Author Archives: davidrcurry

Responding to Ebola in the Democratic Republic of Congo

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Humanitarian Exchange Magazine
Number 77, March 2020
https://odihpn.org/magazine/the-crisis-in-yemen/

 

Responding to Ebola in the Democratic Republic of Congo
by Humanitarian Practice Network
This edition of Humanitarian Exchange, co-edited with Anne Harmer, focuses on the response to the Ebola outbreak in the Democratic Republic of Congo (DRC). Although at the time of publication the outbreak appeared to have ended, over its course it claimed 2,200 lives, with more than 3,300 infected, making this the world’s second largest outbreak ever.

In the lead article, Natalie Roberts reflects on the extent to which humanitarian actors have applied learning from the outbreak in West Africa in 2014–2016. Richard Kojan and colleagues report on the NGO ALIMA’s flexible, patient-centred approach to reducing mortality, Marcela Ascuntar reflects on lessons learned from community feedback and Bernard Balibuno, Emanuel Mbuna Badjonga and Howard Mollett highlight the crucial role faith-based organisations have played in the response. In their article, Theresa Jones, Noé Kasali and Olivia Tulloch outline the work of the Bethesda counselling centre in Beni, which provides support to grieving families. Reflecting on findings from a recent assessment by Translators without Borders, Ellie Kemp describes the challenges involved in providing clear and accessible information on Ebola and the response, and Sung Joon Park and colleagues explain how humane care and treatment can help increase trust and confidence in the response. Stephen Mugamba and his co-authors highlight the importance of community involvement in Ebola research, and Gillian McKay and her co-authors examine the impact of the Ebola outbreak and response on sexual and reproductive health services.

Stacey Mearns, Kiryn Lanning and Michelle Gayer present an Ebola Readiness Roadmap to support NGOs in preparing for an outbreak, while Edward Kumakech, Maurice Sadlier, Aidan Sinnott and Dan Irvine report on a Gap Analysis tool looking at the communication, community engagement and compliance tracking activities that need to be in place before an Ebola vaccine is deployed. Emanuele Bruni and colleagues describe the development of a new monitoring and evaluation framework for strategic response planning. The edition ends with an article by Adelicia Fairbanks, who argues for an acceptance strategy in the DRC to improve security and access for responding agencies.

Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19Assessing the Risks and Identifying Needed Reforms

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JAMA
March 24/31, 2020, Vol 323, No. 12, Pages 1111-1216
http://jama.jamanetwork.com/issue.aspx

 

Online First
April 1, 2020
Viewpoint
Potential Legal Liability for Withdrawing or Withholding Ventilators During COVID-19Assessing the Risks and Identifying Needed Reforms
I. Glenn Cohen, JD; Andrew M. Crespo, JD; Douglas B. White, MD, MAS
free access has active quiz
JAMA. Published online April 1, 2020. doi:10.1001/jama.2020.5442
This Viewpoint discusses the legal risks to health care workers and hospital systems from withdrawing or withholding ventilation from COVID-19 patients and cites a Maryland statute that offers legal immunity to clinicians making good faith decisions under emergency conditions as an example for other states to follow.

A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic

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JAMA
March 24/31, 2020, Vol 323, No. 12, Pages 1111-1216
http://jama.jamanetwork.com/issue.aspx

 

Viewpoint
March 27, 2020
A Framework for Rationing Ventilators and Critical Care Beds During the COVID-19 Pandemic
Douglas B. White, MD, MAS; Bernard Lo, MD
free access is active quiz has multimedia online first
JAMA. 2020; doi: 10.1001/jama.2020.5046
This Viewpoint describes a framework for rationing ventilators during the COVID-19 pandemic should intensive care units find themselves with more patients than they can care for, using a score-based system that incorporates patients’ likelihood of surviving to hospital discharge and beyond and their role in the public health response to the outbreak.

Giving patients a voice: implementing patient and public involvement to strengthen research in sub-Saharan Africa

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Journal of Epidemiology & Community Health
April 2020 – Volume 74 – 4
https://jech.bmj.com/content/74/4

 

Commentary
Giving patients a voice: implementing patient and public involvement to strengthen research in sub-Saharan Africa (31 January, 2020)
Carol Bedwell, Tina Lavender
…Active involvement in research and healthcare is very much expected and is well established within many high-income settings. However, in low-income settings, PPI is in its infancy, with few researchers understanding the concept.4 This may lead to a failure to match health need with appropriate research,5 particularly when the research agenda is set by others, leading to acknowledged power imbalances.6 In such settings, empowerment of individuals is low and patients are not included in research design or conduct. In sub-Saharan Africa, gender inequalities mean that women have limited input into both healthcare-related decisions and research.7 Experience of working in these settings highlighted that this is the case even in research which is women-centred, such as maternity care…

Redefining vulnerability in the era of COVID-19

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The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

 

Editorial
Redefining vulnerability in the era of COVID-19
The Lancet
What does it mean to be vulnerable? Vulnerable groups of people are those that are disproportionally exposed to risk, but who is included in these groups can change dynamically. A person not considered vulnerable at the outset of a pandemic can become vulnerable depending on the policy response. The risks of sudden loss of income or access to social support have consequences that are difficult to estimate and constitute a challenge in identifying all those who might become vulnerable. Certainly, amid the COVID-19 pandemic, vulnerable groups are not only elderly people, those with ill health and comorbidities, or homeless or underhoused people, but also people from a gradient of socioeconomic groups that might struggle to cope financially, mentally, or physically with the crisis.

