Epidemiology Update – New SARS-CoV-2 variants

• In countries where the B.1.1.7 variant is dominating, the picture is getting much worse. French ICUs are packed with 5,000+ COVID-19 patients for the first time since April 2020. Turkey has reached record daily case numbers. Canada reports rising case numbers and hospitalizations.
• Brazil’s out-of-control outbreak could seed more dangerous variants, given “the virus’s track record of acquiring mutations in areas where it abounds,”. The P.1 variant first discovered in Manaus has since reached 34 other countries—and has been shown to be “more pernicious than its predecessors.”
• The T cell response—a crucial element of the immune system—induced by infection with the original coronavirus was shown to be protective against the top 3 virus variants, those first discovered in the UK, South Africa, and Brazil.
• India reports novel COVID-19 variant, daily deaths at year’s high.
• In Brazil, more young people seem to be getting severely ill and dying from Covid-19.

VACCINES AND VARIANTS

NEW VARIANTS

Source: WHO      ; Date: 03/30/2021

Other Headlines

• Globally, new COVID-19 cases rose for a fifth consecutive week, with just over 3.8 million new cases reported in the last week. The number of new deaths increased for the second consecutive week, increasing by 5% compared to last week, with over 64,000 new deaths reported. All regions reported an increase in the number of cases this week. Europe and the Americas continue to account for approximately 80% of all new and cumulative cases and deaths.
• AMR and COVID-19 Many Hospitalized COVID-19 Patients Are Given Antibiotics.  As the Covid-19 pandemic continues into its second year, public health experts are increasingly concerned that the response to this global crisis may be accelerating another one: the development and persistence of the antibiotic-resistant bacteria known as superbugs. Why? All antibiotic use hastens the emergence of resistance. And although antibiotics aren’t used to treat Covid-19, which is a viral illness, they’re often prescribed to Covid-19 patients who are at risk for bacterial infection.
• First baby born with COVID antibodies after mom got the Moderna vaccine— here's why that matters.
• Global Leaders Unite in Urgent Call for International Pandemic Treaty – 25 heads of government and international agencies come together in extraordinary joint call for a new treaty that would signal high-level political action needed to protect the world from future health crises. The main goal of a new international treaty for pandemic preparedness and response would be to foster a comprehensive, multi-sectoral approach to strengthen national, regional and global capacities and resilience to future pandemics.
• COVID-19 drives a more severe form of acute kidney injury.

UPDATE ON KEY TOOLS

Vaccine Development and WHO approval

• Shanghai mRNA COVID-19 vaccine begins phase 1 clinical trials -The double-blind placebo-controlled vaccine trials are being conducted among people at high risk of contracting COVID-19 aged 18 and above.
• Pfizer has started a clinical trial testing its COVID-19 vaccine on healthy 6-month to 11-year old children, a crucial step in obtaining federal regulatory clearance to start vaccinating young kids and controlling the pandemic.
• AstraZeneca has begun advertising for participants in an early-stage trial to deliver the COVID-19 vaccine it jointly developed with AstraZeneca as a nasal spray.
• Novavax’s Covid-19 Vaccine Trials Start in India with the aim of launching it by September.
• mRNA vaccines and monoclonal antibodies protect against new NYC-B.1.526 variant research team tested how susceptible the B.1.526 variants were to neutralizing antibodies from convalescent plasma, monoclonal antibodies, and mRNA vaccines.
• Pfizer and Moderna vaccines were 90% effective in preventing Covid-19 infection in a real-world setting.
• Vaccine effectiveness of the first dose of ChAdOx1 nCoV-19 and BNT162b2 against SARS-CoV-2 infection in residents of Long-Term Care Facilities (VIVALDI study).  The first dose of BNT162b2 and ChAdOx1 vaccines was associated with substantially reduced SARS-CoV-2 infection risk in LTCF residents.

