Vaccines and Global Health: The Week in Review :: 22 Feb 2020

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David R. Curry, MS
Executive Director
Center for Vaccine Ethics and Policy

EMERGENCIES

Emergencies

Editor’s Note:
While we have concentrated the most current key reports just below, COVID-19 announcements, analysis and commentary will be found throughout this issue, in all sections.
Beyond the considerable continuing coverage in the global general media:
Daily WHO situation reports here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
WHO Coronavirus disease (COVID-2019) daily press briefings here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resources/press-briefings

Coronavirus [COVID-19]
Public Health Emergency of International Concern (PHEIC)
Situation report – 33 [WHO]

Novel Coronavirus (COVID-19)
22 February 2020
[Excerpts]
SITUATION IN NUMBERS
Globally :: 77,794 laboratory-confirmed [599 new]
[Week ago: 49,053 laboratory-confirmed [2056 new]]
China :: 76,392 laboratory-confirmed [397 new]
:: 2,348 deaths [109 new]
Outside of China
:: 1,402 laboratory-confirmed [58 new]
:: 28 countries
:: 11 deaths [1 new]

WHO RISK ASSESSMENT
China – Very High
Regional Level – High
Global Level – High

HIGHLIGHTS
:: Two new countries (Lebanon and Israel) reported cases of COVID-19 in the past 24 hours.
:: The role of environmental contamination in the transmission of COVID-19 is not yet clear. On 18 February, a new protocol entitled “Surface sampling of coronavirus disease (COVID-19): A practical “how to” protocol for health care and public health professionals” was published. This protocol was designed to determine viable virus presence and persistence on fomites in various locations where a COVID-19 patient is receiving care or isolated, and to understand how fomites may play a role in the transmission of the virus.
:: The WHO Director-General briefed the emergency ministerial meeting on COVID-19 organized by the African Union and the Africa Centres for Disease Control and Prevention. Details can be found here.

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National Health Commission of the People’s Republic of China
http://en.nhc.gov.cn/
Selected News & Announcements
Feb 22: Daily briefing on novel coronavirus cases in China
On Feb 21, 31 provincial-level regions on the Chinese mainland as well as the Xinjiang Production and Construction Corps reported 397 new cases of confirmed infections, 1,361 new cases of suspected infections, and 109 deaths.
[See Emergencies above for detail]

China races to develop vaccines against coronavirus
2020-02-21
BEIJING — Chinese scientists are racing to develop vaccines against the novel coronavirus by adopting five technological approaches, a senior National Health Commission official said on Feb 21.
“Some projects have entered the stage of animal testing,” Zeng Yixin, deputy director of the commission, told a news conference on China’s fight against the novel coronavirus outbreak.
“Under the premise of ensuring safety, effectiveness and accessibility (of vaccines), (we) foresee that as soon as from April to May this year some vaccines could enter clinical trials, or under specific conditions, could be applied for emergency use,” he said.
“Our goal is that if required by the outbreak situation, the emergency use of vaccines, as well as the emergency review and approval process, can be activated in accordance with laws,” the official said.

 

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Johnson & Johnson to Expand Partnership with U.S. Department of Health & Human Services to Accelerate the Discovery of Potential COVID-19 Treatments
NEW BRUNSWICK, N.J., Feb. 18, 2020 /PRNewswire/ — Johnson & Johnson (NYSE: JNJ) today announced that its Janssen Pharmaceutical Companies will expand its existing partnership with the Biomedical Advanced Research and Development Authority (BARDA), part of the Office of the Assistant Secretary for Preparedness and Response (ASPR) at the U.S. Department of Health & Human Services, to seek treatment solutions for COVID-19, the disease caused by the novel coronavirus, SARS-CoV-2 (also known as 2019-nCoV). This latest collaboration will enhance Janssen’s ongoing work with global partners to screen a library of existing antiviral molecules, with the aim of identifying compounds with promising antiviral activity against SARS-CoV-2.
The expanded partnership with BARDA builds on Johnson & Johnson’s multipronged response to the COVID-19 outbreak. These efforts, in addition to the ongoing development of a potential vaccine candidate, bring hope of finding a solution against COVID-19 for communities in greatest need in China and around the world…

 

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WHO Director General – Speeches Emergency Ministerial meeting on COVID-19 organized by the African Union and the Africa Centres for Disease Control and Prevention

Milestones :: Perspectives :: Research

 

WHO Director General – Speeches

Emergency Ministerial meeting on COVID-19 organized by the African Union and the Africa Centres for Disease Control and Prevention
22 February 2020
Your Excellency Mr Moussa Faki Mahamat, Chairperson of the African Union Commission, Commissioner Amira El Fadil, WHO Regional Director Dr Matshidiso Moeti and Director John Nkengasong,
[Excerpts]
Excellencies, dear colleagues and friends,
…It’s hard to believe that only 52 days ago, WHO’s country office in China was notified of a cluster of cases of pneumonia of unknown cause in Wuhan city.

