Virus World

The coronavirus disease 2019 (COVID-19) pandemic, along with the implementation of public health and social measures (PHSMs), have markedly reshaped infectious disease transmission dynamics. We analysed the impact of PHSMs on 24 notifiable infectious diseases (NIDs) in the Chinese mainland, using time series models to forecast transmission trends without PHSMs or pandemic. Our findings revealed distinct seasonal patterns in NID incidence, with respiratory diseases showing the greatest response to PHSMs, while bloodborne and sexually transmitted diseases responded more moderately.

8 NIDs were identified as susceptible to PHSMs, including hand, foot, and mouth disease, dengue fever, rubella, scarlet fever, pertussis, mumps, malaria, and Japanese encephalitis. The termination of PHSMs did not cause NIDs resurgence immediately, except for pertussis, which experienced its highest peak in December 2023 since January 2008. Our findings highlight the varied impact of PHSMs on different NIDs and the importance of sustainable, long-term strategies, like vaccine development. Public health and social measures for COVID-19 also impacted the incidence of other infectious diseases. In this study, the authors characterise the impacts of these measures on 24 notifiable infectious diseases in China until December 2023.

Published in Nature Comm. (May 8, 2024):

https://doi.org/10.1038/s41467-024-48201-8 

A U.S. House of Representatives panel yesterday released evidence that a Chinese research team submitted a SARS-CoV-2 genome to a U.S. database on 28 December 2019, nearly 2 weeks before a sequence from another group became public and kick-started the race to develop vaccines and drugs for COVID-19. The revelation, first reported by The Wall Street Journal, renewed allegations that Chinese officials tried to cover up early sequences of the new coronavirus. Lawmakers said the new information also raises the question of whether the U.S. National Institutes of Health’s (NIH’s) GenBank database should somehow flag submissions of pathogen sequences with urgent public health importance. The agency had marked the researcher’s submission as incomplete and deleted the sequence before it became public. The never-completed GenBank submission was “a huge missed opportunity” to start developing drugs, diagnostics, and vaccines earlier, agrees virologist Jeremy Kamil of Louisiana State University Health Shreveport.

Ministry of Civil Affairs scraps figure from delayed statistics release, and provinces also appear to be withholding the information, making it harder for public to understand impact of last winter’s Covid-19 surge. China did not release data on the number of cremation services held in the fourth quarter of 2022, blocking from public view a key indicator of death during the country’s first nationwide Covid-19 wave last winter. On the national level, the Ministry of Civil Affairs has scrapped the figure from its quarterly release of national civil affairs data, which was published on June 9. This defied the ministry’s long-time practice, dating back to 2007, of releasing cremation numbers on a quarterly basis. Before 2020, fourth-quarter cremation data was typically released in the first two months of the following year, along with other civil affairs data such as social welfare and marriage registrations. Thouh the time lag for data releases has increased slightly since 2020, when the country was first hit by Covid-19, the most recent release came after a longer-than-average delay of six months after the end of the quarter. Several provincial-level regions also scrapped the release of cremation services data for the fourth quarter of last year.

The new wave goes against the grain of Chinese health officials’ estimate that COVID-19 had peaked in April. L ast week when a Chinese senior health adviser projected 65 million COVID-19 cases per week in China by June, some health experts sounded the alarm. China has been facing a new COVID-19 wave fueled by the XBB variant since April. Data from Zhong Nanshan—a respiratory disease doctor who was among the first to confirm COVID-19’s easy transmissibility—provided a rare insight into how the disease could possibly be spreading in China almost six months after Beijing abruptly ended its draconian zero-COVID strategy. Since pivoting to “living with the virus” policy from early December, the Chinese Center for Disease Control and Prevention stopped updating weekly infections. But the sudden relaxation of anti-epidemic protocols also led to an estimated 37 million new infections a day weeks later. By January, experts said they believed almost 80% of China’s 1.4 billion population had already been infected in this first wave.

