February 15, 2024



US CDC reportedly considering loosening 5-day isolation guidance for COVID-19

The US CDC reportedly is considering changing its COVID-19 guidance regarding how long people need to isolate, reflecting how attitudes and norms have changed after the pandemic’s end. This potential shift, which is being discussed internally and with state health officials, would advise that people who test positive for COVID-19 would no longer need to isolate once their symptoms begin to resolve and they have been fever-free for 24 hours without the aid of medication. The current CDC guidance, in place since 2021, advises people to isolate for at least 5 days if they test positive for COVID-19 and then continue to mask when in public.

If adopted, the new guidance would align COVID-19 isolation with that for other respiratory viruses, such as flu. While most people have developed some level of immunity to SARS-CoV-2 due to prior infection or vaccination, it is important to note the new recommendations would not apply to hospitals, nursing homes, and other facilities where residents are less socially mobile or more vulnerable to severe outcomes. “The updated CDC guidance … reflects a harm reduction approach to a virus that is endemic and for which there are more tools than any other respiratory virus,” Center for Health Security Senior Scholar Dr. Amesh Adalja, said. “Increasingly, it has been clear that COVID guidance would need to be integrated with other respiratory viruses and not singled out in perpetuity.”

California and Oregon, states that were more cautious during the height of the pandemic, have already moved away from the current CDC guidance in efforts to balance safety, social disruptions, and economic concerns. The CDC has not confirmed the potential change to its guidance but stated that it will continue to make decisions based on the best evidence and science to keep communities healthy and safe. The change in guidance could come as soon as April, although timing remains uncertain.

Articles examine how vaccine misinformation contributes to low uptake of RSV immunizations, US CDC efforts to engage health professionals as trusted messengers

In a case study, Politico Magazine reports on how the persistent spread of misinformation is influencing public opinion and contributing to vaccine hesitancy, describing the low uptake of new RSV immunizations for infants and young children, older adults, and pregnant people. In addition to misinformation, some doctors and pharmacists mistakenly administered the wrong shots to populations for which they were unapproved, the New York Times reports. Errors such as these are also likely to contribute to hesitancy surrounding novel preventatives, and officials are working to better educate healthcare providers. The Politico article highlights several individuals’ and organizations’ efforts to debunk or “prebunk” misinformation on the internet and social media platforms and in communities nationwide. Many of these efforts involve respected community voices, which helps to build trust.

In its Morning Pulse newsletter published today, Politico highlights US CDC Director Dr. Mandy Cohen’s efforts to urge doctors to become more engaged in health messaging. Personal doctors also are crucial in promoting vaccination, and Dr. Cohen said doctors speaking with patients is key to turning public health priorities such as vaccination into realities. A recent study confirms that personal healthcare providers are the most trusted sources, outpacing public officials, in influencing vaccine uptake. And a recent survey (preprint) of more than 70,000 people in 67 countries found high levels of trust in scientists, with many saying they want researchers to get more involved in policymaking.

The Center for Health Security’s new Practical playbook for addressing health misinformation was also featured in the Politico morning roundup. This playbook is designed to help public health practitioners, health professionals, and other health communicators respond when faced with misinformation. The guide provides detailed tools, checklists, templates, and examples to help prepare for rumors and understand when and how to respond. The publication, which was supported by CDC, builds on the agency’s new Health Information Management and Alert System, which outlines a 4-phase approach to tackling circulating health misinformation. For more information, see our news story.

Alaska reports first known fatality from Alaskapox virus, first case outside state’s interior region

Alaska health officials have reported the first known death linked to Alaskapox virus (AKPV). An epidemiological bulletin notes that state officials have recorded 7 AKPV cases since the virus was identified in 2015, but most occurred in residents of the Fairbanks area and involved mild symptoms, such as rash or lesion and swollen lymph nodes. This case presented in September 2023 in an older male with a weakened immune system due to cancer treatment; he was hospitalized in November and died in late January. Alaskapox was not initially suspected, demonstrating the challenges in diagnosing the infection.