Vaccine  Access, Delivery, and Rollout

• UK will produce up to 60m doses of Covid-19 vaccine under a new deal to boost domestic supply, due to potential export bans hitting shipments of vaccines from Europe and India.
• BioNTech-Pfizer raise 2021 vaccine output goal to 2.5 billion doses.
• Iran’s ‘Fakhra’ vaccine to be mass-produced by late May.
• EMA gives BioNTech, AstraZeneca and Moderna approval for new COVID-19 production facilities which will become one of the largest mRNA vaccine manufacturing sites in Europe and the world. Elsewhere, additional sites are also set to produce AstraZeneca and Moderna doses.
• BioNTech-Pfizer Raise 2021 Vaccine Output Goal to 2.5 Billion Doses after opening of a new German facility.
• Canada to pause AstraZeneca COVID-19 vaccine use for those under 55, require new risk analysis based on age and gender.
• EU leaders support “global value chains” rather than support Brussels in using new powers to block COVID-19 jab exports to highly vaccinated countries, despite being told that 21m doses had been sent to the UK.
• Novavax is delaying signing a contract to supply its COVID-19 vaccine to the European Union as the U.S. biotech company warned it was struggling to source some raw materials.
• UK is reportedly planning on giving millions of Covid-19 vaccines to Ireland in a bid to stave off a third wave in Northern Ireland.
• China's CanSino has proposed supplying "tens of millions of doses" of its single-dose COVID-19 vaccine to the global vaccine-sharing scheme COVAX .
• Russia has celebrated the arrival of its homegrown vaccine, Sputnik V, in Latin America and Africa, and even in some countries in Europe, calling it a solution to shortages around the world, while importing vaccines at home.
• Russian Direct Investment Fund  had reached an agreement with China's Shenzhen Yuanxing Gene-tech to produce over 60 million doses of Russia's Sputnik V vaccine against the coronavirus in China, with production due to start in May.
• COVID-19 vaccine hesitancy could lead to thousands of extra deaths - High numbers of people refusing or delaying a vaccine could increase the mortality rate by up to eight times compared with ideal vaccination uptake. The team estimate that this hesitancy would lead to an extra 236 deaths per million population over a two year period for a vaccine with high efficacy.
• Asian countries scrambled to find alternative sources for COVID-19 inoculations on Tuesday after export restrictions by manufacturer India left a World Health Organization-backed global vaccine sharing programme short of supplies.
• Johnson & Johnson would start delivering its single-shot Covid vaccine to Europe on April 19, giving the continent a boost as it struggles to speed up its vaccination drive.
• Israel plans to buy millions of additional doses of coronavirus vaccine that may be used once its initial inoculation drive is complete.
• A new factory in Abu Dhabi will start manufacturing Sinopharm’s COVID-19 vaccine later this year.
• India extends shelf life of AstraZeneca vaccine.
• Third Covid vaccine in India likely to be approved soon.

Africa (AFE and AFW)

• Johnson&Johnson will supply up to 220 million doses of its single-shot COVID-19 vaccine to African Union’s 55 member states from the third quarter of 2021.
• Ethiopia expects to receive a consignment of 300,000 doses of the China-backed Sinopharm vaccines on March 30.
• Kenya confirms presence of new Covid-19 variants.
• Mali approves Russia's Sputnik V vaccine.

Europe and Central Asia

• Excess deaths in Russia suggest Covid death toll is closer to 450,000 than the official number of 94,000.
• Ukraine and Bulgaria are reporting record numbers of COVID-19 deaths and cases, respectively,;  in the Bulgarian city of Yambol, 98% of hospital beds are occupied.
• Uzbekistan to start mass coronavirus vaccination from April 1.
• A third wave of coronavirus infections was emerging in Russia, which has recorded more than 4.5 million cases since the start of the pandemic.

East Asia and Pacific

• A court in Vietnam on Tuesday issued a two-year suspended jail term to a flight attendant over breaking COVID-19 quarantine rules and allegedly spreading the virus to others.

Latin America and the Caribbean

• Despite Chile’s speedy covid-19 vaccination drive, cases soar in the country.
• Brazil to spend extra $1 billion to fight pandemic as country hits daily death record.
• Hospitals in Ecuador's capital overwhelmed by COVID-19 infections.

Middle-East and North Africa

• Egypt's COVID-19 robot hospital assistant might just save lives.

South Asia Region

• Pakistan continues to grapple with third wave of coronavirus. Pakistan’s President and Finance Minister test positive for COVID-19 as hospitals reach capacity.
• India has highest number of critical cases. India pushes ahead with coronavirus vaccination drive to head off new surge.
• India donates 200,000 vaccines to protect UN blue helmets against COVID.
• India suffers highest daily coronavirus infections in five months.

