“We hope to finish this pandemic in less than two years, especially if we can pool our efforts,” Dr. Tedros Adhanom Ghebreyesus, Director-General, World Health Organization (WHO), said on Friday, August 21. Comparing COVID-19 to the 1918 Spanish flu (which took two years to control), Dr. Tedros noted that current advances in medicine could help the world overcome the virus in a shorter timeframe: “Of course with more connectedness, the virus has a better chance of spreading…But at the same time, we have the technology…and the knowledge to stop it.”
Although governments, the healthcare industry, the public health community, and others are working round-the-clock to end the pandemic, we are seeing the emergence of second waves of coronavirus infection as well as new evidence on long-term symptoms and reinfection.
This week’s edition of Rabin Martin’s COVID-19 Briefing focuses on the policy and public health implications of the pandemic as our scientific understanding of COVID-19 continues to evolve. How can the world best prepare for a second wave when the science remains unclear? Please find our earlier COVID-19 Briefings here.
There have been 5,843,293 confirmed cases and 180,118 deaths in the U.S. On Monday, August 24, the U.S. Centers for Disease Control (CDC) modified its COVID-19 testing guidelines to exclude people who are asymptomatic, even if they have been exposed recently.
Regardless of a country’s infection rate, COVID-19 continues to challenge policymakers and the public health community. Countries are seeing ebbs and flows in new infections, often following changes to regulations around face coverings and restrictions on social distancing and mobility. In Europe, countries such as Spain, France, and Germany, have experienced spikes in cases over the past weeks. South Korea recorded a 180 percent increase in cases between the week ending Sunday, August 23 and the previous week, related primarily to religious gatherings. In response, South Korean officials have mandated that masks be worn both indoors and outdoors and have imposed restrictions on social events.
Emmanuel Macron, President, France
Similarly, after a small cluster has grown to more than 100 new cases in Auckland earlier this month, New Zealand extended its lockdown measures and is now requiring everyone using public transport and traveling on airplanes to wear masks in an attempt to regain control over the country’s epidemic. “I’m asking New Zealanders to once again be strong and be kind,” implored New Zealand’s Prime Minister Jacinda Ardern.
Global COVID-19 Cases (Johns Hopkins University Center for Systems Science and Engineering)
Evolving Science, Evolving Policies
Our scientific understanding of COVID-19’s long-term health consequences continues to develop, compelling policymakers and public health experts to adapt their strategies. Reports of persistent symptoms, such as loss of smell/taste, breathing difficulties, and extreme fatigue, are becoming more prevalent – with experts estimating that as many as 1 in 3 patients recovering from COVID-19 could experience these after-effects.
On Monday, August 24, the first confirmed case of COVID-19 reinfection was reported in Hong Kong. The patient, a 33-year-old man, was diagnosed with two separate infections four months apart. The man did not report any symptoms during his second infection, potentially due to functional immunity derived from his previous exposure. Such immunity (whether produced through natural infection or vaccination) yields protection from severe illness in subsequent infections. On Tuesday, August 25, two additional patients in Europe were confirmed to have been re-infected. These incidents have sparked a wide range of reactions from the scientific community, and the public at large, about the prospect of immunity. However, WHO epidemiologist Dr. Maria Van Kerkhove cautioned against panic, noting that reinfection remains rare: “There’s been more than 24 million cases reported to date. We need to look at this at a population level.”
The news is likely to have implications for forthcoming vaccines against COVID-19, raising questions of whether booster shots or additional doses will be required. Governments and public health officials must now consider new complexities in achieving epidemic control. For example, countries like China, where infection has subsided due to high community immunity and strict travel guidelines, may have to revisit their containment strategies and associated enforcement.
In recent weeks, there has been conflicting guidance regarding the use of convalescent plasma as a treatment option for COVID-19: research remains inconclusive and U.S. government agencies have offered contradictory advice. On Wednesday, August 19, The New York Times reported that the U.S. Food and Drug Administration (FDA) had declined to issue an emergency use authorization (EUA) for convalescent plasma following concerns expressed by National Institutes of Health Director, Dr. Francis Collins, and National Institute of Allergy and Infectious Disease Director, Dr. Anthony Fauci. They cautioned that current data from non-randomized control trials were insufficient to demonstrate efficacy. But just days later, the FDA reversed course, and on Sunday, August 23, issued an EUA for the therapy. After receiving criticism, on Monday, August 24, FDA Commissioner Dr. Stephen Hahn acknowledged that he had mischaracterized the study findings the day before – citing absolute risk reduction when he should have said relative risk reduction – further confusing matters.
From the Experts
“If countries like Brazil, India, the U.S., and other large countries control the disease, then that’s not just contributing to national numbers going down, but that will ultimately contribute to the overall impact of the pandemic being reduced.”