 

In just seven weeks, this outbreak has captured the world’s attention, and rightly so, because it has the potential to cause severe political, social and economic upheaval.  

…The data from China continue to show a decline in new cases. This is welcome news, but it must be interpreted very cautiously. It’s far too early to make predictions about this outbreak.
Outside China, there are now 1200 cases in 26 countries, with 8 deaths. As you know, there is one confirmed case on the African continent, in Egypt.

Several African countries have tested suspected cases of COVID-19, but fortunately they have been found negative.

Although the total number of cases outside China remains relatively small, we are concerned about the number of cases with no clear epidemiological link, such as travel history to China or contact with a confirmed case.

We are especially concerned about the increase in cases in the Islamic Republic of Iran, where there are now 18 cases and four deaths in just the past two days. WHO has supplied testing kits to Iran, and we will continue to provide further support in the coming days and weeks. What has been reported from South Korea and Italy yesterday is also a matter of concern and how the virus is now spreading to other parts of the world. But in addition to that, as I said earlier in my press conference, the window of opportunity is narrowing. This meeting, I hope, will help us come together as a continent in attacking this virus.

 

As you know, a WHO-led international team of experts – including a representative from the Nigerian CDC, our colleague Chikwe Ihekweazu, has been on the ground in China for the past week, visiting three provinces, and is today traveling to the epicenter in Wuhan.

With every day that passes, we know a little bit more about this virus, and the disease it causes.

We know that more than 80% of patients have mild disease and will recover. But the other 20% of patients have severe or critical disease, ranging from shortness of breath to septic shock and multi-organ failure. These patients require intensive care, using equipment such as respiratory support machines that are, as you know, in short supply in many African countries. And that’s a cause for concern.

In 2% of reported cases, the virus is fatal, and the risk of death increases the older a patient is, and with underlying health conditions. We see relatively few cases among children. More research, of course, is needed to understand why.

Our biggest concern continues to be the potential for COVID-19 to spread in countries with weaker health systems. And I said earlier, our Africa regional office in partnership with the Africa CDC — we’re working hard to prepare countries in Africa for the potential arrival of the virus.

WHO has identified 13 priority countries in Africa because of their direct links to China or their high volume of travel with China. As my sister Tshidi said, an increasing number of African countries are now able to test for COVID-19 with laboratory test kits supplied by WHO, compared with only one just a couple of weeks ago.

Some countries in Africa, including DRC, are also leveraging the capacity they have built up to test for Ebola, to test for COVID-19. This is a great example of how investing in health systems can pay dividends for health security.

 

We have also shipped more than 30,000 sets of personal protective equipment to several countries in Africa, and we’re ready to ship almost 60,000 more sets to 19 countries in the coming weeks.

We’re working with manufacturers of personal protective equipment to address the severe disruption in the market for masks, gloves, gowns and other PPE, to ensure we can protect health workers.

 

During the past month about 11,000 African health workers have been trained using WHO’s online courses on COVID-19, which are available free of charge in English, French and other languages at OpenWHO.org.

We’re also providing advice to countries on how to do screening, testing, contact tracing and treatment.

Last week we brought the international research community together to identify research priorities, especially in the areas of diagnostics, therapeutics and vaccines.

 

Two weeks ago, I briefed the UN Secretary-General Antonio Guterres, and we agreed to activate the United Nations Crisis Management Team, led by Dr Mike Ryan, to enable WHO to focus on the health response while other agencies bring their expertise to bear on the social, economic and developmental implications of the outbreak.

We have also held two calls with UN resident coordinators all over the world, to brief them on the actions they can take to prepare their countries and ensure the United Nations system is working as one. And I hope, your excellencies, ministers, that you will work with our resident coordinators and WHO representatives to respond in a very coordinated fashion at country level.

 

The increasing signs of transmission outside China show that the window of opportunity we have for containing this virus is narrowing.

We are calling on all countries to invest urgently in preparedness. We have to take advantage of the window of opportunity we have, to attack  the virus outbreak with a sense of urgency.

Thank you all for your attention to this issue. I assure you that WHO is committed to working with all African countries to do everything we can to prevent transmission and detect and treat cases as early as possible.