The strategies most recommended to control the spread of COVID-19—social distancing and frequent handwashing—are not easy for the millions of people who live in highly dense communities with precarious or insecure housing, and poor sanitation and access to clean water. Often people living in these settings also have malnutrition, non-communicable diseases, and infectious diseases such as HIV/AIDS and tuberculosis. In South Africa, 15 million people live in townships where the incidence of HIV is around 25%. These immunocompromised populations are at greater risk to Covid-19. Another concern in African countries is that the response to COVID-19 will come at the expense of treating other diseases. For example, in the Democratic Republic of the Congo, the response to Ebola resulted in the resurgence of measles.

The effect of the policy response on children in the fight against COVID-19 is also a concern. On March 23, UNICEF reported that in Latin America and the Caribbean over 154 million children are temporarily out of school because of COVID-19. The impact of this policy is more far-reaching than just the loss of education—in this region, school food programmes benefit 85 million children, and the UN Food and Agriculture Organization assessed that these programmes constitute one of the most reliable daily sources of food for around 10 million children.

Questioning whether appropriate evidence exists to support the reduction of transmission through school closures, Richard Armitage and Laura Nellums considered the long-term risks of deepening social, economic, and health inequities for children in a letter published in The Lancet Global Health. A 2015 UN report analysing the socioeconomic effects of Ebola in Africa also highlighted the increased risks of pregnancy in young girls, school dropout, and child abuse.

The most vulnerable children are part of families in which parents have informal jobs and are not able to work from home. This predicament is particularly concerning in countries like India, where over 80% of its workforce is employed in the informal sector and a third of people work as casual labourers. In socioeconomically fragile settings, a lockdown policy can exacerbate health inequalities and the consequences need careful consideration to avoid reinforcing the vicious cycle between poverty and ill health. Human Rights Watch has reported that the lockdown in India has disproportionately affected marginalised communities because of the loss of livelihood and lack of food, shelter, health, and other basic necessities. Under this unprecedented challenge, governments must be mindful that strategies to address the pandemic should not further marginalise or stigmatise affected communities.

Vulnerable groups and health inequalities are also evident in developed countries. The USA is a stark reminder of the divide that exists in countries without a universal health-care system. For people who do not have private medical insurance, this pandemic might see them face the choice of devastating financial hardship or poor health outcomes, or both. During the 2009 H1N1 influenza pandemic in the USA, individuals with poorer health outcomes were those in the lowest socioeconomic groups. This same group of vulnerable people have now been caught in the middle of a major health emergency as a result of long-standing differences in affluence.

While responding to COVID-19, policy makers should consider the risk of deepening health inequalities. If vulnerable groups are not properly identified, the consequences of this pandemic will be even more devastating. Although WHO guidance should be followed, a one-size-fits-all model will not be appropriate. Each country must continually assess which members of society are vulnerable to fairly support those at the highest risk.

COVID-19 will not leave behind refugees and migrants

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The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

 

COVID-19 will not leave behind refugees and migrants
The Lancet
Never has the “leave no one behind” pledge felt more urgent. As nations around the world implement measures to control the spread of SARS-CoV-2, including lockdowns and restrictions on individuals’ movements, they must heed their global commitments. When member states adopted the UN 2030 Agenda for Sustainable Development, they promised to ensure no one will be left behind. Chief among the world’s most vulnerable people are refugees and migrants. The COVID-19 crisis puts these groups at enormous risk. Yet global pandemic efforts have so far failed in their duty of care to refugees and migrants.

There are millions of refugees and migrants in camps and detention centres worldwide. Resettlement procedures have been suspended by the UN. UNHCR reports that 34 countries hosting substantial refugee populations have seen local transmission of SARS-CoV-2. The often appalling conditions of migrant camps are fertile for infectious disease outbreaks. With few latrines and water supplies, basic hygiene to prevent spread is difficult. With extreme overcrowding, physical distancing is impossible.

In Europe, tens of thousands of migrants live in densely packed camps along the Mediterranean, without adequate medical personnel and infrastructure to cope. With no emergency COVID-19 plan in place by governments, Médicins san Frontières has demanded evacuation of 42 000 asylum seekers on the Greek islands to suitable accommodation. In a Lancet Comment, WHO leaders appeal for more attention for refugees and migrants, including in humanitarian settings, which are facing disruption of essential supplies of food, medicines, and aid workers.

The worst might be yet to come. 80% of refugees live in low-income and middle-income countries, the sites of the expected fourth wave of COVID-19 behind China, Europe, and the USA. Already, these settings have weak health-care systems, scarce protective equipment, and poor testing and treatment capacity. They need enormous global support to prepare for an impending crisis. This virus disregards all borders. COVID-19 responses must not overlook refugees and migrants.

Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma

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The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

 

Mass gathering events and reducing further global spread of COVID-19: a political and public health dilemma
Brian McCloskey, et al. on behalf of the WHO Novel Coronavirus-19 Mass Gatherings Expert Group

The case for replacing live oral polio vaccine with inactivated vaccine in the Americas

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The Lancet
Apr 04, 2020 Volume 39 5Number 10230 p1089-1166, e62-e63
https://www.thelancet.com/journals/lancet/issue/current

 

Viewpoint
The case for replacing live oral polio vaccine with inactivated vaccine in the Americas
Jorge A Alfaro-Murillo, et al
Abstract
Before the development of the inactivated poliovirus vaccine (IPV) and live oral poliovirus vaccine (OPV), sporadic outbreaks of poliomyelitis were reported to cause as many as 18 000 cases of paralysis and over 3000 deaths in the USA alone.1 The straightforward oral administration, high effectiveness, and relatively low cost of OPV was fundamental to the substantial reduction in polio achieved by mass vaccination campaigns. Wild polioviruses were certified by WHO to be eliminated throughout the Americas in 1994 . However, an adverse effect of OPV is vaccine-associated paralytic polio. Among the countries exclusively using OPV in 2012, an estimated 400 cases of vaccine-associated paralytic polio occurred that year.2 This burden is more than double the incidence of wild polio in 2019. 3 Vaccine-derived polioviruses (VDPV) can also spread from person to person, a process that led to more than 250 additional cases of paralysis during 2019. 4 The risk of paralytic polio associated with OPV spurred many countries to switch to the safer IPV. While IPV elicits a much weaker mucosal immune response than OPV, 5 and is thus less effective at averting transmission, it is very protective against disease. In the Americas, Canada transitioned to exclusive IPV use in 1995, the USA in 2000, Costa Rica in 2010, and Uruguay in 2012. However, the remaining 31 countries in the Americas ( appendix) continue to administer at least one dose of OPV.

Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study

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Lancet Global Health
Apr 2020 Volume 8 Number 4 e451-e611
http://www.thelancet.com/journals/langlo/issue/current

 

Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: a systematic review and modelling study
Xin Wang,et al. for the Respiratory Virus Global Epidemiology Network

Efficacy, immunogenicity, and safety of an oral influenza vaccine: a placebo-controlled and active-controlled phase 2 human challenge study

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Lancet Infectious Diseases
Apr 2020 Volume 20 Number 4 p383-510, e50-e78
http://www.thelancet.com/journals/laninf/issue/current

 

Articles
Efficacy, immunogenicity, and safety of an oral influenza vaccine: a placebo-controlled and active-controlled phase 2 human challenge study
David Liebowitz, et al.

Safety and immunogenicity of a highly attenuated rVSVN4CT1-EBOVGP1 Ebola virus vaccine: a randomised, double-blind, placebo-controlled, phase 1 clinical trial

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Lancet Infectious Diseases
Apr 2020 Volume 20 Number 4 p383-510, e50-e78
http://www.thelancet.com/journals/laninf/issue/current

 

Safety and immunogenicity of a highly attenuated rVSVN4CT1-EBOVGP1 Ebola virus vaccine: a randomised, double-blind, placebo-controlled, phase 1 clinical trial
David K Clarke, ey al

Ivermectin as a novel complementary malaria control tool to reduce incidence and prevalence: a modelling study

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Lancet Infectious Diseases
Apr 2020 Volume 20 Number 4 p383-510, e50-e78
http://www.thelancet.com/journals/laninf/issue/current

 

Ivermectin as a novel complementary malaria control tool to reduce incidence and prevalence: a modelling study
Hannah C Slater, Brian D Foy, Kevin Kobylinski, Carlos Chaccour, Oliver J Watson, Joel Hellewell, Ghaith Aljayyoussi, Teun Bousema, Jeremy Burrows, Umberto D’Alessandro, Haoues Alout, Feiko O Ter Kuile, Patrick G T Walker, Azra C Ghani, Menno R Smit
Summary
Background
Ivermectin is a potential new vector control tool to reduce malaria transmission. Mosquitoes feeding on a bloodmeal containing ivermectin have a reduced lifespan, meaning they are less likely to live long enough to complete sporogony and become infectious. We aimed to estimate the effect of ivermectin on malaria transmission in various scenarios of use.
Methods
We validated an existing population-level mathematical model of the effect of ivermectin mass drug administration (MDA) on the mosquito population and malaria transmission against two datasets: clinical data from a cluster- randomised trial done in Burkina Faso in 2015 wherein ivermectin was given to individuals taller than 90 cm and entomological data from a study of mosquito outcomes after ivermectin MDA for onchocerciasis or lymphatic filariasis in Burkina Faso, Senegal, and Liberia between 2008 and 2013. We extended the existing model to include a range of complementary malaria interventions (seasonal malaria chemoprevention and MDA with dihydroartemisinin–piperaquine) and to incorporate new data on higher doses of ivermectin with a longer mosquitocidal effect. We consider two ivermectin regimens: a single dose of 400 μg/kg (1 × 400 μg/kg) and three consecutive daily doses of 300 μg/kg per day (3 × 300 μg/kg). We simulated the effect of these two doses in a range of usage scenarios in different transmission settings (highly seasonal, seasonal, and perennial). We report percentage reductions in clinical incidence and slide prevalence.
Findings
We estimate that MDA with ivermectin will reduce prevalence and incidence and is most effective in areas with highly seasonal transmission. In a highly seasonal moderate transmission setting, three rounds of ivermectin only MDA at 3 × 300 μg/kg (rounds spaced 1 month apart) and 70% coverage is predicted to reduce clinical incidence by 71% and prevalence by 34%. We predict that adding ivermectin MDA to seasonal malaria chemoprevention in this setting would reduce clinical incidence by an additional 77% in children younger than 5 years compared with seasonal malaria chemoprevention alone; adding ivermectin MDA to MDA with dihydroartemisinin–piperaquine in this setting would reduce incidence by an additional 75% and prevalence by an additional 64% (all ages) compared with MDA with dihydroartemisinin–piperaquine alone.
Interpretation
Our modelling predictions suggest that ivermectin could be a valuable addition to the malaria control toolbox, both in areas with persistently high transmission where existing interventions are insufficient and in areas approaching elimination to prevent resurgence.
Funding
Imperial College Junior Research Fellowship.

