January 11, 2024



Nearly 10,000 COVID deaths last month; US records more than 1,600 COVID deaths first week of December; US FDA leaders call for stronger vaccination efforts

Holiday gatherings and the circulation of a new SARS-CoV-2 variant—the WHO variant of interest JN.1—led to an increased number of COVID-19 cases globally last month, WHO officials said this week. Nearly 10,000 COVID-19-related deaths were reported in December and hospital admissions grew by more than 40% in the almost 50 countries that continue to share pandemic trend information, mostly in Europe and the Americas.

The US is experiencing the second largest COVID-19 wave since the start of the pandemic, based on wastewater data, and more than 1,600 people died of the disease the week of December 9, 2023, the last week of complete US CDC data. Experts predict the surge could reach its peak this week or soon after, but high transmission levels are expected to continue for at least another month. The JN.1 variant, an offspring of the BA.2.86 Omicron subvariant of SARS-CoV-2, accounts for an estimated 62% of US COVID-19 cases. Though the number of US COVID-19 hospitalizations continues to increase, JN.1 has not caused a surge in hospitalizations as was seen with Omicron.

Additionally, influenza-like illness (ILI) activity continues to accelerate, with about 1 of 14 doctor visits being made for fever, cough, or sore throat. Influenza accounts for the majority of that symptom burden, based on emergency department visits and test positivity rates. According to CDC, 38 US states are experiencing “high or very high” levels of respiratory illness activity. In response, hospitals across the country are reinstating mask mandates for healthcare facilities.

Last week, US FDA leaders warned in a JAMA viewpoint that an increasing number of people in the US who are declining vaccination for a variety of reasons is threatening to erode population immunity against some vaccine-preventable infectious diseases, including COVID-19. They urged the clinical and biomedical community to redouble their efforts to provide accurate and accessible information on the individual and collective benefits and risks of vaccination.

Avian flu detected in sub-Antarctic mammals for first time; vaccination of poultry should not impact poultry trade, WOAH policy brief says

Scientists with the UK Animal and Plant Health Agency and the British Antarctic Survey this week announced they have detected avian flu in seals and other animals for the first time in the sub-Antarctic region, on the island of South Georgia. Experts suspected avian flu was the cause of elephant seal deaths there after the virus was confirmed to be the cause of death of several brown skua seabirds in the region in October 2023. After a 3-week expedition in December 2023, scientists detected the virus, highly pathogenic avian influenza H5N1 (HPAI H5N1), in samples from deceased elephant seals, fur seals, brown skuas, kelp gulls, and Antarctic terns. The current global outbreak of H5N1, which has killed millions of poultry farm and wild birds, could be devastating to the fragile ecosystems of the Antarctic.

In December, a polar bear in Alaska was confirmed to have died due to avian flu and an Abert’s squirrel in Arizona was confirmed as H5N1 positive. Earlier in 2023, an estimated 20,000 sea lions perished due to the virus in Chile and Peru. These spillover events are reflective of the global situation and raise concerns that the virus could begin to better adapt to mammals, increasing the risk of zoonotic spread to humans. In a correspondence published in April 2023 in Nature Medicine, experts—including several from the Johns Hopkins Center for Health Security—called on countries and international bodies to reevaluate their pandemic influenza preparedness plans in the wake of the COVID-19 pandemic.

Additionally, in a piece published in June 2023 in Think Global Health, Center for Health Security experts called on governments to reconsider their poultry vaccine strategies, as some of the largest poultry exporters—including the US, Brazil, and EU—do not employ the vaccines because of trade restrictions. In December 2023, the World Organisation for Animal Health (WOAH) published a new policy brief calling on countries to better prepare for HPAI outbreaks, including through vaccination when scientifically justified. The brief says the use of vaccination as a control tool, when carried out appropriately, should “not form an unnecessary barrier to safe trade.”

Experts discuss whether US is prepared for next pandemic; Pandemic Fund approves US$500M for next funding round

Healio: Is the US prepared for the next pandemic?