Mobility

• Nairobi goes into partial lockdown.
• Philippine Capital Back in Lockdown as cases surge.
•  

Treatment

• Lilly-Vir's COVID-19 antibody treatments reduced viral load in low-risk COVID-19 patients, results from a mid-stage trial showed.
• Cynata Theraputics is all set to expand recruitment criteria in its active MEseNchymal coviD-19 (MEND) clinical trial of Cymerus mesenchymal stem cells (MSCs) in intensive care patients with respiratory failure.
• How new insights into COVID's spike protein could guide treatment design SARS-CoV-2, the virus behind the COVID-19 pandemic, is structurally similar to SARS-CoV-1, the virus that caused a much smaller outbreak two decades ago. So why has today’s iteration of the virus been so much more infectious?
• The PROTECT-V trial investigating UNIONs COVID-19 candidate receives Urgent Public Health Prioritization from the UK government
• Pfizer began the phase one trial of a pill to treat COVID-19. The treatment is a potent protease inhibitor, the same kind of technology used to treat HIV and hepatitis C. The pill demonstrated potent in vitro anti-viral activity against SARS-CoV-2, as well as activity against other coronaviruses.
• New phase III data shows investigational antibody cocktail casirivimab and imdevimab reduced hospitalization or death by 70% in non-hospitalized patients with COVID-19.
• Foresee Pharmaceuticals FP-025 showed significant therapeutic efficacy in preclinical inflammation and fibrosis models of the lung, suggesting that FP-025 may potentially avert the lung injury and fibrosis caused by COVID–19 infections.
• Antibody agents effective at neutralizing European, South African, and United States SARS-CoV-2 variants - Researchers in the United States have demonstrated the effectiveness of three antibody agents at neutralizing recently emerged variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the agent responsible for the coronavirus disease 2019 (COVID-19) pandemic.

Diagnostics

• New economical test can accurately detect covid-19 antibodies in a drop of blood in less than an hour.

Epidemiology Update – New SARS-CoV-2 variants

• IHME reports that global case increases in recent weeks are being driven by the spread of the P1 variant of concern in Brazil, Peru and some neighboring areas; and the spread of the VOC 501Y.V1 (VOC 202012/01) variant of concern, compounded by increases in mobility and decreases in mask use, in Europe and the US. IMHE states that helping South America to vaccinate on an accelerated basis should be a global priority.
• Researchers from the London School of Hygiene and Tropical Medicine estimate a 55 per cent higher hazard of death associated with the VOC 202012/01 variant of concern. This analysis suggests that this variant is not only more transmissible than pre-existing variants, but may also cause more severe illness.
• Supercomputer analysis reveals why B.1.1.7 and B.1.351 Coronavirus Variants Are More Contagious, Deadly.
• The neutralizing-antibody response to four variants is compared in infected and vaccinated individuals to determine how mutations within the spike protein are associated with virus neutralization.
• India reports novel coronavirus variant, daily deaths at year's high.

VACCINES AND VARIANTS

Source: WHO  Date March 16^th, 2021

Other Headlines

• WHO epidemiological update: Globally, COVID-19 confirmed cases continued to rise for a fourth consecutive week, with just under 3.3 million new cases reported in the last week (ten percent increase from last week). At the same time, the number of new deaths reported plateaued after a six week decrease, with just over 60,000 new deaths reported.
• UNICEF, WHO and UNFPA report that drastic cuts in the availability and use of essential public health services across South Asia, due to COVID-19, may have contributed to an estimated 239,000 additional child and maternal deaths in 2020.

• G7 nations support the IMF’s plan to increase aid for low-income nations.
• Past infection confers 80.5 per cent protection against reinfection, which decreases to 47.1 per cent in those aged 65 years and older. These findings show the importance of policies to protect the elderly during the pandemic.
• Domestic travel measures implemented in Wuhan were effective at reducing the importation of cases internationally and within China, and additional travel restrictions were also likely important. The findings highlight the need to evaluate the potential effectiveness of travel measures using a risk and context-based assessment and suggest the need to strengthen WHO’s PHEIC procedures.
• Tuberculosis may have claimed an extra 500,000 lives in 2020 because of the lack of TB diagnosis and care, according to a new WHO report published ahead of World TB Day today. According to the report, 1.4 million fewer people received the TB care they needed in 2020 compared to the year before.
• The virus that causes the common cold can effectively remove the Covid virus out of the body's cells, say researchers.