For the second wave since April, Zhong’s modeling revealed that the XBB variant is expected to cause 40 million infections weekly by May, going up to 65 million in June. This goes against the grain of Chinese health officials’ estimate that the wave had peaked in April. In Beijing, the number of new infections recorded between May 15 and 21 grew four times in four weeks. While Zhong said vaccines targeting this specific variant will be rolled out soon, the projection of new COVID-19 infections nonetheless frazzled markets. China’s collective immunity has always been in question: a refusal to use foreign-sourced mRNA vaccines meant the public got inoculated against COVID-19 with a jab that proved less effective in preventing infection during early clinical trials, say researchers, and the stringent virus containment protocols restricted the possibility of developing natural immunity. Yanzhong Huang, senior fellow for global health at the Council on Foreign Relations, tells TIME that although only mass testing can detect the true extent of the COVID-19 surge, the population has obtained some immunity from the preceding wave.

Genetic samples from the market were recently uploaded to an international database and then removed after scientists asked China about them. An international team of virus experts said on Thursday that they had found genetic data from a market in Wuhan, China, linking the coronavirus with raccoon dogs for sale there, adding evidence to the case that the worst pandemic in a century could have been ignited by an infected animal that was being dealt through the illegal wildlife trade. The genetic data was drawn from swabs taken from in and around the Huanan Seafood Wholesale Market starting in January 2020, shortly after the Chinese authorities had shut down the market because of suspicions that it was linked to the outbreak of a new virus. By then, the animals had been cleared out, but researchers swabbed walls, floors, metal cages and carts often used for transporting animal cages. In samples that came back positive for the coronavirus, the international research team found genetic material belonging to animals, including large amounts that were a match for the raccoon dog, three scientists involved in the analysis said. The jumbling together of genetic material from the virus and the animal does not prove that a raccoon dog itself was infected. And even if a raccoon dog had been infected, it would not be clear that the animal had spread the virus to people. Another animal could have passed the virus to people, or someone infected with the virus could have spread the virus to a raccoon dog. But the analysis did establish that raccoon dogs — fluffy animals that are related to foxes and are known to be able to transmit the coronavirus — deposited genetic signatures in the same place where genetic material from the virus was left, the three scientists said. That evidence, they said, was consistent with a scenario in which the virus had spilled into humans from a wild animal.

Beijing will begin distributing Pfizer's Covid-19 drug Paxlovid to the city's community health centers in the coming days, state media reported Monday. The report comes as the city grapples with an unprecedented wave of infections that has severely strained its hospitals and emptied pharmacy shelves. The state-run China News Service reported Monday that after receiving training, community doctors will administer the medicine to Covid-19 patients and give instructions on how to use them. “We have received the notice from officials, but it is not clear when the drugs will arrive,” it cited a worker at a local community health center in Beijing’s Xicheng district as saying. Paxlovid remains the only foreign medicine to treat Covid that has been approved by China’s regulator for nationwide use, but access is extremely difficult to come by. When a Chinese healthcare platform offered the antiviral drug earlier this month, it sold out within hours. Azvudine, an oral medicine developed by China’s Genuine Biotech, has also been approved. After nearly three years of lockdowns, quarantines and mass testing, China abruptly abandoned its zero-Covid policy this month following nationwide protests over its heavy economic and social toll. The abrupt change in policy has sparked panic buying of fever and cold medicines, leading to widespread shortages, both at pharmacies and on online shopping platforms. Long lines have become routine outside fever clinics and hospital wards overflowing with patients in the capital Beijing and elsewhere in the country.