AKPV belongs to the orthopoxvirus genus, which includes viruses like smallpox and mpox. The virus primarily infects small mammals—mostly documented in red-backed voles and at least one domestic pet—with human infections occurring after contact with these animals or pets that interact with them. The man had contact with a stray cat that hunted small mammals and frequently scratched him, suggesting a possible route of transmission.

Notably, this case happened more than 300 miles south of the Fairbanks area, where all previous cases were documented, indicating that Alaskapox is more geographically widespread in the state than previously known. State and federal scientists are testing small mammals outside of Alaska’s interior region to determine the prevalence of AKPV. The case underscores the need for increased awareness among clinicians in Alaska, the virus’s potential for severe outcomes in immunocompromised individuals, and the importance of monitoring emerging infectious diseases. Officials stated there is no reason for concern among those outside of Alaska.

WHO Director-General once again calls on nations to better prepare for disease emergencies

Metro: World is not ready for Disease X and it will be worse than Covid, warns WHO

WHO: WHO Director-General's speech at the World Governments Summit – 12 February 2024

Harvard T.H. Chan School of Public Health: Improved future pandemic responses hinge on more government involvement, experts say

The BMJ: Will the pandemic treaty make it over the line? (opinion)

See also: Nature Medicine: A decision-making tree for policy responses to a pathogen with pandemic potential (comment)

World Trade Organization TRIPS council members fail to reach consensus on IP waiver for COVID-19 tests, treatments

The Guardian: WTO fails to reach agreement on providing global access to Covid treatments

World Trade Organization: TRIPS Council finalizes preparations for MC13

Leaked draft of trade deal between India, European Free Trade Association raises concern among public health groups over access to generic medicines

STAT: Leaked version of EFTA-India free trade deal sparks alarm over access to medicines

Hindu Business Line: Pro-public health groups raise concerns on India-EFTA trade deal negotiations

New BMJ analysis, opinion discuss US pandemic preparedness

The BMJ: Legal infrastructure for pandemic response: lessons not learnt in the US

The BMJ: Is the US prepared for the next pandemic? No, but it could be (opinion)

Scientists using new technologies to more effectively, quickly identify emerging pathogens

Undark: The Uncharted World of Emerging Pathogens

The Telegraph: The new mile-high club: Why airline toilets could give early warning of the next pandemic 

Majority of US COVID-19 cases caused by JN.1 variant; CDC tracking new variant detected in S. Africa

New York Times: How Protected Am I Against the Covid Variant JN.1?

CIDRAP: CDC tracking BA.2.87.1 SARS-CoV-2 variant

US News: CDC Tracks New Variant as COVID Winter Wave Recedes

Uptake of new COVID vaccines lower among nursing facility residents, staff than for fall 2022 version, analysis shows

The Hill: New COVID shots sparse at nursing homes

KFF: Few Nursing Facility Residents and Staff Have Received the Latest COVID-19 Vaccine

KFF Health News: Do We Simply Not Care About Old People?

See also: New York Times: Covid Shots for Children

Cost, confusion, lack of access, fear of rebound preventing use of Paxlovid among eligible COVID patients

Politico: Paxlovid puzzle

Politico Pro: Good intentions, muddled messaging and Covid’s toll: The story of Paxlovid

Washington Post: Getting free Paxlovid is not hard. But consumers need to be proactive. (opinion)

Adults who meet US physical activity guidelines have lower risk of COVID-19 infection, hospitalization

CIDRAP: Study: Older US adults who exercised prepandemic at lower risk of COVID infection, hospitalization

HealthDay News: Exercise a Lot? You May Lower Your Risk of COVID Infection, Hospitalization

US NIH announces additional funding for RECOVER research program for long COVID

STAT: Long Covid research funding at NIH gets a nearly 50% boost

US NIH: NIH to bolster RECOVER Long COVID research efforts through infusion of $515 million

Millions of people in US have long COVID, at risk of chronic fatigue; hospitalized patients at greater risk of developing post-acute symptoms

