to have zero cases. Kim, wearing a mask, ordered all cities to lock down Thursday after a hastily called Politburo meeting.

North Korea watchers said Kim likely disclosed the outbreak because it’s too big to hide, and it’s more important now to appear like he’s responding quickly. He has reason to worry that it could be devastating: North Korea has so far refused all foreign vaccines, leaving its 26 million people vulnerable to even mild strains in a nation where healthcare is already unreliable.

The decision to come clean about infections likely indicated that it would no longer “be plausible to continue with their zero-Covid claims,” Ankit Panda, a senior fellow in the nuclear policy program at the Carnegie Endowment for International Peace, wrote on Twitter.

A widespread outbreak in the capital Pyongyang, where about one in 10 North Koreans live, would hit elite members of the regime who are relatively more informed about global affairs. A lockdown in the city this week led to panic buying in stores and long lines for public transport, specialist service NK News reported on Thursday, citing sources on the ground.

Still, Kim is likely confident the outbreak can be managed, according to Rachel Minyoung Lee, a non-resident fellow with the 38 North Program at the Stimson Center.

“The North Korean leadership likely felt that acknowledging an outbreak in a timely manner -- and showing the public that the leadership was responding quickly -- was necessary for effectively controlling the situation and seeking the people’s cooperation in the regime’s stepped-up quarantine efforts,” said Lee, who worked as an analyst for the CIA’s Open Source Enterprise for almost two decades.

There are plenty of places where the virus could’ve entered North Korea. While airports have largely been shut during the pandemic, the regime reopened a rail link with China in January and black-market traders frequently cross the border. A United Nations body has said satellite images show sea traffic at its main international port of Nampho, and illicit trade is conducted on open seas in violation of sanctions.

In the meantime, North Korea has held several large-scale gatherings, including a military parade last month that included tens of thousands of maskless soldiers, a maskless leader and maskless masses.

Kim Jong Un Puts ICBMs on Parade With Vow to Expand Nuke Program
Still, North Korea should be able to keep the public in order. It maintains one of the most repressive systems on the planet, with a slew of political prisons for those who fall out of line or dare to question the legitimacy of its leaders. The regime was able to weather a famine in the 1990s that some estimates said killed as many as 3.5 million people over a number of years.

‘Comrade, Neighbor and Friend’
Over the course of the pandemic, Kim’s regime has tried to show its people that it takes public health seriously, even going to extremes to make the point. In July 2020 it locked down the border city of Kaesong out of fear a person who defected from South Korea may have carried the virus. It investigated the military unit responsible for patrols and pledged to “administer a severe punishment” to those responsible, official media said.

China Foreign Ministry spokesman Zhao Lijian on Thursday said Beijing could help Pyongyang in its fights against the virus.

“As the DPRK’s comrade, neighbor and friend, China is ready to provide all out effort for the DPRK’s fight against pandemic at any time,” Zhao told a regular briefing in Beijing, referring to North Korea by its formal name.

‘More Dangerous Enemy’
The latest in global politics

It’s unclear if that would include vaccines. North Korea’s official media has included commentary that vaccines may not prove effective against new virus variants -- potentially an attempt to paper over the country’s lack of doses. The propaganda apparatus has focused on showing Kim thoroughly engaged in halting infections, perhaps to deflect blame to lower ranking officials if the disease spreads.

KCNA echoed that line on Thursday.

Even as Kim expressed confidence that North Korea would beat the virus, he said the “more dangerous enemy” was “unscientific fear, lack of faith and weak will.”

Ukraine war, COVID: How German society is divided [DW (English), 12 May 2022]

by Marcel Fürstenau

How polarized is Germany? This question is controversially discussed at the European Police Congress. Result: It depends on who you ask.

At the European Police Congress in Berlin, the topic of debate is "divided society," and a politician, a psychologist, a police chief, and a digital expert sat down to discuss the issue. Four people, four opinions? Katrin Göring-Eckardt, a member of the Green Party and Vice President of the German Bundestag, kicks things off: "There's no reason to talk about the division in society."

Psychologist Ahmad Mansour disagrees: "We are a divided society."

Göring-Eckardt insists that "the vast majority in our country still stands behind democracy." But also acknowledges "very noisy groups" such as enemies of Ukraine, Putin-understanders, and COVID deniers have made their presence felt. The noise they make sometimes leads to "the talk of a divided society." So things aren't so bad? That's not how the politician wants to be understood: Enemies of democracy must be watched very closely and punished if they become criminals.

Everyone agrees on that, but Mansour sees another problem: The defamation of dissenters has become such a common problem that one has to say: "Our society needs a massive basic course in discourse culture." He believes there is a tolerance problem in how discussions are conducted. "That's a very big danger to democracy," he argues.

'We are always the buffer stop'
Britta Zur, police chief of Gelsenkirchen, in the state of North Rhine-Westphalia, agrees with Göring-Eckhardt: "The majority in our society remains civil and does not violate any laws," she says. But stresses that the police must be vigilant, which should include a transparent, open police force that makes it clear "that we have no place for extremists, either outside our organization or inside."

To live up to this claim as much as possible, the force that Britta Zur heads is very active on social media. But she has no illusions about the role of the police: "We are always the buffer for very, very many people who are insecure, who are dissatisfied, who have perhaps also started to radicalize." Speaking for instance about protests against COVID measures, she says, "My colleagues are the ones who are on the street and have to deal with contrarians."

The dispute over heavy weapons for Ukraine
Göring-Eckardt sees it similarly: COVID, the climate crisis, the war in Ukraine — all of these put people "under insane stress." But that's not why she would say society is divided. In her role as a politician, she often sees herself in a dilemma: The expectation of having to react to everything very quickly means that background information and motives don't play any role at first.

The discussion about military support for Ukraine is just such a case, especially from the Green Party's perspective. Göring-Eckardt is in favor of the delivery of heavy weapons, but: "This is not an easy decision, but a very difficult one." She says it was necessary to explain what arguments and facts had led to this decision.

'Two hours on Twitter, that's exhausting'
In this context, Göring-Eckardt is critical of communication via social media. "Two hours on Twitter, that's already very exhausting." What fake news can trigger, she said, is currently being experienced on a massive scale from the Russian side. "We are confronted with statements where "You can see at first glance that this is nonsense," she says. But people don't like to leave their bubbles.

Ahmad Mansour also advocates heavy weapons for Ukraine. "But I also have to put up with other people disagreeing with me." He finds this ability lacking among many. The willingness to engage in dialogue decreases when it comes to issues such as refugees, integration, COVID or Russia, he says. The digital revolution has not "led to us becoming smarter."

Why isn't media literacy a school subject?
Mansour emphasizes that his aim is not to demonize social media. He has long wondered why media literacy is still not a central subject in schools. Even seven- and eight-year-olds are on the move on smartphones in social media and YouTube "and yet they are not able to distinguish between fake news and truth." Britta Zur agrees, saying that young people need to be taught that there are many sources of information. "That's a big task for all of us."

Digitization expert and philosopher Nikolai Horn concludes that polarization is part of the "DNA of democracy," he says. He is skeptical, however, about the increasing emotionalization, "where many people refuse to be convinced by a good argument." But social media, he says, should not be made a scapegoat in the debate.