On Monday, Chinese state media CCTV quoted President Xi Jinping as saying the country needed a more targeted health strategy to protect people’s lives as the Covid situation in China changes. “Xi Jinping emphasized that our country is currently facing a new Covid outbreak situation and new responsibilities, we need to conduct our patriotic health movement in a more targeted manner,” the CCTV report said. It was one of the first public statements made by Xi about China’s Covid situation since the government’s decision to ease its strict restrictions. An emergency room doctor in Beijing told the state-run People’s Daily on Thursday that four doctors on his shift did not have time to eat or drink. “We have been seeing patients nonstop,” he said. Another emergency room doctor told the newspaper he had been working despite having developed fever symptoms. “The number of patients is high, and with fewer medical staff, the pressure is multiplied,” said the doctor. In a sign of the strain on Beijing’s medical system, hundreds of health professionals from across China have traveled to the city to assist medical centers.

As the capital, Beijing has some of the best medical resources in the country. However, the abrupt zero-Covid u-turn has left people and health facilities ill-prepared to deal with a surge in infections. China’s official Covid case count has become meaningless after it rolled back mass testing and allowed residents to use antigen tests and isolate at home. It has stopped reporting asymptomatic cases, conceding it was no longer possible to track the actual number of infections. According to an internal estimate from the National Health Commission, almost 250 million people in China have caught Covid in the first 20 days of December – accounting for roughly 18% of the country’s population. Experts have warned that as people in big cities return to their hometowns for the Lunar New Year next month, the virus could sweep through China’s vast rural areas, where vaccination rates are lower and medical resources are severely lacking.

Nearly 37 million people in China may have been infected with Covid-19 on a single day this week, according to estimates from the government’s top health authority, making the country’s outbreak by far the world’s largest. As many as 248 million people, or nearly 18% of the population, likely contracted the virus in the first 20 days of December, according to minutes from an internal meeting of China’s National Health Commission held on Wednesday, confirmed with people involved in the discussions. If accurate, the infection rate would dwarf the previous daily record of about 4 million, set in January 2022...

What is already known about this topic?

Severe   acute   respiratory   syndrome   coronavirus   2(SARS-CoV-2)  Omicron  subvariant  has  a  stronger transmission  capacity  and  faster  transmission  speed than the previous strain.

What is added by this report?

The first coronavirus  disease  2019  (COVID-19)  case infected  with  the  SARS-CoV-2  Omicron  subvariant BA.2.76 who caused local transmission was reported in Chongqing  Municipality  on  August  16,  2022.  For 35minutes, the Patient Zero jogged along a lake at a local park without wearing a mask. Among the 2,836 people potentially exposed  at  the  time,  39  tested  positive. Overall, 38 out of 39 cases did not wear a mask on the morning of August 16. All 39 cases lacked any previous exposure to the variant before testing positive on their nucleic acid test.

What are the implications for public health practice?

It is essential to  maintain  personal  wellbeing  by ensuring one maintains personal protection and follows regulated  guidelines  such  as  maintaining  safe  distances from others both indoors and outdoors.

The first coronavirus disease 2019 (COVID-19) case infected with the  severe  acute  respiratory  syndrome coronavirus   2   (SARS-CoV-2)   Omicron   subvariant BA.2.76  causing  local  transmission  was  reported  in Chongqing Municipality on August 16, 2022. For 35 minutes, Patient Zero jogged along  a  lake  in  a  park without wearing mask. Of the 2,836 people potentially exposed in the park,  39  tested  SARS-CoV-2  positive. Gene   analysis   from   the   39   cases   showed   highly homologous   when   compared   to   Patient   Zero. Epidemiological  investigations  supported  Patient  Zero transmitted  to  the  following  33  visitors  and  2  park cleaners and the 2 cleaners transmitted to 4 colleagues. This outbreak indicated  that  the  Omicron  subvariant BA.2.76 could be easily transmitted to others outdoors if  they  are  not  equipped  with  effective  protection equipment.  The public  should  be  encouraged  to  use good  protection  measures  and  retaining  safe  distances amongst others both indoors and outdoors....