COVID-19: delay, mitigate, and communicate

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Lancet Respiratory Medicine
Apr 2020 Volume 8 Number 4 p321-422, e14-e26
http://www.thelancet.com/journals/lanres/issue/current

 

Editorial
COVID-19: delay, mitigate, and communicate
The Lancet Respiratory Medicine
On March 11, 2020, WHO declared COVID-19 a pandemic and has called for governments to take “urgent and aggressive action” to change the course of the outbreak. As of March 12, 2020, the USA has suspended all travel from 26 European countries, and Italy is the latest country to enforce widespread lockdown measures to curb the spread of the virus. Robust plans and policies to avoid the disease trajectories seen in the worst-hit countries are urgently needed. These responses must be proportionate to each country’s situation and communicated in a clear and balanced way to avoid spreading fear and panic.

The UK preparedness plan for tackling COVID-19, informed by WHO guidance and launched on March 3, 2020, includes four phases: containment, delay, mitigation, and, alongside these, research to better understand the disease and its effects, and to address the challenges of imperfect diagnostic approaches and absence of proven treatments or a vaccine. Containment measures, aimed at preventing the disease from taking hold, are broadly in line with those of other European countries at a similar stage in the outbreak, encompassing early detection, isolation, and care of people already infected, with careful tracing and screening of their contacts. These measures might have staved off a sharp rise in cases, as seen in Italy, for now but case numbers are inevitably climbing. Although the controversial containment measures used in China have bought some time for other regions of the world, such strategies are unlikely to be replicated in Europe. The example of Singapore could be informative for many countries: having learned lessons from the severe acute respiratory syndrome epidemic of 2002–03, Singapore has so far managed the outbreak well, with rapid testing of suspected cases, clear public health messages from the outset, and by individuals taking action to protect themselves and others.

With cases approaching 500, the UK has now moved to the delay phase, a decision that has been criticised for coming too late. The delay phase aims to slow the spread and push the peak impact away from the winter season to reduce pressure on an already overstretched NHS. Social distancing strategies, some of which are already in place in other European countries, such as the cancellation of conferences and other large gatherings, reducing non-essential use of public transport, and closure of schools, are under consideration but yet to be implemented in the UK. Rather, simple but important containment measures such as handwashing are being promoted, as is self-isolation for 7 days for those with symptoms, which is thought to be more effective than school closures and bans on mass gatherings. Although the list of countries imposing tight restrictions on people who have travelled from regions with high caseloads is growing, the UK is unlikely to follow suit, and WHO does not recommend large-scale international travel restrictions or closure of borders owing to the major implications for trade, international collaboration, and supply chains for food and resources, including medical equipment. Decisions about delay strategies must be scientifically based and clearly justified to the public—via all communication platforms, including social media—to counter misinformation and avoid fuelling panic.

Mitigation planning for widely established infection—as seen in China, Italy, Iran, and South Korea—is essential to enable optimum care for patients, maintenance of essential hospital services, and provision of ongoing support for infected people in the community to minimise disruption to society, public services, and the economy in the event of a prolonged pandemic. The higher rates of severe or fatal cases in Italy compared with other countries with major outbreaks (eg, South Korea) might reflect the older population in affected regions of Italy and highlight the need to tailor mitigation plans to local demographics. Many health systems will be stretched beyond capacity by the demands of increasing COVID-19 caseloads. In the UK, for example, intensive care unit (ICU) bed numbers per person are already worryingly low compared with those of other European countries, so thorough surge capacity planning is needed. Interim strategies with makeshift intensive care facilities outside ICU settings could be provided to care for less severely affected patients, but such an approach would not be sustainable in the long term. Support for health-care professionals on the frontline should also be prioritised.

All governments must now take decisive action to more aggressively combat the outbreak. COVID-19 represents a substantial risk to large sections of the population, and especially elderly people and those with pre-existing health conditions. As the outbreak progresses, balanced, coherent, and consistent public health communication, based on science, will be essential.