2nd Global COVID-19 Summit Commitments [The White House, 12 May 2022]

The second Global COVID-19 Summit, co-hosted by United States, Belize, Germany, Indonesia, and Senegal, convened over partners and organizations from around the world to accelerate collective efforts to get shots into arms, enhance access to tests and treatments, protect the health workforce, and finance and build health security for future pandemics and other health crises.

The Summit garnered new financial commitments totaling $3.2 billion, not yet announced, above and beyond pledges made to date in 2022. This includes nearly $2.5 billion for COVID-19 and related response activities and $712 million in new commitments toward a new pandemic preparedness and global health security fund at the World Bank. (Note: This builds on $250 million previously pledged for this fund.) We encourage partners to join, as much more is needed to control COVID-19 and build better health security.

Commitments[1] from Government, Other Partners, and Entities
Note: Country text is being validated with host governments and is not yet final.

• African Union: Will expand and continue its Saving Lives and Livelihoods Program to purchase COVID-19 vaccines for the African people, support the delivery of the vaccines, and support vaccination rollout programs at country level and increase vaccine manufacturing in Africa in partnership with Africa CDC and the Mastercard Foundation and other partners. Will also, through coordination by Africa CDC, strengthen public health institutions, increase local capacity for producing medical products, strengthen the health workforce, and establish action-oriented partnerships through its New Public Health Order Program.

• Australia: Pledged additional AUD $85 million in 2022 to COVAX and has delivered on the first half of its commitment made at the first Global COVID-19 Summit, to share 60 million vaccine doses by the end of 2022. Announced a AUD 375 million second phase for the Health Security Initiative for the Indo-Pacific region as well as committed AUD 100 million to the Coalition for Epidemic Preparedness Innovations.

• Austria: In 2022, committed to provide EUR 1.6 million annually to CEPI from 2022-2024 for a total of EUR 4.8 million. Delivering up to 14 million vaccine doses by mid-2022. Committed to remain active in donating vaccines and providing financial support and emergency assistance.

• Belgium: Will provide an additional EUR 15 million for COVID-19 vaccination efforts, including EUR 10 million for the ancillary costs needed for vaccine delivery and EUR 5 million for COVAX.

• Belize: Will accelerate efforts to vaccinate 70% of the population by September 2022 and promote boosters for at risk populations. Will support an extensive public education campaign to overcome vaccine hesitancy. Will construct a BZE1 6.8 million hospital to better serve community health needs and to expand and provide an additional BZE 3.2 million to the National Health Insurance Program.

• Brazil: The Government of Brazil reaffirmed its commitment to donate $86.7 million to COVAX AMC, adding to the 5.6 million doses it has already donated. It further underscored its success in vaccinating more than 77 percent of the Brazilian population against COVID and supplementing its national health system with an extra $20 billion.

• Belize: Will accelerate efforts to vaccinate 70% of the population by September 2022 and promote boosters for at risk populations. Will support an extensive public education campaign to overcome vaccine hesitancy. Will construct a $16.8 million hospital to better serve community health needs and to expand and provide an additional BZE 3.2 million to the National Health Insurance Program.

• Botswana: Commits to vaccinate at least 80 percent of its population according to the Country’s National Vaccine Deployment plan, implementing the second stage of Phase 4 (5–12-year-olds) by mid-2022 pending successful consultation. Commits to sharing lessons learned on its success with other countries to help them reach Botswana’s levels of vaccination success , the third highest vaccination rate in Africa. Will continue to focus on improving and accelerating vaccine uptake and coverage. Commits to setting policy to offer and avail free treatment to all people who are infected with COVID-19, have mild to moderate as well as severe illness, or are at risk for death due to risk factors, with treatment modalities are based on Botswana’s updated treatment guidelines. Commits to manufacturing COVID-19 vaccines to improve local and regional equitable vaccines supply chain by the end of 2022, drawing lessons from the global demand-supply mismatch and non-equitable distribution of vaccines.

• Canada: Will provide CAD 732 million in funding for the Access to COVID-19 Tools-Accelerator (ACT-A), enabling Canada to meet its fair share for the 2021-2022 ACT-A budget cycle, assessed at CAD 747 million. This funding includes a previous allocation of CAD 220 million to the COVAX Advance Market Commitment (AMC), announced by the Prime Minister on April 8, 2022 at the Gavi COVAX AMC Summit, and builds on the CAD 15 million announced by the Prime Minister on October 30, 2021, in support of COVAX Manufacturing Task Force partners. Canada is contributing to the international pandemic response and will continue to work with partners to ensure that we strengthen our collective ability to prevent, prepare and respond to disease outbreaks going forward.

• Colombia: Will continue to vaccinate the nearly 2 million Venezuelan migrants in Colombia and other vulnerable populations. Will share lessons learned on linking joint efforts with the private sector. Will provide technical assistance for mass vaccination campaigns, to improve supply chain logistics, and for surveillance of possible adverse events related to vaccination. Will also contribute to the discussions within the WHO on ways to strengthen prevention, preparedness, and response to pandemics. Will make efforts to increase the number of migrants registered in the social security system from 400,000 to 700,000 in 2022.

• Côte D’Ivoire: Will increase vaccine demand creation and uptake, and accelerate vaccine coverage while immediately prioritizing fully vaccinating and providing boosters to key sub-populations such as teachers, healthcare workers, people with comorbidities, and adolescents. Will strengthen genomic sequencing to identify new variants. Will expand and sustain health system capacity and financing; increase domestic health budgets; and improve funds disbursement to enable timely salary, incentive, and other supportive payments for health care workers. Committed to continue promoting the One Health approach and strengthening the national One Health platform.

• Denmark: Will provide over USD 10 million for vaccine rollout via ACT-A (COVAX). Minister Møller Mortensen expressed support for strengthening WHO and support for WHO agreement on pandemic preparedness, prevention, and response.

• European Union: The European Union budget will provide 300 million euro for vaccination support. Will provide 100 million euro for other ACT-A pillars. Will provide $450 million USD for the pandemic preparedness and global health security financial intermediary fund at the World Bank.

• France: Will provide EUR 220 M: 100 million euros to COVAX, 50 million euros to ACT-A, and 70 million euros to strengthen vaccine production capacity in developing countries, including Rwanda, Senegal, and South Africa.

• Georgia: According to the National Vaccine Deployment Plan, intends to vaccinate at least 65% of population by mid-2022. Will use the Financial Incentives scheme to continue to motivate citizens over 50 years old. Pediatric doses of Covid-19 vaccine will be made available for 5-12 year old kids In order to provide access to novel drugs, will continue to procure antivirals the treatment of mild Covid-19 patients with the high risk of hospitalization in March 2022. Has extended its COVID-19 vaccination and treatment program for all Ukrainian citizens who entered the country after the war crisis. Is implementing an active information and communication campaign with support from USAID, WHO, European Commission and other international partners. Commits to a full program accelerating vaccine coverage while immediately prioritizing fully vaccinating and providing boosters to at-risk populations, accelerating vaccine coverage for vulnerable populations, saving lives with access to tests and treatments, supporting health and frontline workers, and expanding and sustaining health capacity and financing including support for the establishment of a global health security and pandemic preparedness fund.

