S.Africa: Vaccines, prior infection leading to mild COVID-19 cases

A woman is vaccinated against COVID-19 at the Hillbrow Clinic in Johannesburg, South Africa, on Dec 6, 2021. (SHIRAAZ MOHAMED / AP)

BRUSSELS / BRASILIA / COPENHAGEN / ATHENS / HAVANA / HELSINKI / LONDON / OTTAWA / BERLIN / PARIS / LILONGWE / JOHANNESBURG – South Africa's health minister said on Friday that the government believed that vaccines and high levels of prior COVID-19 infection were helping to keep disease milder in a wave driven by the Omicron variant.

There have been early anecdotal accounts suggesting that the Omicron variant driving the fourth wave, which saw the country report a record number of daily infections earlier this week, is causing less severe illness than previous variants in South Africa but scientists say it is too early to draw firm conclusions.

"We believe that it might not necessarily just be that Omicron is less virulent, but … coverage of vaccination (and) … natural immunity of people who have already had contact with the virus is also adding to the protection," Health Minister Joe Phaahla told a news conference. "That's why we are seeing mild illness."

South Africa has given 44 percent of its adult population at least one dose of COVID-19 vaccine, more than many African countries but well short of the government's year-end target. But among the over-50s vaccination coverage levels are over 60 percent.

In another development, South Africa said it would donate roughly 2 million doses of Johnson & Johnson's COVID-19 vaccine to other African countries.

The shots will be made available over the next year through a medical supplies platform set up by the African Union.

"This donation embodies South Africa's solidarity with our brothers and sisters on the continent with whom we are united in fighting an unprecedented threat to public health and economic prosperity," the South African government said in a joint statement with an AU vaccine task team.

A commuter wears a protective face mask in a subway station, in Sao Paulo, Brazil on Dec 1, 2021 amid the COVID-19 pandemic. (ANDRE PENNER / AP)

Brazil

Brazil's health regulator Anvisa said on Thursday it has approved the use of Pfizer's COVID-19 vaccine for children aged from 5 to 11 years old.

The regulator said the benefits of mass-immunization far outweigh the risks associated with the vaccine. It remains unclear, however, as to when Brazil might roll out doses to this age group.

A woman receives a dose of the Pfizer COVID-19 vaccine in a vaccination clinic set up at St Columba's Church in Sheffield on Dec 15, 2021 as the UK steps up the country's booster drive to fight a "tidal wave" of Omicron. (OLI SCARFF / AFP)

Britain

Fuelled by the rapid spread of the Omicron variant, Britain registered a record number of daily coronavirus cases for the second day in a row.

A total of 88,376 new cases were reported, up from 78,610 cases 24 hours earlier, bringing the total number of coronavirus cases in the country to 11,097,851, according to official figures released Thursday.

Another 1,691 Omicron cases have been found in Britain, the biggest daily increase since the COVID-19 variant was detected in the country, taking the total Omicron cases found in the country to 11,708,  the UK Health Security Agency (UKHSA) confirmed Wednesday.

Meanwhile, Britain expects to have antiviral COVID-19 pills produced by Merck & Co Inc and Pfizer available over the winter, its Antiviral Taskforce Chair said on Thursday, as Omicron continues its lightning advance through the country.

Eddie Gray told reporters he expected both Merck's molnupiravir and Pfizer's paxlovid treatments to be available throughout the winter period, which he defined as between now and the end of March. Britain has yet to approve paxlovid.

"If there's a successful approval of paxlovid we'll want to fold that into the PANORAMIC process," Gray said, referring to a UK clinical trial examining the real-world efficacy of antiviral treatments against Omicron within a highly-vaccinated population.

PANORAMIC is currently underway, trialling Merck's pill in COVID-19 patients at risk of serious illness in a bid to avoid hospitals overloading. It has enlisted more than 250 people out of a target of 10,000 subjects, Gray said.

