Building on the experience of battling the COVID-19 pandemic, African countries are strengthening health systems to prepare for the next health crisis, the World Health Organization’s Africa director said Thursday.
At the onset of the pandemic in early 2020, some of the 54 countries in the continent of 1.3 billion people lacked the facilities or trained health workers to respond adequately to the health crisis, with some struggling to provide hospital isolation wards and intensive care units, Matshidiso Moeti, the World Health Organization’s Africa regional director, said at an online briefing Thursday.
However, over the course of three years, African countries have ramped up investments in health infrastructure in the race against the pandemic with support from global donors, she said.
“The future, however difficult the past couple of years have been, will find us in a much better situation in terms of our strategies, our investments and our capacities to confront public health threats,” said Moeti.
“We know now what we need to do to be able to make sure that our systems are resilient to the impact of a shock like an outbreak,” she said.
Across the continent, she said, WHO is working with countries to reinforce their capacities by training first responders while work is also ongoing to strengthen public health institutions and emergency operations.
One of the “most exciting outcomes of the struggle” Africa faced in getting COVID-19 vaccines is that some countries in the continent are now developing their capacities to produce those key tools locally, Moeti added.
“Whatever happens in the future, the next pandemic will find the world and Africa much readier” in its response, she said, optimistic about “important partnerships” and African institutions being established “to take the lead to work in the area of preparedness and also in primary healthcare.”
In Gambia, as in many countries across Africa, the pandemic was “very difficult” for many health systems but it was “an eye-opener for all of us to know where the gaps have been,” said Ahmadou Lamin Samateh, Gambia’s minister of health.
Samateh called for a global support system that offers more assistance and resources to countries experiencing challenges.
“National governments have roles to play but international communities have important roles to play as well,” he said. “We’ve seen in the COVID-19 pandemic that one problem in one part of the world is a problem for the entire world.”
And even with Africa still facing gaps in COVID-19 vaccinations, Moeti, director of WHO’s Africa regional office, warned that more work needs to be done to sustain the gains from the pandemic response.
“As we move into 2023, it’s time to bring COVID-19 out of emergency response mode integrate it into routine health care,” Moeti said.
U.S. regulators on Thursday cleared doses of the updated COVID-19 vaccines for children younger than age 5.
The Food and Drug Administration’s decision aims to better protect the littlest kids from severe COVID-19 at a time when children’s hospitals already are packed with tots suffering from a variety of respiratory illnesses.
Omicron-targeted booster shots made by Moderna and rival Pfizer already were open to everyone 5 and older.
The FDA now has cleared their use in tots starting at age 6 months — but just who is eligible depends on what vaccinations they’ve already had, and which kind. Few youngsters have gotten the full primary series since shots for the littlest kids began in June.
The FDA decided that:
–Children under age 6 who’ve already gotten two original doses of Moderna’s COVID-19 vaccine can get a single booster of Moderna’s updated formula if it’s been at least two months since their last shot.
–Pfizer’s vaccine requires three initial doses for tots under age 5 — and those who haven’t finished that vaccination series will get the original formula for the first two shots and the omicron-targeted version for their third shot.
–Children under 5 who already got all three Pfizer doses aren’t yet eligible for an updated booster. Data expected next month should help the FDA determine if and when those tots need the omicron-targeted booster.
The Centers for Disease Control and Prevention is expected to sign off soon, the final step for shots to begin.
Just 3% of tots under 2 and nearly 5% of those 2 to 4 have gotten their primary doses so far, according to the CDC.
“Vaccines remain the best defense against the most devastating consequences of disease caused by the currently circulating omicron variant,” FDA vaccine chief Dr. Peter Marks said in a statement.
The updated vaccines from Moderna and Pfizer are combination shots, containing half the original vaccine and half tweaked to match the BA.4 and BA.5 omicron strains that until recently were dominant. Now BA.5 descendants are responsible for most COVID-19 cases.