• Germany: Will contribute EUR 50 million toward the establishment of a new global health security and pandemic preparedness fund housed at the World Bank. Committed EUR 1.1 billion to ACT-A’s 2021/2022 replenishment cycle earlier in 2022 and an additional EUR 224 million for bilateral projects to help increase vaccine uptake. Part of Germany’s overall contribution are EUR 850 million targeted support for vaccine logistics and strengthening of absorption capacities, especially in African countries (“LastMile Initiative”) bilaterally and multilaterally through ACT-A. All contributions are subject to parliamentary approval.

• India: Will continue to extend boosters coverage to eligible populations and expand vaccinations to those under age 18, and continue working towards complete vaccination coverage for India’s adult population. With the increased funding allocated for the 2022-2023 domestic health budget, will provide insurance coverage for healthcare workers, increase the number of health and wellness centers. Will increase the number of integrated public health and regional disease control laboratories, as well as bio-safety labs. Is increasing zoonotic surveillance, and will continue to supply vaccines and work on extending a SARS -CoV2 genomic consortium to neighboring countries.

• Indonesia: Will provide $5 million to CEPI for the period of 2022-2026, adding to the $1 million contribution made in 2020. Will continue accelerating vaccination efforts to achieve the WHO vaccination goal of the 70% population, including for the 189 million people of Indonesia by June 2022, while ensuring equitable access to vaccines across income and age groups, and those most at risk. Earmarked Rp122,54 trillion of the 2022 national budget to continue vaccination efforts, care for COVID-19 patients, provide health worker and tax incentives, and support local governments. As Co-Chair of COVAX AMC EG, commits to contribute to the global effort to ensure equitable access to vaccines and getting shots in arms, and to increase local and regional vaccine production capacity and research capability, including for vaccines beyond COVID-19 pandemic, including through the use of WHO mRNA technology hubs. In the framework of ACT-A, will continue to accelerate global equitable access to vaccines, therapeutics, diagnostics, and PPE through its roles as Co-Chair of the Tracking and Accelerating Progress Working Group and as Member of the Facilitation Council, the Financial and Resource Mobilization Working Group, and the Vaccine Manufacturing Working Group. As G20 President, supports the establishment of a new financing facility to ensure adequate and sustained financing for pandemic prevention, preparedness and response, with a central coordinating role of the WHO, and supported by the World Bank and in close cooperation with international partners. Commits to strengthen the central role of WHO in coordinating global health actions through leadership in the Working Group on Strengthening WHO Preparedness and Response to Health Emergencies together with the United States. Through multilateral cooperation , seeks political and financial support for developing countries, including as Co-Host of COVAX AMC Summit and Second Global COVID-19 Summit, and ACT-A diplomatic outreach with likeminded partners.

• Italy: Will donate an additional 31 million doses through COVAX and pledge 200 million euros via the ACT-Accelerator and in order to strengthen global preparedness.

• Japan: Will contribute up to $500 million to COVAX and expand the scope of the Last One Mile Support of additional $30 million US dollars to 17 new Latin American and the Caribbean and African countries. Pledges to contribute $300 million to CEPI. Will provide assistance of up to $200 million USD through JICA to enhance local production capacity for pharmaceutical and medical products including vaccines in Africa. Total contributions increase from $3.9 billion USD announced at the first Summit to $5 billion USD.

• Liechtenstein: Provided CHF 300,000 to COVAX in 2022.

• Nepal: Will accelerate vaccine coverage and immediately prioritize fully vaccinating and providing boosters to at-risk populations. Will provide a detailed plan and targets at the national and sub-national level for getting shots into arms and overcoming key barriers for at-risk populations, and will track and report on full vaccination and booster rates by key subgroups. Will designate a “high-level leader” to coordinate with donors, multinational development banks, and the COVID-19 vaccine delivery partnership. Will also develop a national and community level strategy to expand access to testing and prompt treatment, focusing on those at highest risk and integrating COVID-19 testing /treatment with existing health systems, and will update relevant testing and treatment guidelines. Will improve and expand community access to testing and treatments and pharmacovigilance programs. Will support health and frontline workers by providing PPE and water, sanitation, and hygiene access, and training.

• New Zealand: Will provide NZD 2.25 million to UNICEF to fund COVID-19 diagnostics in Vietnam and to maintain essential health services in the Philippines, and NZD 8 million to the Global Fund’s COVID-19 Response Mechanism for lifesaving tests, treatments and personal protective equipment. Will continue its support in the Pacific region to enable access to and uptake of vaccines within comprehensive public health responses to the COVID-19 pandemic, as well as continuing its support for health security and health systems strengthening.

• Nigeria: Will support vaccination efforts for 112 million citizens above age 18 towards a vaccination goal of 70% of the population being vaccinated by December 2022. Will expand access to COVID 19 testing and treatment, focusing on those at highest risk, and will integrate testing/treatment into existing health systems while prioritizing COVID-19 for monthly reporting on the Integrated Disease Surveillance and Reporting system platform. Will train an additional 10,000 frontline healthcare workers by December 2022 on basic infection prevention and control measures, ensuring availability of oxygen, and eliminate stock-outs of PPE. Will strengthen laboratory capacity for genomic sequencing and specimen bio-banking for both diagnostics and surveillance activities, and will implement a national bio-bank policy. Will designate highest-level leadership to coordinate relevant government sectors to achieve these goals, in collaboration with the international community and its development partners, and will progressively increase domestic health budgets. Will promote businesses in Nigeria to integrate health security into organizational policies and business goals.

• Norway: Provided USD 222 million to the 2021/2022 budget cycle of ACT- A. Supports establishing a global health security and pandemic preparedness fund housed at the World Bank.

• Pakistan: Will accelerate vaccine coverage from 82 percent to 90 percent and provide boosters to eligible and at-risk populations, including school-aged children eligible for vaccines (age 12-18), by summer 2022. Plans to launch a second iteration of its robust national vaccination campaign in late May, striving to vaccinate hard-to-reach populations.

• Palau: Will maintain a proactive and robust response to the ongoing pandemic, maintain and enhance existing services and plans including non-COVID essential services, and will strengthen social protection programs for the vulnerable and affected population.

• Philippines: The Philippine government committed to measures to boost efforts for expanding health care capacity that adheres to global standards, to adopt systematic approaches for effectively implementing emergency programs, and to develop a Comprehensive Pandemic Response Framework that will safeguard the country from future pandemics.

• Republic of Korea: Will provide $300 million USD for ACT-A over 3 years, from 2023-2025. This builds on the $212 million USD committed to ACT-Accelerator since its launch. Support developing countries move toward vaccine self-sufficiency by establishing WHO Global Biomanufacturing Workforce Training Hub. Express political support for the pandemic preparedness and global health security fund at the World Bank.

• Rwanda: Will vaccinate five- to eleven-year-old children with at least one dose by the end of 2022 and will vaccinate at least seventy percent of the total population with the primary series (two shots) by June 2022. Will double booster coverage from thirty percent to sixty percent of those eligible, and will continue to expand the Government of Rwanda’s capacity to locally manufacture vaccine.

• Saudi Arabia: Provided $2.8 million to the WHO in 2022 to provide logistical support for vaccine delivery in order to vaccinate ten percent of Yemenis.