Preprint available in China CDC Weekly (Nov. 18, 2022)

https://doi.org/10.46234/ccdcw2022.209 

The country’s drug regulator has granted conditional authorization for an HIV drug to be used to treat COVID-19.  China’s drug regulator granted conditional approval on Monday for an HIV drug to be used to treat COVID-19. The drug, Azvudine, developed by Chinese drugmaker Genuine Biotech, is the first oral antiviral for the disease made in China. Genuine Biotech, headquartered in Pingdingshan, applied for regulatory approval earlier this month. In an announcement, the company said that 40% of people with COVID-19 who were given Azvudine for a week in a phase III clinical trial showed “improved clinical symptoms”, compared with 11% of those given a placebo. However, detailed data from the trial, including whether the treatment reduced the risk of hospitalization or death, have not been released. Although drug-efficacy data are lacking, Jun Wang, a pharmacologist at Rutgers University in New Brunswick, New Jersey, says because Azvudine is already approved in China as an HIV treatment, it should have abundant safety data, which would have fast-tracked its application. Genuine Biotech will need to submit more post-marketing data in order for the drug to receive full approval. Most antivirals target two SARS-CoV-2 proteins that are essential for replication, a polymerase and a protease. Azvudine tricks the virus’s polymerase into incorporating the drug into its RNA, which stops the virus from replicating1. In China and globally, the demand for COVID-19 therapies is enormous, says Sheng Ding, a pharmaceutical chemist at Tsinghua University in Beijing. Until the Azvudine authorization, China had approved only one oral antiviral to treat the disease, Paxlovid, developed by Pfizer in New York City. It is highly effective — it reduces the risk of hospitalization and death by nearly 89% — but supplies in China are limited. “The market will have room for several more drugs that may not outperform Paxlovid, but allow more people to access effective therapies,” adds Ding. Another Chinese-made oral antiviral, VV116, is in the final stages of development, and another dozen are in various stages of development.

Published in Nature  (July 26, 2022):

https://doi.org/10.1038/d41586-022-02050-x

SHANGHAI, March 27 (Reuters) - China's financial hub of Shanghai said on Sunday it would lock down the city in two stages to carry out COVID-19 testing over a nine-day period, after it reported a new daily record for asymptomatic infections. Authorities said they would divide Shanghai into two for the exercise, using the Huangpu River that passes through the city as a guide. Districts to the east of the river, and some to its west, will be locked down and tested between March 28 and April 1. The remaining areas will be locked down and tested between April 1 and 5. Public transport, including ride-hailing services, in these areas will be suspended when they are locked down, the city government said on its official WeChat account, adding that unapproved vehicles will not be allowed on the roads. It also said that all firms and factories will suspend manufacturing or work remotely during the lockdown, apart from those involved in offering public services or supplying food.

"The public is asked to support, understand and cooperate with the city's epidemic prevention and control work, and participate in nucleic acid testing in an orderly manner," the government added. Shanghai has battled a new COVID-19 surge for nearly a month and for Saturday it reported its highest daily number of cases since the initial outbreak in China receded. The city recorded 2,631 new asymptomatic cases, which accounted for nearly 60% of China's total new asymptomatic cases that day, plus 47 new cases with symptoms. While the number of cases in Shanghai remains modest by global standards, the city of 26 million people has become a testing ground for China's "zero-COVID" strategy as it tries to bring the highly infectious Omicron variant under control. Shanghai authorities have previously resisted a broad lockdown of the city to avoid destabilising its economy and opted for a more bespoke "slicing and gridding" approach, which involves screening neighbourhoods one by one.

Different choices that were available and plausible could have been made at several crucial turning points.  Zeynep Tufekci's Latest:  Dive deep into the internet, technology, politics and society with Zeynep Tufekci's latest column as soon as it’s published. This article is part of Times Opinion’s reflection on the two-year mark of the Covid pandemic. Read more in a note from Alexandra Sifferlin, Opinion’s health and science editor, in our Opinion Today newsletter.