"Early treatment in the community could have the furthest reach and impact here," chief investigator Professor Chris Butler told reporters. "Diminishing the burden on hospitals and getting people recovering quicker is the next phase in this area of research."

People enter a COVID-19 rapid testing business in Montreal on Dec 4, 2021. (GRAHAM HUGHES / THE CANADIAN PRESS VIA AP)

Canada

Ontario, Canada's most populous province, is expected to see intensive care capacity reach unsustainable levels in January without an "immediate circuit breaker" to stem the spread of Omicron variant, according to Ontario's Science Advisory Table on Thursday.

The Omicron variant is set to become the dominant strain in the province this week and without some type of circuit breaker, COVID-19 cases could exceed 10,000 per day before Christmas, according to the modeling issued by the Science Advisory Table.

"Although vaccines are less effective against Omicron infection, boosters can substantially increase protection," the modeling says. "Even two doses likely provide strong protection against severe illness. The risk of severe illness is dramatically higher in the unvaccinated."

Ontario, with a population of 14 million, reported 2,421 new COVID-19 cases on Thursday for the first time in seven months and as well as nine deaths related to the disease.

Children attend a ceremony to mark the resuming of the 2020-2021 school year at the educational centre Ciudad Escolar Libertad in Havana, on Nov 15, 2021. (Yamil LAGE / AFP)

Cuba

Cuba registered zero COVID-19 death for the fifth consecutive day on Thursday, keeping its pandemic death toll at 8,313, the Ministry of Public Health said.

The country's total number of infections reached 963,885, after 72 new cases were detected in the past 24 hours, the ministry said in its daily report.

Meanwhile, Cuba have detected four more cases of the Omicron variant of the novel coronavirus, the ministry said in a statement.

The ministry said the cases involve two Cuban healthcare workers returning from South Africa, and one Ethiopian traveler and one Somali traveler arriving from Kenya.

The four patients were "in good health" and asymptomatic, but under quarantine in keeping with Cuban pandemic regulations.

ALSO READ: EU leaders struggle to find common ground on travel curbs

Danish Prime Minister Mette Frederiksen arrives for an EU summit in Brussels, Friday, Oct 22, 2021. (OLIVIER HOSLET / POOL PHOTO VIA AP)

Denmark

Denmark's Prime Minister Mette Frederiksen on Thursday warned that further measures to curb a third wave of the COVID-19 epidemic could be imminent after the Nordic country saw a doubling of daily cases of the Omicron variant.

"Infection rates are unfortunately as expected very, very high," Mette Frederiksen said on Instagram. "I have no doubt that new initiatives will be needed to break the chains of infection," she wrote.

Denmark has logged almost 3,000 Omicron infections in the past 24 hours, bringing the total number of cases to 9,009.

Daily infections also broke another record, as 9,999 new ones were logged. Death rates and hospital admissions, however, are still far below the levels seen a year ago.

The government will meet with parliament on Friday to discuss the latest recommendations from health authorities, typically a sign that new restrictions are in the pipeline.

This file photo dated April 20, 2021 shows an exterior view of the European Medicines Agency (EMA) in Amsterdam, the Netherlands. (PETER DEJONG / FILE / AP)

European Medicines Agency (EMA)

European Union countries can use Pfizer's antiviral COVID-19 pill Paxlovid early after diagnosis of an infection even though its full review for regulatory approval has not been completed, the bloc's drugs regulator said on Thursday.

Patients at risk of suffering severe forms of the infection should start the five-day course of Paxlovid as soon as possible after diagnosis or within 5 days of symptom onset but not when supplemental oxygen is already required.

"The Agency's advice can now be used to support national recommendations on the possible use of the medicine before marketing authorization," the European Medicines Agency (EMA) said in a statement.

Data released this week showed Pfizer's pill was nearly 90 percent effective in preventing hospitalizations and deaths in high-risk patients, and recent lab data suggests the drug retains its effectiveness against the fast spreading Omicron.