The CDC last month released the first real-world data showing that an updated booster, using either company’s version, does offer added protection to adults. The analysis found the greatest benefit was in people who’d never had a prior booster, just two doses of the original COVID-19 vaccine — but that even those who’d had a summertime dose were more protected than if they’d skipped the newest shot.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
The coronavirus pandemic interrupted efforts to control malaria, resulting in 63,000 additional deaths and 13 million more infections globally over two years, according to a report from the World Health Organization published Thursday.
Cases of the parasitic disease went up in 2020 and continued to climb in 2021, though at a slower pace, the U.N. health agency said Thursday. About 95% of the world’s 247 million malaria infections and 619,000 deaths last year were in Africa.
“We were off track before the pandemic and the pandemic has now made things worse,” said Abdisalan Noor, a senior official in WHO’s malaria department.
Alister Craig, dean of biological sciences at the Liverpool School of Tropical Medicine, noted that progress in reducing malaria deaths had stalled even before COVID-19.
“It is almost as if we have reached a limit of effectiveness for the tools we have now,” said Lister, who was not linked to the WHO report.
Noor said he expected the wider rollout of the world’s first authorized malaria vaccine next year to have a “considerable impact” on reducing the number of severe illnesses and deaths if enough children get immunized, adding that more than 20 countries have applied to vaccines alliance Gavi for help in securing the shot. Still, the vaccine is only about 30% effective and requires four doses.
Bed nets can protect people from being bitten by the mosquitoes that spread malaria. The WHO report found that about three-quarters of nets provided by donors have been distributed, but there are major gaps in some of the worst-hit countries. Authorities in Nigeria, for example, gave out just over half their nets, while Congo distributed about 42% of theirs.
Officials also raised concerns about a new invasive mosquito species that thrives in cities, is resistant to many pesticides and which could undo years of progress against malaria. The invasive species has not yet significantly contributed to the continent’s overall malaria burden, but the insects are likely responsible for a recent spike in parts of the horn of Africa, Noor said.
David Schellenberg, a professor at the London School of Hygiene and Tropical Medicine, said there were promising new tools and strategies to tackle malaria, but that “the elephant in the room is the level of funding.” WHO estimated the total investment into malaria — about $3.5 billion — was less than half of what was needed to dramatically reduce its impact.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
China began implementing a more relaxed version of its strict “zero COVID” policy on Thursday amid steps to restore normal life, but also trepidation over a possible broader outbreak once controls are eased.
The country reported 21,165 new coronavirus cases on Thursday, though it was unclear whether the lower number reflected fewer infections or a reduction in testing.
The National Health Commission issued relaxed anti-pandemic regulations on Wednesday, including a loosening of lockdowns and the elimination of a requirement that a recent negative COVID-19 test be shown to enter most public places.
The commission said it was due to “positive results” in fighting the virus and because of a recognition that the current omicron variant is less dangerous than earlier versions of the virus — a fact long embraced by other countries that have reopened their societies.
“Our country’s epidemic prevention and control work is facing new situations and new tasks,” commission spokesperson Mi Feng said. Neither Mi nor other experts appearing with him at a briefing Thursday addressed the possibility of a new outbreak once restrictions are eased.
The relaxation also follows street protests — the largest in decades — by people fed up with the draconian controls, which have been blamed for hobbling the economy, upending millions of lives and causing the deaths of some people refused hospital treatment because they lacked proper test results.
“This is an inevitable trend. We must let go sooner or later, and we can’t always stick to previous measures,” said Xin Guijun, a 70-year-old Beijing resident.
“However, one thing is that we are on our own to protect ourselves, and we must cultivate our own awareness of personal protection,” Xin told The Associated Press.
While the relaxation sent a wave of relief through Chinese society, much uncertainty remains and the move was not met with universal acclaim.