Emergencies – Ebola

Emergencies

Ebola – DRC+
Public Health Emergency of International Concern (PHEIC)

Ebola Outbreak in DRC 80: 16 February 2020
[Excerpts]
Situation Update
This week, the incidence of Ebola virus disease (EVD) cases continued to be low (Figure 1). From 10 to 16 February 2020, one new confirmed case was reported in Beni Health Zone, North Kivu Province in Democratic Republic of the Congo. The case was reported on 11 February 2020, and was listed and followed as a contact at the time of detection, with known epidemiological links. Early detection of cases reduces the probability of transmission of EVD in the community and significantly improves the clinical outcome for the patients…

While we are cautiously optimistic about the overall trend and reduced geographic spread of the outbreak, the security situation in several EVD-affected health areas remain volatile, and the risk of spread within Democratic Republic of the Congo and neighbouring countries remains high. Given delays in isolation of some cases in recent weeks and continued reports of nosocomial transmission, we expect to see additional cases in the coming weeks. It is critical that response teams rapidly detect, investigate and follow-up all cases and their contracts…

…Conclusion
While there is room for cautious optimism around the low number of new confirmed cases reported in recent weeks, the situation remains fragile and further cases should be expected. It is important to ensure continued access and heightened vigilance for response activities, including early case identification, contact tracing, and improving infection prevention and control measures in healthcare facilities.

 

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WHO & Regional Offices [to 22 Feb 2020]

WHO & Regional Offices [to 22 Feb 2020]
19 February 2020 News release
World failing to provide children with a healthy life and a climate fit for their future: WHO-UNICEF-Lancet

 

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Weekly Epidemiological Record, 21 February 2020, vol. 95, 08 (pp. 69–76)
:: Progress towards measles elimination – China, January 2013–June 2019
:: COVID-19 update

 

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WHO Regional Offices
Selected Press Releases, Announcements
WHO African Region AFRO
:: WHO pledges to support African countries on joint coronavirus disease preparedness a…
22 February 2020
:: Polio-Nigeria leaves no stone unturned, targets over 55 million children in house-to…
20 February 2020

WHO Region of the Americas PAHO
:: Update on COVID-19 in the Region of the Americas
Washington, DC, February 20, 2020 (PAHO) – The Pan American Health Organization (PAHO) has announced a total of 23 confirmed cases of coronavirus 2019 (COVID-19) in the Region of the Americas. As of 18 February, all cases were reported in the United States (15) and Canada (8)…

WHO South-East Asia Region SEARO
No new digest content identified.

WHO European Region EURO
:: Towards an agreement for improving access to high-cost medicines 21-02-2020

WHO Eastern Mediterranean Region EMRO
:: Polio eradication on United Nations Secretary General’s agenda during Pakistan visit
18 February 2020

WHO Western Pacific Region
No new digest content identified.

CDC/ACIP [to 22 Feb 2020]

CDC/ACIP [to 22 Feb 2020]
http://www.cdc.gov/media/index.html
https://www.cdc.gov/vaccines/acip/index.html
ACIP Meetings
Next ACIP Meeting: February 26-27, 2020
Agenda (Draft) pdf icon[2 pages]

Latest News Releases
:: Transcript for CDC Telebriefing: Update on COVID-19 Friday, February 21, 2020

MMWR News Synopsis Friday, February 21, 2020
Interim Estimates of 2019–20 Seasonal Influenza Vaccine Effectiveness — United States, February 2020
CDC preliminary vaccine effectiveness estimates indicate that the 2019-20 flu vaccine is providing substantial protective benefit, particularly among children, who were hard hit by flu this season. Flu vaccines are reducing doctor visits associated with flu illness by 45% overall and 55% in children. CDC’s interim flu vaccine effectiveness (VE) estimates show that the flu vaccine has reduced doctor visits associated with flu illness by almost half (VE = 45%) so far this season. This is consistent with estimates of flu vaccine effectiveness from previous seasons that ranged from 40%-60% when flu vaccine viruses were similar to circulating flu viruses. Vaccination is providing substantial protection (VE = 55%) for children, who have been particularly hard hit by flu this season.

Africa CDC [to 22 Feb 2020]

Africa CDC [to 22 Feb 2020]
http://www.africacdc.org/
News
Eighty experts participate in training on enhanced surveillance at points of entry
ADDIS ABABA, ETHIOPIA, 17 FEBRUARY 2020. Eighty participants from 18 African countries are participating in a training on enhanced surveillance at points of entry currently holding in Narobi, Kenya, for points of entry surveillance officers, national surveillance officers, airport authority officers, and representatives of airlines.   The training is organized by the Africa Centres for Disease Control and Prevention in…
Actions taken include training representatives of Member States in laboratory testing of coronavirus, infection prevention and control, risk communication, and surveillance. Africa CDC is also supporting countries to source for and obtain reagents needed to rapidly test for the virus.
This training is to strengthen capacity in the continent and ensure standardization of points of entry surveillance by the different countries so they can quickly detect and contain the outbreak while at its lowest magnitude in the continent…