CNN: Millions of people have long Covid, including children and pregnant people, studies show

Financial Times: Scientists grapple with long Covid puzzle as millions fall sick

MMWR: Notes from the Field: Long COVID Prevalence Among Adults — United States, 2022

Los Angeles Times: Risk for chronic fatigue soars among those who had COVID-19, study says

CIDRAP: Those hospitalized with COVID-19 later at risk for several key symptoms

CIDRAP: Studies spotlight cognitive issues, depression, fatigue in those with long COVID

Flu activity increased, remained relatively steady across most of US last week; vaccine manufacturers to move back to trivalent shot for this year

AP: Flu hangs on in US, fading in some areas and intensifying in others

Force of Infection: Outbreak Outlook - National - February 12

Precision Vaccinations: Trivalent Flu Shot Formulations Coming Next Season

See also: CIDRAP: Even mild flu tied to double risk of heart attack, stroke in older patients

Cambodia reports fourth human case of H5N1 avian flu; viral clade different than virus currently circulating in wild birds, poultry worldwide

CIDRAP: Cambodia reports fourth H5N1 avian flu case of the year

CIDRAP: Cambodia's recent H5N1 avian flu cases involved older clade

US CDC: First Human Influenza A(H5N1) (Bird Flu) Virus Infections in Cambodia Reported for 2024

China reports one human case of combined H3N2, H10N5 avian flu; human-to-human transmission risk considered low, WHO notes

Reuters: WHO sees low risk of spread after China reports combined H3N2, H10N5 bird flu case

CIDRAP: Ducks identified as source of H10N5 avian flu in Chinese woman's coinfection

H5N1 threatens Antarctica’ penguin, wild bird populations, impacting US poultry farms

Scientific American: Antarctica’s Penguins Could Be Devastated by Avian Influenza

The Guardian: Bird flu causing ‘catastrophic’ fall in UK seabird numbers, conservationists warn

NPR: The recent avian flu surge is affecting poultry farmers across the U.S.

See also: Reuters: US is '18 months or so' away from finding bird flu vaccine, says agriculture secretary

Urgent efforts needed to curb global measles outbreak, experts say, urge nations to get childhood vaccination campaigns back on track after pandemic interruptions

NPR: It's no surprise there's a global measles outbreak. But the numbers are 'staggering'

Axios: Measles comeback is "canary in the coal mine" for U.S., vaccine expert says

MSNBC: Past vaccination efforts made us forget how bad measles is. It’s back to remind us. (opinion)

The BMJ: Measles: increasing vaccine uptake is vital in preventing outbreaks (opinion)

Ebola vaccine reduces risk of death from disease, even among people infected with virus before vaccination, analysis shows

STAT: Ebola vaccine cuts fatality even in people who were infected before the jab, new study shows

Healio: Ebola vaccine halves mortality rate, new data show

Severe weather, lack of vaccines, poor water, sewer infrastructure fueling severe cholera outbreaks in central, southern Africa

New York Times: Deadliest Cholera Outbreak in Past Decade Hits Southern Africa

DW: Cholera outbreak in southern Africa: a multinational fight

The Telegraph: Zambia’s worst-ever cholera outbreak spirals into ‘uncontrollable health crisis’

Reuters: Cholera vaccine stocks 'empty' as cases surge

CIDRAP: Global cholera threat continues to escalate with surges in parts of Africa

Dengue emergency in Brazil has US experts concerned more cases could appear in Puerto Rico, southern US states this year

New York Times: Brazil Has a Dengue Emergency, Portending a Health Crisis for the Americas

France 24: What's behind Brazil's surge in dengue fever?

Oregon records first human plague case since 2015; human-to-human transmission rare

NBC News: Oregon's first case of human plague in 8 years likely came from a pet cat

Fox News: Oregon health officials confirm first human bubonic plague case since 2015

Washington Post: The bubonic plague is still around in 2024. How is that possible?

NPR: So you think you know all about the plague?