Dr. Anthony Fauci, the top U.S. infectious disease expert and a critic of China’s reliance on lockdowns, said China risked unleashing a new wave of virus mutations on the world if it doesn’t “mount and implement a proactive vaccination campaign.”
“Whenever you have a large wave of transmissions of a virus, you give it ample opportunity to mutate,” Fauci said Wednesday at an event organized by the Financial Times newspaper.
“And when you give a virus opportunity to mutate, that allows it to form potentially new variants. And once you get a brand-new variant, that could have an impact on the rest of the world,” Fauci said.
Fauci and other foreign health officials have urged Beijing to import Western COVID-19 vaccines based on mRNA technology, considered more effective than the inactivated vaccines developed by China. Chinese officials have so far ignored such calls.
The changes announced Wednesday include a renewed commitment to vaccinate vulnerable groups and the elderly, whose levels of immunization are far lower than the population as a whole. China has administered 3.4 billion doses to its 1.4 billion people, or about 2.4 doses per person, indicating that large numbers have not received the recommended three shots.
China’s difficulties are compounded by the fact that only a small number of people have been exposed to the virus under “zero COVID,” leaving most with no natural antibodies.
In an editorial on the Wednesday announcement, the official Xinhua News Agency said the changes were “introduced based on the latest epidemic situation and mutation of the virus to contain the epidemic in a more science-based and targeted manner.”
Xinhua emphasized the need to “rectify oversimplified or one-size-fits-all approaches and excessive policy steps, oppose and curb pointless formalities and bureaucratism.”
China has not formally abandoned “zero COVID,” which seeks to track and eliminate all infections, but its recent steps seem to indicate it is dropping it in all but name.
The ruling Communist Party credits the policy with sparing China the large numbers of cases and deaths seen in other countries.
China’s official death toll is 5,235 since the start of the pandemic, versus a U.S. count of 1.1 million.
In a move that caught many by surprise, China announced a potentially major easing of its rigid “zero-COVID” restrictions, without formally abandoning the policy altogether.
It’s not clear what exactly prompted the move, although it follows the largest show of public dissent against the ruling Communist Party in more than 30 years by residents fed up with constant testing, quarantines, travel restrictions, rolling lockdowns and business closures.
Here’s a look at the changes known as the “New Ten Requirements” announced on Wednesday.
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WHAT ARE THE BIGGEST CHANGES?
Among the most significant changes is one that allows people who test positive for COVID-19 but show no or only mild symptoms to recuperate at home rather than being forced into one of the government field hospitals that have become notorious for overcrowding, lights that stay on 24 hours and poor food and hygiene.
Where cases are discovered, lockdowns will be limited to specific apartment floors or buildings. Before, such lockdowns would encompass entire communities, districts and even cities. Widespread lockdowns were a significant factor behind protests in the spring in Shanghai and other cities.
Authorities have reduced the requirement to produce a “health code” on a smartphone app that tracks virus testing and the user’s proximity to areas deemed at high risk of infection and shows test results.
Health codes will still be required for “special places,” including schools, hospitals and nursing homes. That leaves considerable ambiguity. Restaurants in Shanghai and Beijing were still requiring a negative test within the last 48 hours for indoor dining Thursday.
One problem with the change: Centers that provided immediate, free PCR testing with results available overnight are becoming harder and harder to find.
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WHAT ELSE CHANGED?
Other relaxations are more subtle but still significant, like the length of lockdowns, which can only last five days if no new cases are detected. That’s a major change from the open-ended lockdowns that could drag on for weeks and leave residents with no information or ability to plan ahead.
Restrictions on the sale of cold and cough medicine are also being lifted. During the height of the pandemic, such over-the-counter medications could only be purchased through a lengthy application process. While never clearly explained, the rules were thought to be aimed at those trying to cover up COVID-19 symptoms to avoid being tested and sent to quarantine. Just visiting a pharmacy risked triggering the health code smartphone app, resulting in a visit from hazmat-attired health authorities and police.