• Senegal: Commits, with Institut Pasteur de Dakar (IPD), to facilitating the new $200 million Madiba (Manufacturing in Africa for Disease Immunization and Building Autonomy ) biotechnology platform, which will include production of vaccines against COVID-19 and other diseases. In support of the project, Senegal has mobilized financing of $91 million, including an EIB loan of $79 million, and has made a 3.3 Hectares site available. The project also benefits from grants from IFC, DFC, EIB, EU, and AFD, amounting to $14 million.

• Spain: Will provide EUR 100 million to support new COVID-19-related bilateral projects. Will provide USD 200 million for the purchase of 30 million vaccines for donation through COVAX and bilaterally, as needs dictate. When combined with previous donations, Spain will have pledged to donate up to 100 million vaccines, remaining as one of the largest vaccine donor worldwide.

• South Africa: South Africa is committed to work with African leaders to achieve vaccine coverage through mass campaigns across the continent. We continue to advocate for a TRIPS waiver in the WTO to improve global access to vaccines, therapeutics, and diagnostics.

Committed to getting more life-saving vaccines to those in need, South Africa is donating 5 million doses of the Pfizer vaccine and 10 million doses of the J&J vaccine to other African countries. It has contributed $10 million to the Global Fund and plans to contribute financial support to the ACT-Accelerator. As an AU Champion will work towards a goal of 200 million tests administered by the end of 2022 by resourcing and supporting member states to implement Africa CDC’s Enhanced Surveillance Strategy, which includes community-based testing, wastewater testing, and sentinel surveillance. In the same capacity, we tabled at the AU Summit in February and got an endorsement for a common agenda for manufacturing vaccines, medicines, diagnostics, therapeutics, and health products on the continent. The continent’s largest COVID-19 vaccine manufacturing plant opened in South Africa last year, and mRNA hubs for tech transfer have been opened in South Africa, Egypt, Senegal, Tunisia, Kenya and Nigeria. Multilateral agencies and philanthropists need to be procured vaccines and boosters from African manufacturers to ensure the developing capabilities of the continent are retained. Finally, South Africa supports the formation of the Fund as a mechanism to finance global health security.

• Sweden: Committed its health experts to help improve international global health architecture and help advance policies on improved pandemic preparedness. Donated 10 million vaccine doses to COVAX.

• Taiwan: Pledges an additional contribution of $1.5 million to support the fight against COVID. Will continue to provide PPE and medical equipment to fight COVID worldwide, having contributed $70 million in this effort since April 2020.

• Tanzania: Will vaccinate 70% of eligible Tanzanians by fall 2022.

• Thailand: Will donate over 3.3 million doses of COVID-19 vaccines, worth $14.5 million, in 2022. Will continue investing in the development of COVID-19 vaccines and cooperate with global partners on vaccine testing, research and development, and production. Will continue working actively on disease prevention and health emergency preparedness in neighboring countries to better address particularly communicable and emerging diseases. Supports in principle the initiative to establish the pandemic preparedness and global health security fund at the World Bank.

• United Arab Emirates: Will provide $10 million in financial contributions and $50 million in-kind assistance of equipment.

• United Kingdom: Since December, has committed £265 million [$327 million] to the global response to COVID-19 as part of the commitment to ending the acute phase of the pandemic in vulnerable countries and future pandemic preparedness, including £105 million to expand testing capacity globally and boost oxygen supplies, and £160m as part of the UK-hosted Global Pandemic Preparedness Summit to support CEPI to reduce the time to develop vaccines against new health threats – including new COVID variants – to just 100 days. The UK has spent over £2.1 billion since 2020 to help end the pandemic, address its social and economic impacts and to support global efforts to fund, and distribute vaccines fairly.

• United States: Committed an additional $200 million to the pandemic preparedness and global health security financial fund at the World Bank in 2022, bringing the U.S. total pledge to this fund to $450 million to date. In FY 2023, the President’s Budget calls for an additional $4.75 billion for this fund. Committed to share U.S. Government COVID-19 vaccine-related intellectual property and research tools for greater global access. Committed to rapid review of generic products for global COVID-19 response. Committed to pilot “test and treat” strategies for the most vulnerable populations in low and middle-income countries to help prevent hospitalizations and deaths from COVID-19. Committed to additional vaccination support through Global VAX. Committed to expand investments in bilateral global health security programs. Committed to expand dose donations to include boosters and pediatric doses to accelerate global vaccine coverage. Committed to improving guidance for vaccine development to enhance protection. These commitments build on previous commitments announced in 2022, including support for a financing facility for COVID-19 vaccine purchases and delivery through the U.S. International Development Finance Corporation and advancing COVID-19 vaccine research and development through the Coalition for Epidemic Preparedness Innovations.

Commitments[2] from Non-Governmental Organizations, Private Sector, Philanthropies
In addition, we have received commitments from more than 50 organizations, including local and international non-governmental organizations, businesses, philanthropies, advocacy groups, faith-based organizations, and other members of civil society. To date, new commitments in 2022 outlined below exceed $700 million for vaccinating the world, saving lives now, and building better health security.

• Abbott: Abbott will make available to low and middle income countries (LMICs) a dedicated portion of its global manufacturing capacity for WHO EUL-approved antigen rapid diagnostic tests (Ag RDTs), amounting to a minimum of 20 million tests per month and a total of 240 million tests for an entire year, a commitment that amounts to nearly a quarter of the global goal of ensuring access to 1 billion tests in 2022 announced in September.

• Abt Associates: Commits to convening a global coalition to identify health system innovations that emerged during the COVID-19 pandemic that can be adapted and scaled to transform future health systems and Build Better Health Security. As a trusted partner of the governments of the United States, United Kingdom and Australia, Abt Associates developed tools and innovations in our work and will share them broadly. We invite other countries and partners to engage in this collaboration.

• Access to Advanced Health Institute and Immunity Bio: commit to manufacturing next-generation T-Cell vaccines for pandemic preparedness that are stable at room temperature, rapidly modifiable to address current and emergent pathogens, and provide potent, broad and durable protection in sub-Saharan Africa at the billion dose scale by 2025. Commit to bringing the latest immune-stimulating cell therapy and vaccine technology through clinical trials and centers of excellence to develop licensed vaccines and breakthrough immunotherapies that address the pandemics of infectious disease and cancer around the Globe. Committed to expend $1 billion USD over the next 5 years to produce billions of doses of vaccines, fusion proteins, and natural killer cell therapy at our million square feet of 11 plants we currently own globally.

• Africa Frontline First (AFF): Commits to raising $15M by September 2022 in the first phase of its work to build better health security. AFF is a collaborative new financing initiative led by Her Excellency Ellen Johnson Sirleaf to professionalize 200,000 community health workers across 10 African countries by 2030. This workforce will expand critical surveillance, testing, and treatment for emerging disease threats, maintain life-saving care during emergencies, and provide quality jobs, particularly for women.

• Amref Health Africa, HQ: Commits to increase access to and uptake of COVID-19 vaccines in thirty-one countries in Africa. The activities will be led across 11 projects with multiple partners to support the administration of over 4.5 million vaccine doses across 31 countries in East and Southern Africa, training over 15,000 community health workers, and facilitating access to vaccines in hard-to-reach areas. To ensure delivery of this commitment, $46,117,000 has been secured to date.