Hospitals should act now to notify patients about research use of their data and biospecimens

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Nature Medicine
Volume 26 Issue 3, March 2020
https://www.nature.com/nm/volumes/26/issues/3

 

Comment | 11 March 2020
Hospitals should act now to notify patients about research use of their data and biospecimens
Private industry is increasingly soliciting hospitals to sell or share health data and biospecimens, but current laws offer more disclosure and consent protections for research participants than for patients receiving clinical care. Hospitals can offer more protections than required by law, however, and should move toward greater transparency with their patients about the research use of clinical health data and biospecimens to respect patients and avoid distrust.
Kayte Spector-Bagdady

In emergencies, health research must go beyond public engagement toward a true partnership with those affected

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Nature Medicine
Volume 26 Issue 3, March 2020
https://www.nature.com/nm/volumes/26/issues/3

 

Comment | 28 January 2020
In emergencies, health research must go beyond public engagement toward a true partnership with those affected
An Ebola virus outbreak taking place in the complex political and social context of The Democratic Republic of the Congo has forced the research community to reflect on their approach to community engagement. Katharine Wright and Michael Parker, on behalf of the Nuffield Council on Bioethics Working Group on research in global health emergencies, say that those affected need to influence research choices from the very beginning and that the value of their knowledge must be recognized.
Katharine Wright, Michael Parker[…] & Paulina Tindana

Pan-genomics in the human genome era

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Nature Reviews Genetics
Volume 21 Issue 4, April 2020
https://www.nature.com/nrg/volumes/21/issues/4

 

Review Article | 07 February 2020
Pan-genomics in the human genome era
Although single reference genomes are valuable resources, they do not capture genetic diversity among individuals. Sherman and Salzberg discuss the concept of ‘pan-genomes’, which are reference genomes that encompass the genetic variation within a given species. Focusing particularly on large eukaryotic pan-genomes, they describe the latest progress, the varied methodological approaches and computational challenges, as well as applications in fields such as agriculture and human disease.
Rachel M. Sherman & Steven L. Salzberg

Creating a Framework for Conducting Randomized Clinical Trials during Disease Outbreaks

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New England Journal of Medicine
April 2, 2020 Vol. 382 No. 14
http://www.nejm.org/toc/nejm/medical-journal

 

Sounding Board
Creating a Framework for Conducting Randomized Clinical Trials during Disease Outbreaks
Natalie E. Dean, Ph.D., et al
Conducting trials of novel interventions during infectious disease emergencies, such as the ongoing Covid-19 pandemic, is increasingly recognized as important for determining the efficacy of potential vaccines and therapies. Clinical trials to evaluate investigational interventions are being implemented as part of the broader efforts to control the spread of an infectious disease and to improve patient outcomes. In such circumstances, however, it can be challenging to acquire the necessary evidence about the effects of the interventions to inform future patient care and public health planning, in part because of the unpredictable size, geographic location, and duration of outbreaks.

Vaccination coverage survey and seroprevalence among forcibly displaced Rohingya children, Cox’s Bazar, Bangladesh, 2018: A cross-sectional study

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PLoS Medicine
http://www.plosmedicine.org/
(Accessed 28 Mar 2020)

 

Vaccination coverage survey and seroprevalence among forcibly displaced Rohingya children, Cox’s Bazar, Bangladesh, 2018: A cross-sectional study
Leora R. Feldstein, Sarah D. Bennett, Concepcion F. Estivariz, Gretchen M. Cooley, Lauren Weil, Mallick Masum Billah, M. Salim Uzzaman, Rajendra Bohara, Maya Vandenent, Jucy Merina Adhikari, Eva Leidman, Mainul Hasan, Saifuddin Akhtar, Andreas Hasman, Laura Conklin, Daniel Ehlman, A. Alamgir, Meerjady Sabrina Flora
Research Article | published 31 Mar 2020 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003071

Assessment of immunity to polio among Rohingya children in Cox’s Bazar, Bangladesh, 2018: A cross-sectional survey

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PLoS Medicine
http://www.plosmedicine.org/
(Accessed 28 Mar 2020)

 

Assessment of immunity to polio among Rohingya children in Cox’s Bazar, Bangladesh, 2018: A cross-sectional survey
Concepcion F. Estivariz, Sarah D. Bennett, Jacquelyn S. Lickness, Leora R. Feldstein, William C. Weldon, Eva Leidman, Daniel C. Ehlman, Muhammad F. H. Khan, Jucy M. Adhikari, Mainul Hasan, Mallick M. Billah, M. Steven Oberste, A. S. M. Alamgir, Meerjady D. Flora
Research Article | published 31 Mar 2020 PLOS Medicine
https://doi.org/10.1371/journal.pmed.1003070

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

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PLoS One
http://www.plosone.org/
[Accessed 28 Mar 2020]

 

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities
Anyie J. Li, Collins Tabu, Stephanie Shendale, Peter O. Okoth, Kibet Sergon, Ephantus Maree, Isaac K. Mugoya, Zorodzai Machekanyanga, Iheoma U. Onuekwusi, Ikechukwu Udo Ogbuanu
Research Article | published 30 Mar 2020 PLOS ONE
https://doi.org/10.1371/journal.pone.0230783