US CDC urges continued vaccination for mpox as uptake plateaus; study examines clinical vs lab diagnosis; federal health, executive officials outline lessons from epidemic response

Precision Vaccinations: Mpox Vaccinations Uptake Plateaued at 25%

CIDRAP: Clinical mpox diagnosis tracks closely with lab confirmation

JAMA: Lessons From the Mpox Response (viewpoint)

Preprint paper, upcoming report examine safety, security of bioeconomy, research with pandemic risks

Trends in Biotechnology: Shaping the future US bioeconomy through safety, security, sustainability, and social responsibility (preprint paper coauthored by Center for Health Security Fellow Aurelia Attal-Juncqua and Senior Scholar Dr. Gigi Gronvall, et al.)

Bulletin of the Atomic Scientists: New report to offer a responsible path forward for research with pandemic risks

As world exceeds 1.5C over 12-month period for first time, scientists warn over Atlantic Ocean circulation collapse, dangerous air quality, spread of arboviruses to new areas

Al Jazeera: First time world exceeds 1.5C warming limit over 12-month period

Washington Post: Earth breached a feared level of warming over the past year. Are we doomed?

The Guardian: Atlantic Ocean circulation nearing ‘devastating’ tipping point, study finds

The Hill: Climate change is making it more dangerous for kids to play outside, report finds

The Guardian: ‘It’s impossible to breathe’: Delhi’s rubbish dumps drive sky-high methane emissions

The New Humanitarian: Snapshots: How the climate crisis is hurting people in Central America: The spread of arboviruses

WHO publishes updated list of antimicrobial drugs for use in human medicine, with first-ever mention of antibiotics for use in humans only

Health Policy Watch: WHO Issues First-Ever List of Antimicrobials with Category “For Use in Humans Only”

CIDRAP: WHO updates list of medically important antibiotics for use in human medicine

See also: CIDRAP: CDC issues new antibiotic prophylaxis guidelines for invasive meningococcal disease contacts

Fungus associated with multinational outbreak among patients of clinics in Mexico attacked brain stem

NBC News: Fungus that sparked deadly meningitis outbreak aggressively attacked the brainstem

Washington Post: Aggressive fungus caused meningitis outbreak tied to clinics in Mexico

NBC News: The threat of fungal infections is growing. Why is it so hard to make new drugs?

Risk of death remains elevated for nearly 3 months after acute chikungunya infection, study shows

CIDRAP: Risk of death higher for nearly 3 months after chikungunya, data suggest

The Lancet Infectious Diseases: The deadly potential of chikungunya virus (comment)

FROM THE CENTER

Expert panelists discuss convergence of AI, biotechnology at Capitol Hill Steering Committee on Pandemic Preparedness & Health Security event

On February 8, the Capitol Hill Steering Committee on Pandemic Preparedness & Health Security hosted an in-person panel discussion, titled “Policy Frontiers: Realizing the Benefits, Managing the Risks of Artificial Intelligence-Driven Biotechnology.” The Steering Committee is sponsored and managed by the Johns Hopkins Center for Health Security.

Expert panelists joined Johns Hopkins Center for Health Security Director Dr. Tom Inglesby to talk about the impact and implementation of President Biden’s Artificial Intelligence (AI) Executive Order related to the convergence of AI and biotechnology. They touched on the challenges and opportunities that still need to be addressed and Congress’ role in the governance of these rapidly evolving technologies.

Panelists included Helena Fu, Director of the Office of Critical Emerging Technology at the US Department of Energy; Tejal Patwardhan, Technical Staff at OpenAI; Dr. Michelle Rozo, Vice Chair of the National Security Commission on Emerging Biotechnology (NSCEB) and Vice President of Technology at In-Q-Tel; and Dr. Shankar Sundaram, Special Assistant to the President and Senior Director for Global Health Security and Biodefense on the National Security Council of the White House. Read coverage of the event from Politico and STAT. 

Editor: Alyson Browett, MPH

Contributing Editor: Prarthana Vasudevan, MS, MSPH, DrPH (c)