• The Bill & Melinda Gates Foundation: Commits up to $125 million to Build Better Health Security through vaccine research and development, enhanced integrated disease surveillance, workforce capacity development, and expanded access to pandemic tools in low- and middle-income countries. These new investments, which are an extension of the foundation’s longstanding commitment to health equity, are aimed at ending this pandemic and ensuring the world is prepared to prevent another pandemic.

• BlackRock Foundation: Commits $5 million to ensure immediate, equitable access to Covid-19 diagnostic tools across the world, in partnership with FIND – the global alliance for diagnostics – to keep people safe, halt new variants in their tracks and address urgent clinical needs. BlackRock will support FIND to deliver on the goal of increasing the number of daily Covid-19 tests taken in low-income countries from 7.3 per 100,000 individuals to 100 per 100,000 by the end of 2022.

• Catholic Relief Services – US Conference of Catholic Bishops (CRS): Commits to work with its in-country teams to increase vaccine coverage and uptake, directly supporting COVID-19 vaccinations in 22 countries and mobilizing at-risk populations in over 100 countries. CRS will engage local stakeholders to facilitate collaboration and connect local partners with donors to advance localized funding. CRS will mobilize American Catholics to advocate for an equitable global response and will engage with peer organizations through the INGO COVID-19 Vaccine Collaborative. Commits to leveraging its network of over 1500 partners to communicate essential information to reduce COVID-19 transmission, illness and death. CRS will serve as the Global Fund C19RM lead in Republic of Congo, Guinea, Mali, Niger and Sierra Leone, leading on procurement for tests and other commodities. CRS will address the secondary impacts of COVID-19, such as education disruption, the loss of primary caregivers, fraying social cohesion, and increasing hunger and malnutrition. Commits to using its available resources to identify, finance, and fill gaps in health systems in the countries in which it operates. CRS will continue implementing activities to address vaccine hesitancy, conducting primary research to inform vaccine strategies, supporting faith-based organizations, and financing critical health workforce trainings. Further, CRS will continue to work with Ministries of Health and other health service providers to strengthen the capacity of resilient health systems.

• Clinton Health Access Initiative (CHAI): Commits to ensuring affordable and effective antiviral COVID-19 treatment is available in low- and middle-income countries. CHAI has negotiated agreements with generic suppliers to make generic Paxlovid (nirmatrelvir/ritonavir – NIR/r) available at under $25 USD per treatment course for treatment of COVID-19. Equitable access to oral antiviral medications, especially for high-risk populations, will help save lives and limit the impact of future surges.

• Coalition for Epidemic Preparedness Innovations (CEPI): Commits to helping fill the gaps in vaccine research and development that threaten to undermine progress against COVID-19, working in partnership with institutions in low- and middle-income countries. Such research, including clinical trials on “mix-and-match” and fractional dosing, will help to inform COVID-19 vaccination strategies globally. Commits to funding the development of broadly protective COVID-19 vaccines and working to enable equitable access to these globally. Will work to reduce global pandemic risk by delivering innovative R&D programs that help to develop safe, effective, globally accessible vaccines in 100 days. This includes advancing vaccines against known threats; producing a library of prototype vaccines against critical viral families; investing in vaccine manufacturing innovations; advancing enabling science programs critical to rapid vaccine development; and connecting stakeholders to enable rapid countermeasure development, effective response and equitable access.

• CORE Group: Will work with country partners to provide training on addressing vaccine misinformation through social behavioral change norms and provide evidence-based communication training and tools to increase demand and uptake for COVID-19 vaccine. CORE Group will conduct knowledge sharing events and sessions at the regional and global levels, to share innovative ideas of addressing vaccine hesitancy, share tested and translated resources, and convene civil society to improve COVID19 vaccine uptake. Will convene global stakeholders to ensure implementation strategies around health security with a One Health approach and advocate for greater representation of civil society, including people with disabilities, women and children, and under-served communities, to be included in the planning and discussions around their own health security. We commit ensuring evidence-based technical direction and collaboration around Covid-19, global health security, through an integrated multi-sectoral approach, at our October 2022 Global Health Practitioner Conference.

• COVID Collaborative: COVID-19 has now left a staggering 10.4 million children worldwide orphaned by the death of a parent or grandparent caregiver. Many of these children face abuse, violence, and institutionalization. That is why COVID Collaborative, in collaboration with Oxford University, and with support from The New York Life Foundation, commits to advocate for and catalyze country-level policies to incorporate family-based care for COVID-bereaved children into national COVID-19 response plans, focusing on high-burden countries in sub-Saharan Africa.

• Deloitte Touche Tohmatsu Limited (Deloitte): Commits up to US $3 million to make publicly available a playbook that outlines processes and protocols that enable society to provide and scale health-care support and resources, thereby helping to address COVID-19 variants and surges, in support of the goal to Build Better Health Security

• FIND: Commits to enhancing efforts for timely testing, including self-testing, in vulnerable groups, providing vital information to assess transmission in diverse populations and formulate strategies to prioritize those most at risk. These efforts will also help focus testing and treatment strategies. Commits to supporting LMIC governments in the development and roll-out of scaled up testing and test-and-treat programmes, focused on vulnerable populations and equitable global access, as well as maintaining the data gathering and reporting systems that will allow global, regional and national decision-making based on the best possible information about the state of the pandemic. Commits to identify and work with partners for the development and validation of multipathogen diagnosis and care pathways, which must include COVID-19. These new tools and diagnostic pathways will also be designed and tested to strengthen surveillance systems for both endemic and pandemic-prone pathogens, and link to the use of enhanced capacity for genomic sequencing.

• Friends of the Global Fight Against AIDS, Tuberculosis and Malaria: Commits to partner with other organizations to lead advocacy for new investments in pandemic preparedness that are grounded in human rights, integrated with health systems, and include multiple stakeholders. The organization will help mobilize global advocacy to remind donors that the US is hosting the replenishment of the Global Fund, another effective tool in building health systems and preparing for the next pandemic alongside a new pandemic preparedness fund.

• Family Health International (FHI) 360: Commits to engaging in at least 20 LMICs with governments, local organizations, and communities to build their capacity to provide COVID-19 vaccine service delivery and generate demand for COVID-19 vaccines. FHI 360 commits to documenting and sharing innovative ideas and approaches to overcoming vaccine hesitancy globally. Commits to converting technical tools and resources to global goods and taking proactive efforts to make these tools available to LMICs and promote their use for strengthening COVID-19 response programs. FHI 360 commits to enhance health workers’ capacity to deliver oxygen to patients in clinical settings and improve oxygen ecosystems in at least 25 LMICs, to promote equitable access to the highest quality clinical services possible. Commits to support at least 15 LMICs to achieve their health security goals and achieving International Health Regulations (IHR) targets and achieve Sustainable Development Goals. FHI 360 commits to developing new tools and technologies to support these efforts.

• Global Health Council (GHC): Commits to continued advocacy with U.S. congressional leaders to accelerate financing for COVID-19 vaccination campaigns. Global COVID-19 supplemental funding is urgently needed to support these national and sub-national campaigns to make progress toward the 70% target, prioritizing groups like frontline health workers, the elderly, and the immunocompromised. GHC will continue to bolster commitments amongst stakeholders within multilateral organizations and ensure these bodies are sustainably-resourced and well-equipped to address the world’s most pressing health needs.