Projecting hospital utilization during the COVID-19 outbreaks in the United States

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PNAS – Proceedings of the National Academy of Sciences of the United States of America
http://www.pnas.org/content/early/
[Accessed 28 Mar 2020]

 

Projecting hospital utilization during the COVID-19 outbreaks in the United States
Seyed M. Moghadas, Affan Shoukat, Meagan C. Fitzpatrick, Chad R. Wells, Pratha Sah, Abhishek Pandey, Jeffrey D. Sachs, Zheng Wang, Lauren A. Meyers, Burton H. Singer, and Alison P. Galvani
PNAS first published April 3, 2020. https://doi.org/10.1073/pnas.2004064117

Emerging from AI utopia

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Science
03 April 2020 Vol 368, Issue 6486
http://www.sciencemag.org/current.dtl

 

Editorial
Emerging from AI utopia
Edward Santow, Australia’s Human Rights Commissioner.
Summary
A future driven by artificial intelligence (AI) is often depicted as one paved with improvements across every aspect of life—from health, to jobs, to how we connect. But cracks in this utopia are starting to appear, particularly as we glimpse how AI can also be used to surveil, discriminate, and cause other harms. What existing legal frameworks can protect us from the dark side of this brave new world of technology?

Shaping meeting to explore the value of a coordinated work plan for epidemic and pandemic influenza vaccine preparedness

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Vaccine
Volume 38, Issue 16 Pages 3179-3294 (3 April 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/16

 

Conference info Abstract only
Shaping meeting to explore the value of a coordinated work plan for epidemic and pandemic influenza vaccine preparedness
Bruce Ruscio, Amanda Bolster, Joseph Bresee, Atika Abelin, … Anonh Xeuatvongsa
Pages 3179-3183
Abstract
In March 2019, a group of global health leaders with expertise in influenza, vaccinology and pandemic preparedness was convened for a meeting titled “Shaping Meeting to explore the value of a coordinated work plan for epidemic and pandemic influenza vaccine preparedness.” Influenza epidemics occur annually in every country in the world, resulting in significant global burden of illness and deaths. While every country is effected, most deaths and severe disease occur in low- and lower middle-income countries (LIC and LMIC). Influenza immunization programs that limit the burden of disease, deaths, and reduce economic impact are a fundamental public health intervention for seasonal epidemics. In addition, they provide the experience, systems and infrastructure for the timely and efficient use of vaccines and other medical countermeasures critical for effective pandemic responses. Pandemic influenza response activities, including vaccination efforts, will be most effective if used and practiced regularly. Consequently, countries with seasonal influenza prevention and control programs should be better prepared for, and have more effective pandemic responses than countries without such programs. A decade after the 2009 pandemic, despite ongoing prevention efforts, most LICs and LMICs still lack access to robust seasonal influenza immunization programs. Given this current state, meeting participants concluded that there is critical need to advance the expansion and strengthening of seasonal influenza immunization programs in LICs and LMICs not only to reduce the economic and public health effects of annual influenza epidemics, but also to increase preparedness to mitigate the threat of future pandemics and improve global heath security. Many government and private sectors, in a whole of government approach, need to be working together to support and advance countries’ epidemic and pandemic influenza capacities preparedness objectives. Accomplishment of these objectives can be achieved with a coordinated work plan developed and guided by an alliance of international stakeholders, to include, among others, government, and nongovernment organization representation, civil society representatives, vaccine manufacturers, international organizations, and health security and influenza experts

A randomised controlled trial of SMS messaging and calendar reminders to improve vaccination timeliness in infants

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Vaccine
Volume 38, Issue 15 Pages 3073-3178 (30 March 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/15

 

Research article Abstract only
A randomised controlled trial of SMS messaging and calendar reminders to improve vaccination timeliness in infants
R. Menzies, L. Heron, J. Lampard, M. McMillan, … H. Marshall
Pages 3137-3142

Awareness and knowledge of HPV and HPV vaccination among adults ages 27–45 years

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Vaccine
Volume 38, Issue 15 Pages 3073-3178 (30 March 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/15

 

Research article Abstract only
Awareness and knowledge of HPV and HPV vaccination among adults ages 27–45 years
Erika L. Thompson, Christopher W. Wheldon, Brittany L. Rosen, Sarah B. Maness, … Philip M. Massey
Pages 3143-3148

School-based vaccination programmes: An evaluation of school immunisation delivery models in England in 2015/16

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Vaccine
Volume 38, Issue 15 Pages 3073-3178 (30 March 2020)
https://www.sciencedirect.com/journal/vaccine/vol/38/issue/15

 

Research article Open access
School-based vaccination programmes: An evaluation of school immunisation delivery models in England in 2015/16
K. Tiley, E. Tessier, J.M. White, N. Andrews, … M. Edelstein
Pages 3149-3156

Health Literacy, Vaccine Confidence and Influenza Vaccination Uptake among Nursing Home Staff: A Cross-Sectional Study Conducted in Tuscany

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Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 28 Mar 2020)

 