World Bank: The Pandemic Fund Announces Second Round of Funding with Half-a-Billion-Dollar Envelope

WHO holds meetings, consultations to discuss health emergency responses, preparedness

WHO: Second WHO global technical consultation on public health and social measures during health emergencies, November 2023

WHO: A scientific framework for epidemic and pandemic research preparedness

Articles discuss lessons learned from COVAX, various approaches to equitable global vaccine distribution

WEF: Winding down COVAX – lessons learnt from delivering 2 billion COVID-19 vaccinations to lower-income countries

PLoS Global Public Health: Mechanism design for a fair and equitable approach to global vaccine distribution: The case of COVID-19

See also: International Journal of Equity in Health: Group-based trajectory models of integrated vaccine delivery and equity in low- and middle-income countries

US defense agencies to develop new antibiotics to counter potential bioweapon pathogens, discuss technologies to strengthen public health, biosurveillance efforts

Army Technology: US Army medical institutions partner to counter bioweapon threats

The Defense Post: US Discusses Emerging Tech to Bolster Biothreat Security

Mayo Clinic, Cerebras Systems partner to develop healthcare industry AI models; technology holds promise but challenges remain, analysis says

Reuters: Mayo Clinic pairs with Cerebras Systems to help develop AI for health care

Health Affairs: Generative AI In Health Care: Opportunities, Challenges, And Policy

US House Republicans set to explore federal oversight of grants funding infectious disease research abroad following 2-day testimony of former top US health official

STAT: Anthony Fauci talked Covid in Congress in a nine-hour, closed-door grilling — and that was just day one

STAT: After grilling Fauci on Covid origins, House Republicans want to consider new rules for foreign research

The Hill: Democrats accuse GOP of distorting Fauci’s testimony from hours-long meeting

US House Committee on Oversight and Accountability: Wenstrup Releases Statement Following Dr. Fauci’s Two-Day Testimony

See also: Wisconsin Examiner: “Gain of function” research prohibition bill receives public hearing

Paxlovid can reduce risk of hospitalization, death from COVID-19 but few at high risk take it despite no- or low-cost availability

New York Times: I Have Covid. Should I Take Paxlovid?

Washington Post: Should I take Paxlovid if I get covid? Here’s what to know.

"Paxlovid is not a drug that gets you better faster. It's not a drug that decreases long COVID. It's a drug that prevents you from being hospitalized or dying." – Dr. Amesh Adalja, Senior Scholar at the Center for Health Security, told USA Today

COVID-19 rapid tests still work but may take up to 4 days after symptom onset to show positive result

New York Times: How to Make the Most of Your At-Home Covid Test

NBC Bay Area: As COVID cases rise, rapid tests are taking longer to detect infection

Florida surgeon general calls on US FDA, CDC leaders to halt use of COVID-19 mRNA vaccines; experts say claims unfounded, misleading

CBS News: Florida surgeon general wants to halt COVID-19 mRNA vaccines; FDA calls his claims "misleading"

Miami Herald: Here’s why Pfizer, Moderna COVID vaccines do not affect DNA, experts say

Palm Beach Daily: Editorial: Fla. surgeon general's latest dismissal of COVID-19 vaccinations is dangerous (editorial)

See also: Medpage Today: Was the Name 'Operation Warp Speed' Misleading?