More emphasis is also being placed on providing the elderly with vaccines and booster shots, and a greater focus will be placed on members of the population who suffer from cardiovascular diseases, diabetes and other underlying factors that can increase vulnerability to COVID-19.
Local governments are also barred from suspending business and public transportation in areas not considered at risk. They are also forbidden from blocking fire exits — an apparent reference to the apartment fire in the western city of Urumqi last month that helped set off the street protests. In theory, that would prevent some of the more extreme measures taken to block people into their homes, like locking their doors from the outside, welding steel bars across passages and fencing in entire communities.
Schools without cases will be required to return to in-person classes, and emergency patients who do not have a recent negative test can no longer be barred from hospitals.
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WHAT’S THE EFFECT ON CHINA’S SOCIETY, ECONOMY, POLITICS?
The new measures will likely take some time to be implemented and leave considerable wiggle room to keep some restrictions in place. Communities whose health care resources are barely adequate at the best of times will likely be the last to drop what they see as the last line of defense against potentially overwhelming outbreaks.
In the cities, the effect appears to have been more immediate. Subways and busses in Beijing, Shanghai and other major cities are packed with commuters returning to the office.
But the new requirements don’t address is international travel. China’s borders remain largely closed while the rest of the world opens up, although it did reduce the quarantine time for international arrivals from seven to five days at a designated location, followed by three days of isolation at their place of residence.
Politically, the easing of regulations may take some pressure off the regime of President Xi Jinping, who is considered China’s most authoritarian leader since Mao Zedong and recently awarded himself a third five-year term in power. Xi faces no term limits and has packed the top party ranks with loyalists, but the street protests were a reminder of the limits of public patience.
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WHITHER ‘ZERO-COVID?’
“Zero-COVID” has been touted as Xi’s success, and the party is averse to backtracking or admitting mistakes, so some have put forward the notion that China will gradually adopt an approach of “zero-COVID in name only.” That would give China the authority to reimpose controls as it sees fit and punish opponents and critics from among the general public, intellectuals, the business community and even athletes.
In an editorial on the latest regulations — the ninth set released by China since the Pandemic began in late 2019 — the Communist Party newspaper Global Times struck a victorious tone and conceded no errors or overreach.
“We can say that we have come through the most difficult times,” the paper said. “Nearly three years of an exceptionally difficult ‘national fight against the epidemic,’ countless people have made sacrifices, endured hardships and paid an effort to win this battle.”
Though she could walk around campus freely, she was robbed of weekends spent seeing concerts in the city. She couldn’t stomach the cafeteria food — too sweet for her taste buds accustomed to the spicy Sichuanese cuisine she grew up with.
When her boyfriend told her he would “always trust” Shanghai’s government, she broke up with him. After censors took down a video compilation called Voices of April with some of the most defining moments of the lockdown, including crying infants being separated from their parents during quarantine, Zhang broke down.
“I cried to the point where I can’t trust anything anymore,” said Zhang, who asked to be identified by her English name out of fear of government retribution for discussing a sensitive topic. “I can only trust myself, I can’t trust anyone else, or any government.”
Zhang knows that her experience was hardly unique — or even particularly extreme — but it gives a glimpse of how China’s stringent “zero COVID” policy pushed ordinary people to a breaking point, one that led to nationwide protests late last month.
Over 26 million people in Shanghai were confined for two months in one of the country’s strictest and most visible lockdowns. And over the past three years, various Chinese cities have suffered similar fates, as the government held fast to the policy, which aims to stop transmission of the virus through severe isolation procedures and constant mass testing.
But perhaps now more than ever, Chinese people face a confusing mass of measures, as local officials struggle to balance the latest policy directives with the fear of an uncontrolled outbreak.
It was exactly the uncertainty that Zhang found difficult to bear — and permanently changed her relationship to her home, even prompting her to decide to emigrate.