• Global Health Technologies Coalition (GHTC): Committed to amplify evidence of gaps in upstream vaccine research and development (R&D) for the COVID-19 response and work to ensure political support and additional resources to support R&D of next-generation vaccines designed to better reach the last mile and address emerging variants and for strengthening regional research and manufacturing capacities. This includes expanding multisector support for clinical research, strengthening regulatory pathways, and mobilizing sustainable financing for regional manufacturing hubs. Will hold public- and private-sector stakeholders accountable to unlocking funding and advancing research to expand the pipeline of affordable, easy-to-deploy diagnostics and therapeutics, particularly for use in low-resource settings. Will galvanize partners to push for more efficient regulatory pathways for novel COVID-19 technologies; bolstered testing, surveillance, genomic sequencing, and data sharing to better detect and monitor emerging variants; and strengthened regional manufacturing capacities. Supports the creation of a new pandemic preparedness fund and will leverage its network to highlight how the fund should be utilized to bolster country and regional pandemic research and development (R&D) capacities. GHTC is also supporting the Global Health Security Agenda R&D Task Force to develop a tool that enables countries to assess their R&D preparedness capabilities with the goal of aligning emerging financing with articulated R&D gaps.

• Google.org: Donating an additional $150 million in Search ads to the World Health Organization, Gavi, government agencies, and nonprofits to ensure users searching on COVID-19 related topics such as vaccines, testing, or economic recovery initiatives are connected with credible sources. This brings Google.org’s total in-kind global commitment to COVID-19 recovery to over $1 billion.

• HelpAge USA: Commits to promoting the dignity, wellbeing, and voice of older people. We are working with partners at global, regional, national, and local levels to develop and implement inclusive community engagement and advocacy strategies that effectively support COVID-19 vaccine access and uptake among older people and achieve global vaccine equity. Our organization’s goal aligns with the summit’s objective to vaccinate the world.

• Henry Schein, Inc.: Henry Schein commits to working in partnership with the WHO to develop platforms for supply chain data collection to strengthen the resilience of the global healthcare supply chain. This work represents an expansion of the Pandemic Supply Chain Network (PSCN), a public-private partnership founded in 2015. Henry Schein serves as private sector lead of the PSCN, with more than 60 companies participating together with the WHO and other multilaterals. Henry Schein is contributing its core competencies to support this effort, and a cash donation of $25,000.

• The Hygiene and Behaviour Change Coalition 2 (HBCC2): Will encourage vaccine uptake and combat vaccine hesitancy alongside continued hygiene messaging, using its hygiene and behaviour change platform to incorporate vaccine confidence messaging where vaccines are available. The coalition will reach millions through incorporating vaccine messages into public campaigns and programmes, and create digital tools that support people with information on COVID-19 vaccines, including where it is available and how to access it (where applicable). Will help millions of people by supporting measures to reduce transmission of COVID-19 in 18 countries across Africa and Asia by provision of critical WASH products and services as hygiene remains the first line of defence against the virus until vaccines reach all. The coalition will provide communities with hygiene advice and training, products, and handwashing facilities in institutions such as schools, health centres and public places. Will work with national governments and institutions to strengthen local capacity and build resilience of health systems and communities against new COVID-19 variants and future pandemics. The hygiene vulnerabilities and inequalities the pandemic has exposed must be eradicated if we are to defeat the virus and improve health security for all. HBCC2 will advocate for increased investment in hygiene and pandemic preparedness at national and global level.

• International Rescue Committee (IRC): Commits to extending the capacity of governments to deliver Covid-19 vaccines in humanitarian settings as soon as delivery funds and doses become available to us. Based on our current infrastructure and capacity, we can deliver 32 million doses, fully vaccinating 16 million people. With $160 million dollars and sufficient doses, we could reach nearly all eligible people in the fragile and conflict affected settings where we work across 30 countries.

• IPG Health/McCANN HEALTH: Committed to working with countries to develop more effective ways to increase COVID-19 vaccine uptake.

• Living Goods: Commits to supporting community health workers (CHWs) to ensure high levels of uptake of COVID-19 vaccines and to combat COVID-19 vaccine hesitancy. Living Goods commits to supporting government operations for widespread COVID-19 vaccine rollout to the individuals in the rural communities served by Living Goods-supported CHWs.

Finally, Living Goods commits to encouraging uptake of COVID-19 vaccination among frontline health workers and other high-risk populations. Commits to working in partnership with governments to train all staff and community health workers (CHWs) we support in COVID-19 prevention, early case detection, reporting procedures, and personal safety measures. Living Goods commits to supporting CHWs to educate communities on prevention, testing and where to receive care. Living Goods commits to using digital tools to support CHWs to conduct COVID-19 case screenings and connect CHWs with disease surveillance networks. Commits to partnerships with the governments of Kenya, Uganda, Burkina Faso, and others to build resilient community health systems that can withstand shocks. This includes supporting governments to strengthen digital tools that enable the delivery of health services and ensure pandemic preparedness. Over the next five years, Living Goods commits to supporting 32,000 CHWs and their supervisors to reach 18 million people across five countries with quality care.

• Management Sciences for Health: Is costing vaccine delivery to the last mile so that countries, multilateral institutions, and donors can prepare to effectively deliver critical COVID-19 vaccines and achieve the goal of vaccinating the world. This work will help countries better allocate financial resources through evidence-based and sustainable strategies. To date, the organization has supported the vaccination of almost 17 million people across several countries. Management Sciences for Health is committed to Saving Lives Now by continuing to provide access to critical health services, medicines, and other therapeutics across countries, including in fragile and conflict-affected states. The organization continues to focus on strengthening pharmaceutical-sector governance, national public health institutions, regulatory and information systems, infection prevention and control measures, response coordination mechanisms, and emergency supply chains for COVID-19 commodities across governments, the private sector and civil society. Management Sciences for Health is announcing new investments in learning critical lessons from the COVID-19 response by convening a global workshop to examine critical gaps in health security and develop impactful, responsive, and essential recommendations for better pandemic preparedness. MSH is committed to working with country policymakers and government officials to ensure the necessary national policies are in place so that countries are better prepared for future threats through a multihazards approach to pandemic preparedness.

• MedAccess: Commits to provide a $100 million guarantee to accelerate access to COVID-19 vaccines through the COVAX cost-sharing mechanism. The guarantee is part of a $200 million risk sharing facility, with the Open Society Foundations, that will help COVAX respond to country demand for additional doses to meet national vaccination targets.

• Mastercard Foundation: Mastercard Foundation is deploying USD $200 million in partnership with a collaborative of seven African higher education institutions to strengthen the resilience of public health systems in Africa and enabling them to contribute to economic development, and prosperity. To do so, this initiative will train 30,000 front-line health providers and policy shapers and is projected to create 20,000 health sectors jobs; and to enable 2,000 health ventures to improve and expand primary health services and products in the next 10 years.