Open Access Article
Health Literacy, Vaccine Confidence and Influenza Vaccination Uptake among Nursing Home Staff: A Cross-Sectional Study Conducted in Tuscany
by Chiara Lorini , Francesca Collini , Francesca Gasparini , Diana Paolini , Maddalena Grazzini , Francesca Ierardi , Giacomo Galletti , Patrizio Zanobini , Fabrizio Gemmi and Guglielmo Bonaccorsi
Vaccines 2020, 8(2), 154; https://doi.org/10.3390/vaccines8020154 (registering DOI) – 30 Mar 2020

Progress and Prospects on Vaccine Development against SARS-CoV-2

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Vaccines — Open Access Journal
http://www.mdpi.com/journal/vaccines
(Accessed 28 Mar 2020)

 

Open Access Review
Progress and Prospects on Vaccine Development against SARS-CoV-2
by Jinyong Zhang , Hao Zeng , Jiang Gu , Haibo Li , Lixin Zheng and Quanming Zou
Vaccines 2020, 8(2), 153; https://doi.org/10.3390/vaccines8020153 – 29 Mar 2020
Viewed by 686
Abstract
In December 2019, the outbreak of pneumonia caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a serious pandemic in China and other countries worldwide. So far, more than 460,000 confirmed cases were diagnosed in nearly 190 countries, causing globally over 20,000 deaths. Currently, the epidemic is still spreading and there is no effective means to prevent the infection. Vaccines are proved to be the most effective and economical means to prevent and control infectious diseases. Several countries, companies, and institutions announced their programs and progress on vaccine development against the virus. While most of the vaccines are under design and preparation, there are some that have entered efficacy evaluation in animals and initial clinical trials. This review mainly focused on the progress and our prospects on field of vaccine development against SARS-CoV-2

Media/Policy Watch

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Media/Policy Watch
This watch section is intended to alert readers to substantive news, analysis and opinion from the general media and selected think tanks and similar organizations on vaccines, immunization, global public health and related themes. Media Watch is not intended to be exhaustive, but indicative of themes and issues CVEP is actively tracking. This section will grow from an initial base of newspapers, magazines and blog sources, and is segregated from Journal Watch above which scans the peer-reviewed journal ecology.
We acknowledge the Western/Northern bias in this initial selection of titles and invite suggestions for expanded coverage. We are conservative in our outlook in adding news sources which largely report on primary content we are already covering above. Many electronic media sources have tiered, fee-based subscription models for access. We will provide full-text where content is published without restriction, but most publications require registration and some subscription level.

 

The Atlantic
http://www.theatlantic.com/magazine/
Accessed 28 Mar 2020
Ideas
Stretching the International Order to Its Breaking Point
The greatest error that geopolitical analysts can make may be believing that the crisis will be over in three to four months.
April 4, 2020
Thomas Wright, Senior fellow at the Brookings Institution
At this stage in the COVID-19 pandemic, uncertainty prevails. The greatest error that geopolitical analysts can make may be believing that the crisis will be over in three to four months, as the world’s leaders have been implying. As documented in The Atlantic and elsewhere, public-health experts make a compelling case that COVID-19 could be with us in one way or another until a vaccine comes on the market or herd immunity is achieved—either of which could take 12 to 18 months, unless we get lucky with a cure or an effective treatment before then. A long crisis, which is more likely than not, could stretch the international order to its breaking point. Even after a vaccine is available, life will not go back to normal. COVID-19 was not a black swan and will not be the last pandemic. A nervous world will be permanently changed.
COVID-19 is the fourth major geopolitical shock in as many decades. In each of the previous three, analysts and leaders grossly underestimated the long-term impact on their society and on world politics….

 

BBC
http://www.bbc.co.uk/
[No new, unique, relevant content]

 

The Economist
http://www.economist.com/
Accessed 28 Mar 2020
[No new, unique, relevant content]

 

Financial Times
http://www.ft.com/home/uk
Accessed 28 Mar 2020
[No new, unique, relevant content]

 

Forbes
http://www.forbes.com/
[No new, unique, relevant content]

 

Foreign Affairs
http://www.foreignaffairs.com/
Accessed 28 Mar 2020
Domestic Politics   Apr 4, 2020
“America First” Is a Dangerous Fantasy in a Pandemic
Trump’s “America First” approach to coronavirus overlooks the fact that failing to defeat the pandemic abroad undermines our ability to get it under control—and…
Philip H. Gordon

Africa   Mar 31, 2020
When the Pandemic Hits the Most Vulnerable
If nothing changes, the prospect of millions of deaths is far from unrealistic.
Robert Malley and Richard Malley

 

Foreign Policy
http://foreignpolicy.com/
Accessed 28 Mar 2020
[No new, unique, relevant content]

 

The Guardian
http://www.guardiannews.com/
Accessed 28 Mar 2020
[No new, unique, relevant content]

 

New Yorker
http://www.newyorker.com/
Accessed 28 Mar 2020
A Critic at Large
Pandemics and the Shape of Human History
By Elizabeth Kolbert

 

New York Times
http://www.nytimes.com/
Accessed 28 Mar 2020
U.S.
Exclusive: Pressed by Trump, U.S. Pushed Unproven Coronavirus Treatment Guidance
In mid-March, President Donald Trump personally pressed federal health officials to make malaria drugs available to treat the novel coronavirus, though they had been untested for COVID-19, two sources told Reuters.
4/4/2020 By Reuters