A passenger wearing a face mask checks in at the Helsinki Airport, Finland, on June 21, 2021. (PHOTO / XINHUA)

Finland

Finland on Thursday ordered compulsory PCR tests for arrivals from high-risk areas to curb the spread of the Omicron variant of COVID-19.

The policy took effect immediately.

From next Tuesday people arriving from any country outside the European Union or the Schengen area must provide both a negative COVID-19 test that is no more than 48 hours old, and proof of being fully vaccinated.

The requirements do not apply to Finnish nationals, foreign residents in Finland, or transit travelers not leaving the airport.

More than 10,500 new COVID-19 cases were recorded in Finland between Dec 6 and 12, according to official figures. The incidence of new infections has continued to climb over the last 14 days, reaching 360 per 100,000 inhabitants at the end of last week.

A woman waits to receive Pfizer's COVID-19 vaccine at a vaccination site, in Fontainebleau, south of Paris on Dec 6, 2021. (THIBAULT CAMUS / AP)

France

French ethics body CCNE has approved vaccination against COVID-19 for all children aged 5-11, BFM television reports on Friday.

Separately, the rapid spread of the Omicron variant of COVID-19 in the United Kingdom (UK) has prompted France to announce new measures for travelers arriving from the country.

Effective from Dec 18 at midnight, all travelers from the UK over the age of 12 must have a compelling reason to travel, the French foreign affairs ministry said on Thursday. This rule applies regardless of vaccination status.

On boarding flights from the UK to France, travelers must present a negative PCR or antigen test result, carried out less than 24 hours before departure. They must also fill out a passenger form.

After entering France, UK travelers must self-isolate in a location of their choice, the ministry also announced. If the traveler can present a negative PCR or antigen test 48 hours after arriving, they no longer have to quarantine.

Germany

The German government is deploying a rapid booster COVID-19 vaccination strategy in order to avoid overloading the country's healthcare system, Minister of Health Karl Lauterbach said on Thursday.

"We have made a very offensive booster vaccination strategy our main tool, and for that you need a lot of vaccine, and you need the vaccine fast," Lauterbach said at a press conference

The government has made 2.2 billion euros ($2.5 billion) available to purchase 92 million additional doses of the BioNTech/Pfizer and Moderna vaccines for the coming year, the Ministry of Finance said Wednesday.

A pedestrian wearing a face mask to protect against coronavirus walks in front of a mural, at a metro station in Athens, Greece on Nov 15, 2021.” (THANASSIS STAVRAKIS / FILE / AP)

Greece

Foreign travelers can opt to show a rapid antigen test or a PCR test to enter Greece, the country said on Thursday, amending a rule it announced only the day before to help curb the spread of the Omicron variant of the coronavirus.

Health authorities said on Wednesday that the measure – which will be in effect from Dec 19 – would require a PCR test no more than 48 hours old.

Previously, proof of vaccination or recovery from COVID-19 or negative testing were necessary to travel to Greece.

On Thursday, slightly broader options for the testing were announced – with all travelers aged over five needing to show either a PCR test taken no more than 72 hours before their arrival or a rapid test 24 hours before arriving.

"The Omicron variant prompted our country to take one-off measures for foreign visitors," government spokesman Giannis Oikonomou said.

He said the restrictions would apply for the Christmas period and were aimed to delay the spread of the pandemic to give Greek people more time to get booster shots.

A health worker takes oxygen cylinders to COVID-19 wards at Queen Elizabeth Central Hospital in Blantyre, Malawi, Jan 30, 2021. (THOKO CHIKONDI / AP)

Malawi

The Minister of Health in Malawi, Khumbize Chiponda, announced Thursday that the ministry will introduce mandatory vaccination for all public servants and other frontline workers as cases of COVID-19 continue to rise sharply in the country.