Four-fifths of symptomatic cases develop fevers, more than in earlier outbreaks. The findings match trends in other countries where the Delta variant is spreading.  As the Delta variant of the coronavirus spreads in southeastern China, doctors say they are finding that the symptoms are different and more dangerous than those they saw when the initial version of the virus started spreading in late 2019 in the central city of Wuhan. Patients are becoming sicker and their conditions are worsening much more quickly, doctors told state-run television on Thursday and Friday. Four-fifths of symptomatic cases developed fevers, they said, although it was not clear how that compared with earlier cases. The virus concentrations that are detected in their bodies climb to levels higher than previously seen, and then decline only slowly, the doctors said. Up to 12 percent of patients become severely or critically ill within three to four days of the onset of symptoms, said Guan Xiangdong, director of critical care medicine at Sun Yat-sen University in the city of Guangzhou, where the outbreak has been centered. In the past, the proportion had been 2 percent or 3 percent, although occasionally up to 10 percent, he said. Doctors in Britain and Brazil have reported similar trends with the variants that circulated in those countries, but the severity of those variants has not yet been confirmed.

The testimonies from China are the latest indication of the dangers posed by Delta, which the World Health Organization last month labeled a “variant of concern.” First identified this spring in India, where it was blamed for widespread suffering and death, Delta has since become the dominant variant in Britain, where doctors suggest that it is more contagious and may infect some people who have received only one of two doses of a Covid-19 vaccine. China has uniquely detailed data, however, because it has essentially universal testing in the vicinity of outbreaks, allowing officials to gather detailed information on the extent of cases. Delta’s spread in southeastern China focuses more attention on the effectiveness of China’s self-made vaccines. The Chinese authorities have not indicated how many of the new infections have occurred in people who had been vaccinated. In some other countries where Chinese-made vaccines are in wide use, including the Seychelles and Mongolia, infections among vaccinated people are rising, although few patients have reportedly developed serious illness. Nearby Shenzhen had a handful of cases last week of the Alpha variant, which first emerged in Britain.

As some other parts of the world still struggle to acquire and administer large numbers of coronavirus tests, southeastern China has used its local production of scarce chemicals to conduct testing on a remarkable scale. The authorities said that they had conducted 32 million tests in Guangzhou, which has 18 million people, and 10 million in the adjacent city of Foshan, which has seven million.

Guangzhou has also isolated and quarantined tens of thousands of residents who had been anywhere near those infected. The testing and quarantine appear to have slowed but not stopped the outbreak. China’s National Health Commission announced on Friday that nine new cases had been found in Guangzhou the previous day. “The epidemic is not over yet, and the risk of virus transmission still exists,” said Chen Bin, deputy director of the Guangzhou Municipal Health Commission.

A leading Chinese Covid-19 vaccine developed by Sinovac Biotech was just 50.38% effective in late-stage trials in Brazil, significantly lower than earlier results showed, according to a statement published by the government of Sao Paulo Tuesday.  While the number exceeds the threshold required for regulatory approval, it falls far below the 78% previously announced, raising questions as to the veracity of the data and fueling skepticism over the apparent lack of transparency regarding Chinese vaccines. Analysts said the efficacy rate of Sinovac's Coronavac vaccine in Brazil -- the lowest among its global competitors -- could affect international confidence in Chinese-made vaccines and hamper Beijing's effort to repair its image from its early mishandling of the initial outbreak by providing Covid-19 vaccines to developing countries. "The Butantan Institute and the Government of Sao Paulo report that the coronavirus vaccine achieved a 50.38% overall efficacy rate in the clinical study conducted in Brazil, in addition to (an efficacy rate of) 78% for mild cases and 100% for moderate and severe cases of Covid-19. All rates are higher than the 50% level required by the WHO (World Health Organization)," the statement released Tuesday said. The razor-thin margin for regulatory approval is likely to lead to concern among scientists, given that last week the Butantan institute released partial "clinical efficacy" results celebrating 78% to 100% efficacy in preventing infections. The state body financed the phase 3 trials of the vaccine, which involved 13,000 health workers across eight Brazilian states. "Regarding the overall efficacy of the analysis, we met the requirements of the World Health Organization with 50.38%," Ricardo Palacios, medical director for clinical research at the Butantan biomedical center in Sao Paulo said Tuesday during a news conference. However, on Tuesday, high-ranking members of the Brazilian Health Ministry told CNN affiliate CNN Brasil that "the effectiveness is borderline," and that because "It is at the limit. We have to wait for ANVISA (Brazilian Health Regulatory Agency) to evaluate." A representative of Sinovac said the company is discussing the result but declined to give further comment. The final efficacy rate of the vaccine will be determined by China's drug regulator, the National Medical Production Administration, according to the representative. 

