• Defense One reports that scientists at Walter Reed Army Institute of Research are expected to announce that they have developed a pan-COVID vaccine, called Spike Ferritin Nanoparticle COVID-19, which is effective against all variants of SARS-CoV-2, including Omicron. Results from a phase I trial were positive, although enrollment took longer than researchers anticipated because only unvaccinated people and those who had not been previously infected were eligible. Source
• France cancels its order of 50,000 doses of Merck’s molnupiravir, which it has not authorized, because “The latest studies weren’t good,” said Olivier Veran, the country’s Minister of Solidarity and Health. Source
• Hans Kluge, the WHO Regional Director for Europe, warns countries to prepare for a“significant surge” of COVID-19 from Omicron, saying “We can see another storm coming. Within weeks, Omicron will dominate in more countries of the region, pushing already stretched health systems further to the brink.” Although the WHO Director-General has repeatedly asked countries to save boosters for the most vulnerable and ensure worldwide access to primary vaccination, Mr. Kluge is advocating for widespread use of boosters to protect people from Omicron, urging them to “boost, boost, boost.” Source
• A pre-print article assesses the severity of illness caused by the Omicron variant in South Africa. Researchers linked and analyzed data from SARS-CoV-2 laboratory tests, COVID-19 case data, the pneumonia surveillance programme, genome data, and the DATCOV national hospital surveillance system, which covers all of South Africa, comparing outcomes based on Omicron versus other variants between 1 October to 30 November 2021.
Of the 161,328 COVID-19 cases reported nationally; 38,282 were tested using TaqPath PCR and 29,721 were suspected to be Omicron (based on S gene target failure when tested with TaqPath, which was used as a proxy). The proportion Omicron infections increased from 3 percent in early October to 98 percent by early December. Overall, Omicron was associated with a 70 percent reduction in the risk for hospitalization; 2.5 percent of people with Omicron were admitted to the hospital versus 12.8 percent of people with other SARS-CoV-2 variants, but once hospitalized, the risk of severe disease did not differ by variant. Source
• A pre-print paper from the University of Edinburgh assesses vaccine protection against and severity of the Omicron variant, drawing from the Scotland-wide Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 (EAVE II) platform, a database linking information on primary care, vaccination, PCR testing, sequencing, hospitalization and mortality data from 5.4 million (99% of the population). Researchers analyzed data from all patients who tested positive for SARS-CoV-2 in Scotland from 1 November to 19 December 2021. Their findings included a ten times greater risk for reinfection with Omicron, versus Delta; that a booster dose reduced the risk of symptomatic COVID-19 from Omicron by 57 percent overall and from Delta by over 80 percent; and that Omicron was far less likely to cause hospitalization than Delta. The researchers noted that “Although preliminary, these national data should provide reassurance that Omicron is substantially less likely to result in severe outcomes than Delta and that third/booster vaccine doses are associated with considerable added protection against symptomatic disease when compared to second doses.” Source
• Researchers at Imperial College release a report assessing differences in hospitalisation risk between the Omicron and Delta variants of SARS-CoV-2, drawing from national databases and including all PCR-confirmed SARS-CoV-2 cases in England with a last PCR test performed between 1 December – 14 December 2021. They found that, versus Delta, Omicron reduced the risk of being hospitalized for one or more days by 40-45 percent (and by 61 percent among people with a previous infection), and that people who have received at least two coronavirus vaccine doses retain substantial protection against hospitalization with – but not infection from – Omicron. Source
• The US FDA issues an Emergency Use Authorization for Pfizer’s paxlovid, an oral COVID-19 treatment, for patients age 12 and over who are vulnerable to becoming severely ill. In a phase III trial, paxlovid reduced the risk of hospitalization or death by 88 percent among high-risk, unvaccinated study participants who began taking it within five days of the start of their symptoms.
Patients take three pills at a time: two paxlovid tablets and a low-dose of ritonavir, which helps paxlovid to remain in the body longer. Ritonavir can have severe interactions with commonly used drugs such as statins, blood thinners and certain antidepressants.
The US government has ordered 10 million treatment courses, at $530 per patients. Initially, the supply will be limited; Pfizer will deliver 65,000 treatment courses within a week, with 200,000 more expected in January and an additional 150,000 in February. Source
• Lancet Regional Health publishes research comparing immune responses to the Moderna coronavirus vaccines among 71 people living with HIV versus 10 HIV-negative healthcare workers. All participants living with HIV were receiving ART; 66 of them had an undetectable viral load and the median CD4 cell count was 747 cells/µL.
The researchers found no significant difference in immune responses to the vaccine by HIV status or CD4 cell count (stratified as: <350 cells/µl; 350-500 cells/µl and >500 cells/µl, although only three participants had a CD cell count of <200 cells/ µl). People living with HIV who had a previous SARS-CoV-2 infection had higher anti-S antibody titres and neutralising antibody activity versus those who were COVID-19 naïve. Source
• The U.K. government purchases an additional 1.75 million courses of molnupiravir, and an additional 2.5 million courses of paxlovid, adding to the 480,000 courses of molnupiravir and 250,000 courses of paxlovid it previously bought. Source
• David Powell, a physician and the medical advisor to the International Air Transport Association, says that airline passengers are two to three times more likely to become infected with Omicron during a flight; the risk may be lower in the less-crowded business class cabin. He recommended that people sitting near to one another should try not to be unmasked at the same time during meals. Source
• France’s Health Minister, Olivier Veran, reports that Omicron makes up for a fifth of the country’s coronavirus cases, and a third of cases in Paris; he says that Omicron will become dominant during the period between Christmas and the new year, when he expects “…about 100,000 cases a day.” Source
• Omicron cases have been dropping in South Africa in recent days. After reaching a nationwide high of 27,000 new cases nationwide on 16 December, cases dropped to 15,424 on 21 December. In Gauteng province – the epicenter of the Omicron wave – cases began dropping earlier and have continued to do so. “The drop in new cases nationally combined with the sustained drop in new cases seen here in Gauteng province, which for weeks has been the center of this wave, indicates that we are past the peak,” said Marta Nunes, senior researcher at the Vaccines and Infectious Diseases Analytics department of the University of Witwatersrand, “It was a short wave …and the good news is that it was not very severe in terms of hospitalizations and deaths.” Source
• WHO says the world must focus on prevention of severe illness and death, rather than blanket booster programs – which are worsening vaccine inequity. Currently 20 percent of daily vaccine doses are boosters, as high-income continue to vaccinate over ten times faster than low-income countries. Source
• Israel will administer a fourth dose of coronavirus vaccine to people over age 60 and medical personnel, becoming the first country in the world to do so. Sharon Alroy-Preis, the head of public health services at Israel’s Ministry of Health, objected to the decision because there has not been a trial to inform it, but it had overwhelming support from government and medical experts concerned about the rapid spread of Omicron. Galia Rahav, head of Sheba Medical Center’s infectious disease unit, said ‘It’s much more elegant to decide when you have hard data. But it’s true that if we will wait for hard data it will be too late.” Source
• After record-breaking new daily coronavirus cases driven by the Omicron variant, Britain orders an additional 1.75 million courses of molnupiravir, and an additional 2.5 million courses of paxlovid (which is not yet approved in the UK), oral antivirals used in early SARS-CoV-2 infection to reduce the risk of COVID-19 progressing to severe illness, hospitalization and death. The drugs will be deployed in a trial run by Oxford University. The UK has already ordered 480,000 courses of molnupiravir and 250,000 courses of paxlovid. Source