Chiponda made the announcement at a press briefing held at her ministry's headquarters in Lilongwe, adding that the mandatory vaccination will also be introduced to those working in the social sector, including journalists.

She said the mandatory COVID-19 vaccination will be rolled out in January and that the list of specific categories will be announced soon.

The country recorded 318 new cases of COVID-19 on Wednesday, up from 232 new cases recorded on Tuesday. Cumulatively, Malawi has recorded 62,933 cases of COVID-19, including 2,310 deaths.

This file photo taken on Nov 17, 2020 shows vials with COVID-19 Vaccine stickers attached and syringes with the logo of US biotech company Novavax. (JUSTIN TALLIS / AFP)

Novavax

Novavax's COVID-19 vaccine could receive approval from Europe's drug regulator next week and subsequently an emergency use listing from the World Health Organization, the Financial Times reported on Thursday, sending shares of the US drugmaker up 7 percent.

A WHO approval could come once the health body issued its own emergency use listing or if the European Medicines Agency gave it a conditional marketing authorization, the newspaper reported, citing people familiar with the matter.

That could pave the way for the company and its partner, Serum Institute of India, to ship doses to the COVAX program, providing another vaccine to low-income countries.

The WHO said on Thursday that it would reveal its position over the vaccine in the coming days, following an expert group meeting.

The protein-based vaccine by Novavax in June was shown to be more than 90 percent effective, including against a variety of concerning coronavirus variants, in a large, late-stage US trial.

In this file photo taken on March 19, 2021, a firefighter holds a vial of the Pfizer-BioNTech COVID-19 vaccine, in front of the firefighter truck, in Vaillhauques, southern France.  (SYLVAIN THOMAS / AFP)

Pfizer

Pfizer Inc and its German partner BioNTech SE said on Thursday they have filed for full approval of their COVID-19 vaccine with the US Food and Drug Administration to include adolescents aged 12 to 15.

The vaccine received full approval for ages 16 and above in the United States in August. The shot also has an emergency use authorization for 5 to 15 year olds.

Pfizer is seeking for an approval based on long-term data from a late-stage study conducted among adolescents. The company said in November the two-dose series of the vaccine was 100 percent effective against COVID-19, measured seven days through over four months after the second dose.

The company is seeking clearance for a 30 micrograms dose of the vaccine for those aged 12 and above. Pfizer/BioNTech's vaccine is the only COVID-19 vaccine authorized for the given age group in the US.

Pfizer said it expects to file for approval with the European Medicines Agency and other regulatory authorities around the world in the coming weeks.

The FDA gave the two-dose vaccine emergency-use authorization for adolescents in May.

ALSO READ: WHO: COVID-19 shots may be less effective against Omicron

This photo shows a box of the Johnson & Johnson COVID-19 vaccine in a refrigerator at the Yakima Valley Farm Workers Clinic in Toppenish, Washington, March 25, 2021. (TED S. WARREN / AP)

United States

A panel of outside advisers to the US Centers for Disease Control and Prevention on Thursday voted to recommend Americans choose to receive one of the other two authorized COVID-19 vaccines over Johnson & Johnson's shot, due to rare but sometimes fatal cases of blood clotting.

The CDC's Advisory Committee on Immunization voted unanimously to make the recommendation in favor of the vaccines made by Moderna Inc and Pfizer/BioNTech over the J&J shot. The regulator still needs to sign off on the guidance.

Fewer Americans have received the J&J shot than the other two vaccines by a significant margin. Out of more than 200 million fully vaccinated people in the United States, around 16 million received J&J's vaccine, according to CDC data.

J&J said in a statement that the safety and well-being of those who use their vaccine is its top priority and it looks forward to working with the CDC on the next steps.

Cases of thrombosis with thrombocytopenia syndrome (TTS), which involves blood clots accompanied by a low level of platelets, have previously been reported in recipients of the J&J vaccine. The highest reporting rates are in women under 50.