In early March, with cases rising in Shanghai, Zhang’s university sealed off academic buildings, moved classes online, and locked the front gate to the campus.
She knows she was lucky. Some migrant workers chose to live on the streets so they could continue to work rather than become trapped at home, while middle-class apartment dwellers were forced to beg for essential medicines for those with chronic illnesses.
By contrast, she and her fellow students could walk around the campus and never experienced the food shortages that plagued some Shanghai residents confined to their homes — though metal sheeting around the perimeter ensured they didn’t go out.
After a virus test each morning, Zhang turned on her computer for her classes — but she struggled to pay any attention. Lunch was usually at one of the restaurants on campus.
Afternoons were filled with discussions with classmates on what would happen next or doomscrolling on her phone at one of the exercise fields, she said.
Her greatest escape, she said, was smoking cigarettes after dinner.
For weeks, there was no end in sight. “Every week they’d issue a new notice saying, ‘Next week, we will continue this style of management,’” she said.
While she never went hungry, she missed her easy access to the foods she loved. She would binge at one of the restaurants on the campus, worried each meal there would be the last one — and eventually the eateries did start to close in April because they couldn’t get the supplies they needed.
Her favorite was a malatang shop, which sells veggies dripping in chili- and mala-peppercorn infused oil. It shut down for almost two months. She also missed bubble tea from another shop that closed, and fresh bread, recalling that day in mid-May when it returned to campus after several weeks.
Meanwhile, she was sucked in by a constant stream of posts online about people suffering in the wider city.
Her concern and frustrations separated her from others around her.
Her roommate, for instance, was satisfied that they could eat without worry and move about on campus.
“Some schools at that time had sealed off the dorms, and she said, ‘compared to these people, we’re already living a good life, why are you still complaining?’” Zhang said. “She felt this is a life she can accept, but I absolutely cannot accept this.”
Her boyfriend’s conviction that they could trust the government made no sense to her as she consumed story after story of suffering and brutality.
Reports of pandemic workers beating a pet corgi to death. Elderly people with severe medical needs being forced to quarantine in facilities equipped only with portable toilets and sometimes without basic amenities like showers. The suicide of a local health department official. A 55-year old man who lived alone dying in his apartment because his daughter could not get permission to leave her building and take him to the emergency room.
As these examples built up — and got deleted by censors — people created a virtual archive to record the stories.
In light of these realities, her boyfriend’s words made him seem like a complete stranger, she said.
In late May, when the city finally began lifting some restrictions, Zhang made a plan to go home to her parents in southwestern Chongqing. Several, in fact.
“I had to come up with all sorts of plans, Plan A, Plan B, Plan C, so that if I came across any emergency situation, I could still go home,” she said.
Emerging from Shanghai’s quarantine was a strange journey, she said. At the city’s Hongqiao train station, Zhang was faced with a sea of people in white medical grade protective suits that have become synonymous with the virus in China. The universities had given the suits to students as protection. Zhang decided to just don a face mask.
“I was surrounded by all these hazmat suits, and it was really really terrifying,” she said. But “once I got on that train, I felt, ‘oh I’m already halfway home.’”
After the train journey, a night’s stay in a hotel at the halfway point, and a plane ride, she finally landed in Chongqing, where government workers drove her to a hotel for a seven-day quarantine. They erected a plastic barrier in the car that kept her in a bubble.
The quarantine was hard, but it was bearable because it had an end. She was reunited with her parents on June 1.
She has decided to apply to study abroad for a graduate degree — in the hope that she would never endure another lockdown. As she awaits admissions decisions with nervousness, Zhang said she wants to figure out a way to immigrate more permanently.
“There were a lot of the things that happened during Shanghai’s lockdown in April, some things that were really unacceptable,” she said. “After April, it set my conviction that I definitely need to leave this country.”
Last week, Zhang got a call from Shanghai’s disease control agency saying she was a close contact of someone who tested positive at a concert she attended. She found herself in quarantine once again.