• Merck & Co., Inc. (Merck): Committed to make two million patient courses of its investigational oral antiviral COVID-19 medicine, LAGEVRIO (molnupiravir), available to USAID at Merck’s best access price to increase access in lower-income countries. This builds on previous efforts, including an agreement with UNICEF to supply up to 3 million courses of LAGEVRIO and voluntary licenses to generic manufacturers and the Medicines Patent Pool facilitating access in over 100 low and middle income countries. Committed to provide $5 million annually in 2022-2024 to support efforts to understand how to build vaccine confidence and reach underserved populations through use of social media. This builds on Merck’s earlier funding to help establish The Vaccine Confidence Fund to support research exploring how online communications can influence offline health behavior and build vaccination confidence, and its related announcement with multi-sector stakeholders of the Alliance for Advancing Health Online.

• Nuclear Threat Initiative (NTI): Nuclear Threat Initiative (NTI): Commits to support the Financial Intermediary Fund by using the Global Health Security Index as a tool to inform pandemic preparedness needs—so resources can be allocated to countries most in need and to address the most significant gaps. NTI also commits to contribute $35,000 to the Fund once established—reflecting our view that catalytic funding is needed to guard against current and future biological threats.

• Nursing Now Challenge: Commits to engaging its network to build advocacy skillsets for early-career nurses and midwives to deepen their storytelling skills and to launch local, regional and global efforts to vaccinate the world. The NNC network of immunization advocacy champions will be led by early-career nurses and midwives. They will lead their own vaccine advocacy campaigns and will deliver their voices to at least three global policy forums and quarterly online events.

• Open Society Foundations: Open Society Foundation’s impact investment arm, the Soros Economic Development Fund (SEDF), commits to provide a $100 million procurement guarantee designed to strengthen COVAX’s capacity to increase the distribution of COVID-19 vaccines to low- and middle-income countries. Together with an additional $100m guarantee from MedAccess, the guarantees would free up an additional $200m in donor funds, and position COVAX to deploy an additional 190 million vaccine dosages to low- and middle-income countries globally in 2022.

• Osprey Foundation: Committing $4,000,000 to faith-based organizations that can positively influence COVID-19 vaccine access and uptake in sub-Saharan Africa. Commits to increase vaccine demand in several sub-Saharan African countries by supporting faith leaders and their networks to overcome disinformation and address the root causes of vaccine hesitancy for their communities in both digital and non-digital realms. Concurrently, Osprey Foundation will fund faith-based interventions to improve the delivery of COVID-19 vaccines by strengthening the core of last-mile vaccine infrastructure, improving vaccine readiness, and supporting effective vaccine rollout initiatives.

• Pandemic Action Network: Commits to press governments, multilateral agencies, and donors to galvanize the necessary investments, coordination, and incentives to support delivery of accelerated, robust, and equitable global vaccination plans to achieve equitable global immunization levels. In support of this and all Summit goals, Pandemic Action Network commits to mobilize at least 100 new partners, and Network partners commit to invest at least US$175 million by the end of 2022. Commits to support efforts to drive forward a dynamic global test-to-treat strategy, increase transparency on pricing and supply of tools to fight COVID-19, and advocate to prioritize access to testing, timely reporting, and treatments. The Network also commits to and to create a steady drumbeat of advocacy, coordination, and civic engagement and hold partners accountable for their commitments. In 2022, commits to work with the World Bank, WHO, governments, and other stakeholders to design and launch a dedicated new global fund for pandemic preparedness; mobilize significant new political and financial commitments for the fund; promote cross-country, cross-regional cooperation, and sharing best practices and lessons learned to inform more effective and equitable preparedness and response plans and implementation, to be ready either for the next COVID surge or next potential pandemic.

• PATH: Commits to supporting COVID vaccination campaigns by providing training, mentorship and supervision to health workers tasked with vaccination and to deploying and scaling digital tools to track vaccination and generate demand through targeted social media campaigns. This includes a $5 million investment to reach an estimated 20 million vaccine-hesitant individuals in two years. Additionally, PATH will support the development of a new affordable COVID-19 vaccine that could be manufactured in Brazil, Thailand and Vietnam.

Commits to working with stakeholders to improve oxygen delivery in 10 countries. PATH will work with local partners to build their diagnostics capacities and support the advancement of more affordable and reliable COVID diagnostics in LMICs. PATH will stand up interoperable digital systems in four countries to provide the country governments with the information they need to identify and manage outbreaks vaccination coverage, manage vaccine supplies, and track vaccination records. Commits to leveraging our technical expertise to equip world leaders with the information they need to design a better architecture for global health security. PATH commits to advocating for the funding needed to establish the new global health security and pandemic preparedness fund and holding leaders accountable for other commitments made during the 2nd COVID-19 Summit.

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PAX sapiens: Will work with engaged civil society, philanthropic, government, and private sector actors to identify and promote sustainable funding sources for pandemic prevention, new approaches to information sharing, institutional design, and standards for data collection and sharing, and to encourage new donors to support pandemic prevention. PAX’s work will include grantmaking through the previously announced commitment of $200 million, convening and engagement with other organizations, and developing new information for effective prevention.

• PerkinElmer: Commits to saving lives now by making COVID-19 tests available to all low- and middle-income countries for under $5 per test based on volume commitment and supply chain feasibility. PerkinElmer knows that detecting COVID-19 is still a public health challenge in many places and believes this will enable critical access to diagnostics. PerkinElmer remains dedicated to continuing to develop accessible diagnostic solutions to address the global public health challenges created by the COVID-19 pandemic.

• Pfizer Inc.: Will work to solve concrete challenges to vaccine distribution: working with partners, including UPS, to enable extended use of its shippers to deliver 9.3 million doses to regional vaccination centers in 36 states in Nigeria; expanding its partnership with drone delivery service Zipline to enable transportation of more 380,000 mRNA vaccines on 1,485 drone flights to remote areas; and completing studies to support the extension of transportation time to 48 hours at 2-8 degrees. Pfizer’s COVID-19 oral treatment could significantly change the COVID-19 treatment paradigm, potentially reducing illness severity, hospitalization rates and deaths among a broad population of patients, subject to regulatory authorization or approval. Working with partners such as UNICEF, Pfizer will supply nirmatrelvir [PF-07321332] tablets and ritonavir tablets to countries in need, including emerging economies in Sub-Saharan Africa, Asia, and the Americas. This agreement is part of Pfizer’s comprehensive strategy to work toward worldwide equitable access.

• Platform for ACT-A Civil Society & Community Representatives (co-hosted by WACI Health, Global Fund Advocates Network (GFAN) and STOPAIDS): Will advocate for support of the TRIPS waiver and sharing of vaccine equipment and doses with COVAX and countries. Will advocate for and coordinate community CSO input on a test and treat strategy. Will mobilise support to fully fund ACT-A, advocating for robust health system perspectives, supporting greater community representation in ACT-A and future mechanisms.

• Private Sector Roundtable on Global Health Security (PSRT): The Private Sector Roundtable on Global Health Security (PSRT) – a cross-industry coalition of companies committed to leveraging private sector expertise to strengthen health security – commits to expand efforts to build regional/country capacity in pandemic prevention, preparedness and response. We will seek to partner with a regional institution and three low-middle-income countries in that region to provide a suite of tools, trainings and expert guidance over the next three years to Build Better Health Security.