UPDATE ON KEY TOOLS

Vaccine Development and WHO approval

• AstraZeneca advised that a review of safety data from 17 million people vaccinated in the EU and the UK has shown no evidence of an increased risk of blood clots, in any defined age group, gender, batch or in any particular country.
• CureVac’s COVID-19 vaccine candidate, CVnCoV, demonstrates protection against SARS-CoV-2 B.1.351 variant (first seen in South Africa) in preclinical challenge study.
• Clinical trials approved for CanSino’s inhaled COVID-19 vaccine.
• Premas Biotech, an Indian firm has collaborated with American company Oramed Pharmaceuticals Inc. and announced the development of an oral Covid-19 vaccine candidate that has shown efficacy after a single dose.
• German group Curevac said Monday it will broaden its mRNA Covid vaccine trials to include new virus variants as it aims to file for EU approval in the second quarter of 2021.
• Sinovac said its COVID-19 vaccine is safe in children ages 3-17, based on preliminary data, and it has submitted the data to Chinese drug regulators.
• ZyCoV-D by Zydus Cadila, is undergoing phase III trials. The DNA plasmid platform vaccine is expected to be approved by May-June.

Vaccine  Access, Delivery, and Rollout

• WHO listed the Janssen COVID-19 vaccine (Johnson & Johnson) for emergency use in all countries and for COVAX roll-out. COVAX has shipped over 30 million vaccines to 52 economies.
• An editorial in The Lancet and a letter in The BMJ raised the idea of appointing a Global Vaccine Coordinator, who would lead an international effort for the equitable distribution of vaccines. The authors argue that clear leadership and oversight are needed to organize what has become largely a piecemeal vaccination effort, with nations, NGOs, and the private sector working independently or bilaterally. While a centralized global champion or body could provide high-level coordination for global vaccine allocation and distribution, it would be a major challenge to ensure they have the authority necessary to compel national governments and private sector companies to participate

• AstraZeneca will publish up-to-date results from its major U.S. COVID-19 vaccine trial within 48 hours after health officials publicly criticized the drug maker for using “outdated information” to show how well the immunization worked. Earlier last week, AZ had announced results from Phase 3 trial in Chile, Peru, and the US, claiming the vaccine was 79% effective.

• Nearly 1 in 4 people in the US have received at least one dose of Covid-19 vaccine, US CDC data shows.
• A large plant to manufacture Johnson & Johnson’s COVID-19 vaccine was cleared by U.S. regulators on Tuesday, setting the stage for the weekly U.S. supply to surge more then 20 percent.
• Early successes in developing vaccines by upstarts like Moderna and BioNTech now face the next phase: manufacturing doses on an enormous scale.
• The European Medicines Agency plans to inspect the Sputnik V vaccine production facility to see if it can be authorized in the EU.
• The European Medicines Agency declared that the AZ vaccine was “safe and effective,” and the rollout resumed in France on Friday. However, the reboot efforts were sluggish.
• Swiss drugs regulator Swissmedic approved Johnson & Johnson’s COVID-19 vaccine, but has so far not ordered J&J’s one-shot vaccine.
• India's Stelis Biopharma to make 200 million doses of Sputnik V vaccine.

Africa (AFE and AFW)

• South Africa sells AstraZeneca COVID-19 vaccines to other African countries.
• Several African nations including DR Congo, Cape Verde and eSwatini have suspended the use of the AstraZeneca Covid-19 vaccine citing possible side-effects.
• The first 165,000 AZ doses of up to 7 million COVID-19 vaccine doses that MTN Group is donating to African Union countries have arrived in Ghana.
• Kenya hospitals run out of ICU beds as Covid-19 impact hits hard.
• Mauritius increases lockdown measures to combat Covid-19 spread.
• Mauritius receives 200,000 doses of Covaxin Vaccine from government of India.

Europe and Central Asia

• Excess deaths in Russia suggest Covid death toll is closer to 450,000 than the official number of 94,000.
• Ukraine and Bulgaria are reporting record numbers of COVID-19 deaths and cases, respectively,;  in the Bulgarian city of Yambol, 98% of hospital beds are occupied.
• Uzbekistan to start mass coronavirus vaccination from April 1.

East Asia and Pacific

• Moderna announced that the Philippines has secured 7 million additional doses of COVID-19 Vaccine Moderna through a new supply agreement, bringing its confirmed order commitment up to 20 million doses.
• Vietnam is expected to have the first batch of locally-produced COVID-19 vaccines at the end of the third quarter of 2021.
• Singapore and Malaysia to work towards mutual recognition of Covid-19 vaccine certificates and progressively restore cross-border travel.
• China’s daily output of COVID-19 vaccines has reached about 5 million doses, more than tripling the 1.5 million-dose daily production rate on Feb. 1.
• Indonesia to resume use of AstraZeneca coronavirus vaccine.
• Papua New Guinea will kick-off its coronavirus vaccination program by this weekend, helped by 8,000 AstraZeneca doses from neighboring Australia as it tries to prevent its basic health system being overwhelmed by a surge in COVID-19 cases.
• Macau, China has suspended the use of the COVID-19 vaccine developed by BioNTech SE due to defects found in the caps of some vials.