U.S.
Ex-NYU Hospital Employee Who Refused Flu Vaccine Sues Over His Firing
By Jonathan Stempel
By Reuters April 3

 

Washington Post
https://www.washingtonpost.com/
Accessed 28 Mar 2020
[No new, unique, relevant content]

Think Tanks et al

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Think Tanks et al

Brookings
http://www.brookings.edu/
Accessed 28 Mar 2020
Op-Ed
Ebola lessons for fighting COVID-19
Ngozi Okonjo-Iweala
Thursday, April 2, 2020

Center for Global Development [to 28 Mar 2020]
http://www.cgdev.org/page/press-center
Selected Publications, News and Events
April 3, 2020
A Gender Lens on COVID-19: Pandemics and Violence against Women and Children
Early in the COVID-19 outbreak, we have seen increased reports of increased intimate partner violence (IPV) and violence against children.
Megan O’Donnell, Amber Peterman and Alina Potts

April 2, 2020
Does One Size Fit All? Realistic Alternatives for COVID-19 Response in Low-Income Countries
In the response to the COVID-19 pandemic, it is now evident that many of the public health and hospital-based interventions deployed by high-income countries may be ineffective or infeasible in low- and middle-income countries. We suggest a different order of priority for immediate next steps.
Amanda Glassman, Kalipso Chalkidou and Richard Sullivan

April 1, 2020
The COVID-19 Crisis Is the Time for the World Bank to Embrace Bold Economic Policies
It is often said that governments “fight the last war” during times of economic crisis. But based on David Malpass’ remarks from last week’s G20 Finance Ministers call, it appears the World Bank is preparing to fight the wars of the 1990s by revamping old—and largely discredited—crisis policy prescriptions to address what is likely to be a severe economic downturn caused by the COVID-19 pandemic.
Clemence Landers

Financing and Scaling Innovation for the COVID Fight: A Closer Look at Demand-Side Incentives for a Vaccine
Publication
3/31/20

March 31, 2020
Urgent Call for an Exit Plan: The Economic and Social Consequences of Responses to COVID-19 Pandemic
As governments proceed to pursue social distancing and lockdown measures, we urgently call for the development and communication of exit plans, increased testing to inform planning, and a rethink of global supply chains of critical items such as ventilation equipment.
Richard Sullivan and Kalipso Chalkidou

 

CSIS
https://www.csis.org/
Accessed 28 Mar 2020
Commentary
Covid-19 and Value Chains: Diminishing Returns from Trade Policy
April 3, 2020 | By Scott Miller

Commentary
Trade Symptoms of the Pandemic
April 3, 2020 | By William Alan Reinsch, Jack Caporal

Commentary
Pandemic Pandemonium: How the Virus Could Change the Trading System
April 2, 2020 | By William Alan Reinsch

Commentary
Geopolitical Scenarios for Asia after COVID-19
March 31, 2020 | By Michael J. Green

 

Council on Foreign Relations
http://www.cfr.org/
Accessed 28 Mar 2020
Coronavirus
After the Pandemic: Can the United States Finally Retool for the Twenty-First Century?
Over the more than half a century since the United States embraced its integration into the global economy, it has produced both the strongest and the weakest of the advanced economies.
April 3, 2020
Blog Post by Edward Alden Renewing America

 

Kaiser Family Foundation
https://www.kff.org/search/?post_type=press-release
Accessed 28 Mar 2020
[No new relevant content]

Vaccines and Global Health: The Week in Review :: 28 March 2020

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Vaccines and Global Health: The Week in Review is a weekly digest  summarizing news, events, announcements, peer-reviewed articles and research in the global vaccine ethics and policy space. Content is aggregated from key governmental, NGO, international organization and industry sources, key peer-reviewed journals, and other media channels. This summary proceeds from the broad base of themes and issues monitored by the Center for Vaccine Ethics & Policy in its work: it is not intended to be exhaustive in its coverage. You are viewing the blog version of our weekly digest, typically comprised of between 30 and 40 posts below all dated with the current issue date

.– Request an Email Summary: Vaccines and Global Health : The Week in Review is published as a single email summary, scheduled for release each Saturday evening before midnight (EDT in the U.S.). If you would like to receive the email version, please send your request to david.r.curry@centerforvaccineethicsandpolicy.org.

– pdf version:  A pdf of the current issue is available here: Vaccines and Global Health_The Week in Review_28 Mar 2020

– blog edition: comprised of the approx. 35+ entries posted below.

– Twitter:  Readers can also follow developments on twitter: @vaxethicspolicy.
.
– Links:  We endeavor to test each link as we incorporate it into any post, but recognize that some links may become “stale” as publications and websites reorganize content over time. We apologize in advance for any links that may not be operative. We believe the contextual information in a given post should allow retrieval, but please contact us as above for assistance if necessary.

Support this knowledge-sharing service: Your financial support helps us cover our costs and to address a current shortfall in our annual operating budget. Click here to donate and thank you in advance for your contribution.

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