Dr. Michael Ryan, Executive Director, Health Emergencies Programme, WHO
Friday, August 21
“Vaccine nationalism only helps the virus…Our only way out of this pandemic is together. Initially, when there will be limited supply, it’s important to provide the vaccine to those at highest risk around the world.”
Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO
Monday, August 24
“This virus is going to be with us for a while. Without a vaccine, it’s going to be with us for years. This will not be a fight we win once – but one that will go several rounds. That’s why we need to apply lessons from places that have controlled the virus and let data guide our actions.”
Dr. Carissa Etienne, Director, Pan American Health Organization
Tuesday, August 25
“The flu season is a bit of a ticking time bomb. We are all waiting and trying to prepare as best we can.”
Dr. Amanda Harrington, Medical Director of Microbiology, Loyola University
Tuesday, August 25
What We’re Reading
- Rural Hospitals Are Sinking Under COVID-19 Financial Pressures – Sarah Jane Tribble, National Public Radio
- Syringe Shortage Could Hamper Delivery of COVID-19 Vaccine, Experts Warn – Jessica Glenza, The Guardian
- In The Race For A COVID-19 Vaccine, Pfizer Turns To A Scientist With A History Of Defying Skeptics — And Getting Results – Matthew Herper, STAT News
- COVID-19 Is Complicating Pregnancies. This Black Midwife Has a Plan for That. – Abbie Synan, Rewire News
- Why Is Trust in Vaccines as Important as The Vaccines Themselves? – Heidi Larson, National Public Radio
- To Improve our Dismal COVID-19 Performance, Establish Common Ground Between Lockdown and Open Economy – Steven Phillips, STAT News
- Genetic Data Show How A Single Superspreading Event Sent Coronavirus Across Massachusetts — And the Nation – Sarah Kaplan and Chris Mooney, The Washington Post
- Young Adults’ Pandemic Mental Health Risks – Perri Klass, New York Times
- Women Have Been Better Leaders Than Men During the Pandemic – Andreas Kluth, Bloomberg
Reports from International Governments and Bodies
- WHO COVID-19 Information and Guidance
- WHO Weekly Epidemiological Update: August 24
- WHO Weekly Operational Update: August 21
- CDC Coronavirus Resource Page
- COVID-19 Health Systems Response Monitor
- NCD Alliance COVID resources relevant to NCDs
Funding and Policy Trackers
- International Monetary Fund Policy Tracker
- Kaiser Family Foundation Coronavirus Policy Tracker
- U.S. Chamber of Commerce Foundation Corporate Aid Tracker
- Devex Interactive Funding Tracker
Resource Pages and Market Research Literature
- JAMA Resource Center
- The Lancet COVID-19 Resource Centre
- 2019 Novel Coronavirus Research Compendium (NCRC)
- National Academy of Medicine COVID-19 News and Resources
- WIPO COVID-19 IP Policy Tracker
- The COVID Tracking Project
- PharmaIntelligence: Coronavirus – What will the Impact Be?
- Health Affairs Resource Center
- STAT News COVID-19 Tracker
- Global Health NOW’s COVID-19 Expert Reality Check
- International Association of National Public Health Institutes COVID-19 Resources
- Center for Strategic and International Studies The Reopening and Take as Directed Coronavirus Crisis Update Podcast
- Primary Health Care Performance Initiative Forum
- U.S. Global Leadership Coalition COVID-19 Issue Briefs
- Prevent Epidemics Weekly Science Review
- COVID-19 Watch Weekly Updates
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About Rabin Martin
Rabin Martin is a global health strategy firm working at the intersection of private sector capabilities and unmet public health needs. Rooted in our mission to improve health for underserved populations, we design strategies, programs and partnerships that both deliver public health impact and drive business results. We leverage our deep knowledge and networks across a wide range of geographies and health areas to develop tailored solutions for every client engagement. We have helped many clients create bold global health initiatives and innovative multi-sector partnerships. Our specific areas of expertise include infectious disease and vaccines, non-communicable diseases, rare diseases, maternal and child health, and universal health coverage. Our clients and partners include multinational health care companies, multilateral institutions, government agencies, large foundations and leading NGOs. Rabin Martin is part of the Omnicom Public Relations Group.
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Omnicom Public Relations Group is a global collective of three of the top global public relations agencies worldwide and eight specialist agencies in public affairs, marketing to women, fashion, global health strategy and corporate social responsibility. It encompasses more than 6,000 public relations professionals in more than 330 offices worldwide who provide their expertise to companies, government agencies, NGOs and nonprofits across a wide range of industries. Omnicom Public Relations Group delivers for clients through a relentless focus on talent, continuous pursuit of innovation and a culture steeped in collaboration. Omnicom Public Relations Group is part of the DAS Group of Companies, a division of Omnicom Group Inc. that includes more than 200 companies in a wide range of marketing disciplines including advertising, public relations, healthcare, customer relationship management, events, promotional marketing, branding and research.