COVID-19 continues to spread in China, Airfinity reported, with forecasts showing ~3.6 million new cases per day. Cases are high but appear to be stabilising in Canada and the USA, with deaths still rising, while the case rebound continues in Japan and Australia. Meanwhile an article in Nature quotes modelling from the UK, suggesting that Chinese outbreak peaked in December, and this is matched by recent claims from Chinese health officials – although not all modellers agree. https://www.nature.com/articles/d41586-023-00075-4
According to Airfinity, COVID-19 cases in Japan are expected to increase further following a brief decline at the start of the month and are also increasing in Australia, Canada and Mexico while showing signs of stabilising in the USA despite XBB.1.5 spread.
An article in Nature gives a good overview of the XBB.1.5 sub-variant:
https://www.nature.com/articles/d41586-023-00014-3
WHO commented on XBB.1.5 during a recent press conference:
We don’t yet have data on severity and that is under assessment in the United States but also elsewhere. The data that we’re looking at is to determine whether or not there’s a change in severity. There’s no indication of an increase of severity or decrease of severity compared to other Omicron subvariants.
The Joint EASA-ECDC addendum to the Aviation Health Safety Protocol has been published, referring to the China situation and responses to it: https://www.easa.europa.eu/en/newsroom-and-events/press-releases/easaecdc-provide-guidelines-aviation-part-european-response or directly at: https://www.easa.europa.eu/en/downloads/137460/en
And EU guidance on aircraft wastewater testing was published here: https://wastewater-observatory.jrc.ec.europa.eu/#/guidance and directly: https://wastewater-observatory.jrc.ec.europa.eu/static/pdf/Sampling%20Aircrafts_FINAL_Version%209%20Jan%202023.pdf
Also on COVID – a review of whether throat and nasal swab is better than just nasal (my interpretation: for antigen testing, it seems to be better): https://jamanetwork.com/journals/jama/fullarticle/2800526
Two new NEJM studies on bivalent boosters were published.
Collier et al from Harvard: https://www.nejm.org/doi/full/10.1056/NEJMc2213948
Our data indicate that both monovalent and bivalent mRNA boosters markedly increased antibody responses but did not substantially augment T-cell responses….
These data are consistent with the modest benefits observed with a BA.1-containing bivalent mRNA booster.4 Our findings suggest that immune imprinting by previous antigenic exposure5 may pose a greater challenge than is currently appreciated for inducing robust immunity against SARS-CoV-2 variants.
And Wang et al from New York: https://www.nejm.org/doi/full/10.1056/NEJMp2215780
Boosting with new bivalent mRNA vaccines targeting both the BA.4–BA.5 variant and the D614G strain did not elicit a discernibly superior virus-neutralizing peak antibody response as compared with boosting with the original monovalent vaccines.
Eric Topol looked at the picture on bivalent boosters (including those two papers) and concluded:
There is now more than ample, highly consistent evidence via lab studies and clinical outcomes to support the bivalent’s benefit over the original booster…. A key question is how long the bivalent will help prevent severe Covid. There’s no reason to think it would differ much from what we’ve seen with the original booster, with diminished protection over the course of 4 to 6 months…..
Other infections:
Uganda’s government declared the end (after 42 days without new cases) of a nearly four-month Ebola outbreak that, after a struggle, it was able to bring under control despite the absence of a proven vaccine against the Sudan ebolavirus strain. A total of 164 people were infected and 55 died.
There is an EPI-WIN webinar on the current influenza outbreak and what it means for pandemic influenza at 12:00–13:00 CET Geneva, Wednesday, 18 January 2023. The webinar can also be viewed live and post-event on the EPI-WIN YouTube channel.
A Nipah virus death has been reported in Bangladesh putting the country on alert, while measles continues to spread in Nepal. The CDC has reported that more than 22 million Americans have been infected with influenza this season, prompting the release of a stockpiled antiviral. Meanwhile RSV and influenza cases appear to be declining in UK and Canada.
Australia has ongoing infections with Japanese encephalitis or JEV (45 cases since Mar 2022, and 7 deaths) and now invasive Group A streptococcal infections (now up to 65 cases this year).
Other topics:
There is an EASA Cabin Air research workshop this week. The workshop aims to present the new project launched by EASA under the Horizon 2020 program and provide a follow-up from the previous event organised in Jan 2020 on several research initiatives addressing cabin Air Quality with a focus on contamination events and health risk assessments:
- Measurements of contamination events
- Characterisation of release of pollutants
- Toxicological assessments (dose-response) and investigations of health effects
- Bio-monitoring, medical surveys of aviation professionals
- Risk mitigations
David Powell
IATA Medical Advisor