Latin America and the Caribbean

• UN Deputy Secretary-General highlights that the Latin America and Caribbean (LAC) region has reported 27.8 per cent of global deaths due to the pandemic despite representing only 8.4 per cent of the global population.
• The IMF warns that the economic impact of the pandemic may be felt in the Caribbean long after the health emergency is controlled due to its heavy reliance on tourism. Assuming no new external financing and realistic tourism scenarios, the IMF estimates the region’s financing gap at around US$ 4 billion, 4.8 per cent of regional GDP.
• Uruguay confirmed on Monday that it had detected the presence of two coronavirus variants that originated in neighboring Brazil as the tiny South American nation faces a spike in cases and deaths.
• Chile has vaccinated 25% of its population against COVID-19.
• Chile’s fast vaccination program has reached the shores of Antarctica.
• Colombia will impose new restrictions on movement and enact nightly curfews in municipalities with high occupancy levels in intensive care units as it tries to avoid a severe third wave of COVID-19.

Middle-East and North Africa

• The Egyptian government hopes to sign an agreement with China’s Sinovac Biotech Ltd before the end of March to manufacture its coronavirus vaccine in Egypt.
• Egypt receives its second shipment of Covid-19 vaccines as a gift from China.
• Jordan records 109 COVID-19 deaths, highest daily toll since start of pandemic.

South Asia Region

• Pakistan has bought more than 1 million doses of Chinese Sinopharm and CanSino Biologics COVID-19 vaccines, its first purchase from any manufacturer having previously relied on donations.
• India’s health ministry warned that a huge gathering of devotees for a Hindu festival could send coronavirus cases surging as the country recorded the most new infections in nearly four months.
• Bangladesh sees highest cases in a day in 8 months.
• Understanding Covid-19 vaccine wastage in India.
• Mumbai, India to randomly test for Covid at crowded places without consent.
• India restricts vaccine exports amid rising COVID-19 cases.
• The Serum Institute of India (SII), has told Brazil, Morocco and Saudi Arabia that further supplies of the Oxford/AstraZeneca Covid-19 vaccine will be delayed.
• Nepal becomes third country to give emergency approval to Indian vaccine COVAXIN.
• The suspension of the vaccine campaigns in Europe may be a blessing in disguise for Nepal, which is facing delays in shipments of Covishield.

Mobility

• Spain to welcome German visitors over Easter break despite restrictions on national tourism.
• Ukraine tightens border controls amid rising COVID-19 deaths.
• Bucharest close to quarantine due to rise in COVID-19 cases.
• Indonesian tourism minister says preparations can begin for 'safe travel corridor' between Singapore, Batam and Bintan.
• Royal Caribbean International is resuming cruises aimed at U.S. vacationers. The cruises will depart from Bermuda and the Bahamas, and adult passengers must be vaccinated against COVID-19. Passengers under 18 will be able to sail with a negative coronavirus test. Crew members will also be vaccinated.
• Poland goes into partial lockdown as COVID-19 cases top 2 million.

Treatment

• Pfizer began the phase one trial of a pill to treat COVID-19. The treatment is a potent protease inhibitor, the same kind of technology used to treat HIV and hepatitis C. The pill demonstrated potent in vitro anti-viral activity against SARS-CoV-2, as well as activity against other coronaviruses.
• New phase III data shows investigational antibody cocktail casirivimab and imdevimab reduced hospitalization or death by 70% in non-hospitalized patients with COVID-19.
• Antioxidants and pentoxifylline as co-adjuvant measures to standard therapy to improve prognosis of patients with pneumonia by COVID-19

Diagnostics

• Association of Vitamin D Levels, Race/Ethnicity, and Clinical Characteristics With COVID-19 Test Results.
• The Johns Hopkins Center for Health Security is launching a new informational webinar series on SARS-CoV-2 testing strategies and best practices from selected organizational leaders. This webinar series will be hosted as part of the Center’s new COVID-19 Testing Toolkit, which aims to provide essential information for all organizations seeking to engage in SARS-CoV-2 testing.