• Rotary International: Commits to providing access to our public health infrastructure and network built to facilitate polio eradication and provide free health services to vaccinate the world. Rotary Family Health Days and National Immunization Day campaigns are available to accelerate vaccine coverage in multiple regions with at-risk populations in high-risk countries.

With Rotary’s 1.4 million members worldwide, and over 55,000 African members, our health infrastructure, and relationships with local and national government health departments remain active. Rotary can quickly mobilize, as strategy, structure, accountability, and funding become available.

• The Rockefeller Foundation: The Rockefeller Foundation’s Global Vaccination Initiative commits USD 55 million to support country-led efforts to fully vaccinate 90% of the most at-risk populations in Africa, Asia, Latin America, and the Caribbean. Funding will support programs to increase vaccine demand – access, trust, and information – while leveraging data from trusted, credible sources to strengthen health systems to meet the needs of the most vulnerable.

• Sabin Vaccine Institute: Commits $9 million through its Global Immunization program in 2022 to better understand and address vaccine delivery, acceptance and demand barriers in LMICs; bolster collaboration among immunization professionals; foster action to address barriers in universal vaccination development; and better apply epidemiology to maximize vaccine rollout effectiveness. Sabin commits to fostering the action of 3,000+ close-to-community professionals delivering vaccinations in LMICs – including health workers, program managers, researchers and journalists.

• Seed Global Health: Research estimates that for every $1 allocated to vaccine production, $5 is needed for delivery, with majority cost being associated with health worker training, support, and protection. Establishing integrated health worker networks from the last mile to the facility is critical to enabling access to vaccinations. . Seed Global Health commits to partnering with governments to train and deploy the health workers required to put shots in arms while supporting counter-misinformation campaigns to reduce vaccine hesitancy. Health workers deliver every element of pandemic response and preparedness. Commits to scale our direct work in training and care to sustain essential services to an additional 3 million people; to protect education to strengthen the pipeline of health workers; to respond to emergencies on the frontlines, modeling new methodologies of diagnosis and care; and to align and mobilize the political commitment and resources to support health workers and save more lives. Health workers are the backbone of resilient health systems and pathway to economic recovery and global health security. Commits to mobilize a social contract for health workers, to galvanize action beyond applause. Centered on core principles that provide the evidence-based rationale, framework and accountability, this compact will mobilize and align investments, policies, and programming around long- term country-led planning, to scale-up and protect fit-for-purpose health workforces in service to the world.

• The Task Force for Global Health: Will partner with countries to strengthen immunization programs and field epidemiology training. Through Hepatitis, Polio and Neglected Tropical Diseases programs, we’ll support COVID-19 efforts for the most vulnerable. We’ll distribute medical supplies/equipment and support public health worker mental health and resilience.

We’ll convene thought leaders to envision building upon COVID-related investments for sustainable systems. We’ll advance the scientific understanding of rare adverse events after COVID-19 vaccinations, advancing evidence-based decision-making.

• Thermo Fisher Scientific: In partnership with Afrigen Biologics and Labotec, we are providing cutting-edge technology and personalized capacity building to enable production of the first locally designed and constructed COVID vaccine for Africa. Our support for this WHO-coordinated, end-to-end, sustainable mRNA vaccine production hub includes facility design and bacteria cultivation tools to support DNA plasmid creation, as well as investing in time and expertise to transfer technical knowledge and support so scientists and healthcare leaders can create their own future. As part of our Mission to enable our customers to make the world healthier, cleaner and safer, we have a responsibility to provide access to COVID-19 diagnostic solutions that reach every population, community and individual, regardless of geography or socioeconomic circumstance. We will continue to provide low price, high-quality diagnostic solutions to Governments, United Nations and other global partners because testing is the cornerstone of a continuum of care and treatment of COVID-19 globally. We recognize the importance of building upon lessons learned from the COVID-19 pandemic and will continue to collaborate with Governments, the United Nations and other global partners to create resilient systems to better prevent, detect and respond to the next emerging pathogen. This includes helping to create federated, open pathogen surveillance systems, designing and funding knowledge transfer programs to enable the next generation of scientists in LMICs, and investing in local manufacturing models.

• United Nations Foundation: The United Nations Foundation supports Building Better Health Security through encouraging high ambition, sustained attention, and diverse coalitions to strengthen multilateral capacities for preparedness and response. This includes convening and engaging partners to support Geneva-based processes; supporting solutions for incremental financing, including a Financial Intermediary Fund housed at the World Bank; and engaging Member States in New York and capitals to diversify and broaden a high ambition coalition for this agenda.

• UPS Foundation: Commits to the pro-bono delivery of COVID-19 vaccines to countries below the average vaccination rate for Africa. In 2022, the UPS Foundation also plans to deliver 2 million doses to Cameroon, up to 3 million to Ethiopia, and up to 4 million to Zambia. The UPS Foundation commits to expanding upon its existing Ghana medical drone network in 2022 to provide the delivery of critically needed supplies and expand access to quality health care. In-country transportation has been committed for 1 million doses to new Zipline drone distribution centers in Nigeria and Kenya. In Malawi, the UPS Foundation is funding in-country drone delivery provided by Swoop Aero and Village Reach with plans to reach 3 million people. In partnership with UNICEF, the UPS Foundation is funding ‘Ultra Cold Vaccine Training’ in Malawi, Nigeria, Ethiopia, and Kenya.

• UPS Healthcare: Commits to delivering 5.9 million vaccines to Nigeria in addition to the 9.3 million previously delivered. The shipment is funded through UNICEF and USAID, and coordinated with technical expertise from UPS and donated ultra-cold chain equipment. To date, UPS Healthcare has delivered more than 1.4 billion COVD-19 vaccine doses to over 110 countries.

• Wellcome Trust: As a founding partner of the Coalition for Epidemic Preparedness and Innovations we committed $150M to CEPI this year, as part of Wellcome’s commitment to spend £16B over the next ten years on science to improve health. This includes funding for Infectious Disease and Pandemic Preparedness, to help buildnetworks to detect outbreaks before they escalate, to trainpublic health professionals and enhance capacity globally, and expand Research and Development of countermeasures. Wellcome also supports mobilising additional funds to prevent future pandemics, and is providing £10 million in seed funding toward establishing the pandemic preparedness and global health security Financial Intermediary Fund at the World Bank, signalling our early philanthropic commitment to working in partnership with others in the fund. We applaud this Summit which comes at a critical moment. We believe these collective commitments will contribute to ensuring equitable health security for all and the world has the knowledge and networks in place to prevent and respond to emerging threats whilst remaining committed to long standing endemic health issues of importance to communities.

• Women in Global Health: Commits to advocate for: Equal leadership representation in global health governance, including pandemic decision making and advisory bodies; a new social contract for women health workers with safe, decent and equally paid work. This includes protection from harm and personal protective equipment designed for women’s bodies; and addressing the gender dimensions and impacts of pandemic policies and programmes, using sex disaggregated data.
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[1] All commitments made in 2022 are counted toward the goals of the 2nd Global COVID-19 Summit. Of these, approximately $3.1 billion were raised in new funds, not yet announced.
[2] All commitments made in 2022 are counted toward the 2nd Global COVID-19 Summit. Of these, approximately $700 million was raised in new funds, not yet announced.