The CDC said that the rate of such incidents is higher than previously estimated, both in women and men. The agency has identified more than 50 cases of TTS in the US, about 3.83 cases per million J&J doses administered.

This photograph taken on March 5, 2021 shows the flag of the World Health Organization at their headquarters in Geneva amid the COVID-19 outbreak. (FABRICE COFFRINI / AFP)

World Health Organization

The World Health Organization issued interim recommendations on Thursday for mixing and matching COVID-19 vaccines from different manufacturers for both the second dose and booster shots.

Depending on availability, mRNA vaccines, such as those developed by Pfizer Inc and Moderna Inc can be used as subsequent doses after initial doses of AstraZeneca's vectored vaccine and vice versa, the global health body said.

AstraZeneca and any of the mRNA vaccines can also be used after initial doses of Sinopharm's inactivated vaccine, WHO said.

Viral vector vaccines contain instructions for making coronavirus antigens, while mRNA vaccines use a code from SARS-CoV-2, the coronavirus that causes COVID-19, to prompt an immune response in recipients. Inactivated vaccines take the SARS-CoV-2 virus and inactivate or kill it using chemicals, heat or radiation.

The guidance has been developed based on advice from WHO's Strategic Advisory Group of Experts on vaccines earlier this month.

The recommendation comes after a major study last week said a first dose of AstraZeneca or Pfizer/BioNTech shots followed by a Moderna vaccine nine weeks later induced a better immune response.

However, WHO said the mixing and matching should take into account supply projections, accessibility and the benefits and risks of the COVID-19 vaccines being used.

World Trade Organization Director-General Ngozi Okonjo-Iweala opens the 2021 WTO Public Forum with a round table on COVID-19 and trade, in Geneva, on Sept 28, 2021. (FABRICE COFFRINI / AFP)

World Trade Organization

The World Trade Organization is close to resolving a dispute over how to spread COVID-19 vaccines more widely and fairly, but facing an "orchestrated effort" to block a deal, the body's chief said on Thursday.

WTO Director-General Ngozi Okonjo-Iweala told Reuters she had held talks this month with trade ministers from India, South Africa, the European Union and the United States on how to break an impasse over the issue of intellectual property rights.

Agreement is needed to allow some technology transfer to developing countries without manufacturers there at risk of being sued, she said.

"Ease of use, easy of distribution and affordability. These are things that could be unleashed much more if we came to these kinds of agreements," she said.

"We are getting close to an answer, a solution," she said. "On the other hand, it looks to me that there is an orchestrated effort to block success on the issue."

India and South Africa have proposed waiving intellectual property rights for COVID-19 vaccines and treatments, but developed members such as the European Union, Britain and Switzerland argue it would be better to use existing WTO rules that allow countries to award licences to local producers.

In this Sept 21, 2018 photo, a man leaves the World Trade Organization (WTO) headquaters in Geneva. (Fabrice COFFRINI / AFP)

Discussions on the issue at the WTO, which takes decisions by consensus, have been deadlocked for more than a year. Okonjo-Iweala said she had brought the main actors together, with technical experts now trying to settle details.

However, the WTO head said information on delicate negotiations had since been exposed through leaks to the media, putting a "chill" on the process.

"It's not inadvertent. I think it's a deliberate means of stopping negotiations and stopping an answer. The thing is millions of lives depend on this … Continents like Africa are waiting for this," she said.

In just one of several examples of purported details leaking out, sources in a report in trade publication Washington Trade Daily on Wednesday referred to a waiver of IP rights needing to go beyond just vaccines, as the United States has proposed, and talked of the "obdurate stance" of the European Union.

Okonjo-Iweala said all four parties to the talks had mentioned that they wanted a solution quickly and that she would continue her work towards this end. They had also agreed on a framework that could lead to a solution satisfactory to both sides.

"No one side will get 100 percent, but it's a satisfactory solution that I think both sides could sign onto. We are very much moving in that direction," she said.

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