Exercise can cause severe muscle damage in long COVID patients, study shows, provides biological explanation for energy drain

NPR: A discovery in the muscles of long COVID patients may explain exercise troubles

Bloomberg: Strenuous Exercise Can Trigger Severe Damage to Muscle Tissue, Long Covid Study Shows

Patients, staff at risk at central Gaza’s only operating hospital; WHO condemns attacks on healthcare facilities, says aid delivery severely hampered by lack of security

BBC News: 'Deep concern' for patients and staff at Gaza's al-Aqsa hospital

UN News: UPDATED: Aid relief arriving in Gaza but ‘too little, too late’, warns WHO

UN News: Nearly 600 attacks on healthcare in Gaza and West Bank since war began: WHO

Think Global Health: Trapped in the Crossfire: Gaza’s Health Crisis

Studies examine effectiveness, safety of mpox vaccines, treatment

News Medical: Combined vaccination and behavior change efforts averted 64% of US mpox cases, study reveals

CIDRAP: Study shows safety of MVA-BN vaccine for mpox

Healio: Study: Tecovirimat effective as early treatment for mpox in those with HIV

Oxford scientists begin human trials of Nipah virus vaccine; shot uses same technology as their COVID vaccine

Reuters: Oxford starts human testing of Nipah virus vaccine

The Independent: Scientists test world-first Nipah virus vaccine

See also: Journal of Medical Ethics: Ethical issues in Nipah virus control and research: addressing a neglected disease

Zambia cholera outbreak prompts government appeal for support, delay to start of school year

Xinhua: Zambia appeals for support in cholera response as cases surge

Bloomberg: Zambia Delays Start of School Year as Cholera Deaths Soar

2023 was warmest year on record, putting climate targets at risk

AP: Earth shattered global heat record in ’23 and it’s flirting with warming limit, European agency says

NPR: U.S. cut climate pollution in 2023, but not fast enough to limit global warming

Foreign Policy: The Death of the 1.5 Degree Climate Target (opinion)

See also: Nature: Antibiotic resistance is a growing threat — is climate change making it worse?

Philadelphia health officials confirm 8 cases in measles outbreak, recommend MMR vaccine

ABC News: Philadelphia health officials are tracking a measles outbreak: What to know

Philadelphia Inquirer: Two more daycare children are infected with the measles. Here’s what to know about the outbreak in Philadelphia.

The Hill: Philadelphia blames measles outbreak on people declining vaccines, failing to quarantine

US regulators to allow import of French syphilis drug to alleviate shortages; congenital syphilis constitutes public health emergency, opinion piece says

Reuters: US FDA allows import of syphilis drug to address shortages

The Hill: Call the mother-child syphilis crisis what it is: A public health emergency (opinion)

WHO prequalifies novel oral type 2 poliovirus vaccine, first-ever for vaccine being used under emergency use listing

CIDRAP: WHO prequalifies next-generation oral polio vaccine

Precision Vaccinations: New Polio Vaccine Available in 35 Countries

Militant attacks kill 8, wound 12 police officers assigned to protect polio workers in Pakistan

AP: Suspected militants kill 2 police officers assigned to protect polio workers in northwest Pakistan

AP: Pakistani Taliban claims responsibility for bomb that killed 6 police guarding anti-polio campaign

FROM THE CENTER

Center for Health Security project dissects pandemic-prone viral families

Since 2018, the Johns Hopkins Center for Health Security has focused on the importance of pandemic preparedness—especially medical countermeasure (MCM) development—for several key viral families. Out of approximately 2 dozen viral families that have the capacity to infect humans, focusing the task of pandemic preparedness on those that are most likely to cause a pandemic provides tractability to a critical problem.

In December 2023, the Center released the first of 4 reports that delve deeper into several of these key viral families—Picornaviridae, Paramyxoviridae, Pneumoviridae, and Adenoviridae—to elucidate and enumerate the aspects that are most important for pandemic preparedness. The report, which provides background on the project and focuses on viruses within several genera of the Picornaviridae family, is available online. The other reports will be added online as they become available. 

Editors: Alyson Browett, MPH and Rachel A. Vahey, MHS

Contributors: Vanessa Gregoire, MSc; Amanda Kobokovich, MPH; Alexander Linder, MSc; Aishwarya Nagar, MPH; Christina Potter, MSPH; Matthew Shearer, MPH; Prarthana Vasudevan, MS, MSPH, DrPH (c); Benjamin Wakefield, MSc; and Alex Zhu, MSPH