Background

Methods

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Interpretation

As the COVID-19 pandemic threat seemingly fades into the annals of history, scientists are attempting to identify which pathogen will pose the next large-scale threat to humanity. Could it be the Langya virus? Instead of a resurgence of COVID or an avian flu, it just may be the little-known yet formidable Langya virus, which shares similarities with COVID, according to a new article published this month in the journal Nature Communications. As with COVID initially, the virus causes fever and severe respiratory symptoms, and can lead to fatal pneumonia. Also like COVID, it was first identified among humans in China—last year, when it infected 35 farmers and other residents, likely due to contact with shews.  It wasn’t the first time a Henipavirus—the family Langya belongs to—has jumped to people, and it won’t be the last, researchers warn. Dr. Ariel Isaacs—a researcher at the School of Chemistry and Molecular Biosciences at the University of Queensland in Australia—said humanity is at an “important juncture” with the genus of viruses and can “expect more spill-over events from animals to people.” “It’s important we understand the inner workings of these emerging viruses,” he said in a news release about the research. Here’s what we know about the relatively new (to humans) virus with the potential to cause a global health emergency—and with eerie similarities to the latest human coronavirus....

CHENGDU, China, June 8, 2023 /PRNewswire/ -- On June 8th, 2023, Coviccine® Trivalent XBB.1.5-Recombinant COVID-19 Trivalent (XBB.1.5+BA.5+Delta) Protein Vaccine (Sf9 cell) developed by WestVac Biopharma/ West China Medical Center, Sichuan University was approved for EUA by relevant authorities in China. This is the first COVID-19 vaccine in the world approved for EUA against XBB descendent lineages of SARS-CoV-2. It demonstrates that China is leading the world in the development of COVID-19 vaccines. WestVac Biopharma and its subsidiary company WestVac Biopharma (Guangzhou) leveraged the rapid response of the insect cell expression platform on constructing the vector for Coviccine® Trivalent XBB.1.5-Recombinant COVID-19 Trivalent (XBB.1.5+BA.5+Delta) Protein Vaccine (Sf9 Cell), which is of high purity and high quality for human use. The subunit vaccine antigen is precisely designed based on the structure of the targeting S-RBD and HR proteins of the COVID-19 subvariants XBB.1.5 and BA.5 and self-assembled into stable trimeric protein particles with squalene-based oil-in-water emulsion adjuvant added after purification and mixing. This novel adjuvant significantly raises the titer of neutralizing antibodies, which enables the trimeric protein vaccine to induce a higher level T-cell immune response. Studies have shown that Coviccine® Trivalent XBB.1.5 induced a high titer of neutralizing antibodies against multiple subvariants, including Omicron subvariants XBB.1.5, XBB1.16, XBB1.9.1, XBB.2.3, BA.5, BF.7, BQ.1, BA.2.75. 14 days after injection of this product, the protective efficacy against XBB.1, XBB.1.5, XBB1.9 is 93.28% with an excellent safety profile, demonstrating that it is a broad-spectrum COVID-19 vaccine against multiple prevalent subvariants locally and internationally.

The XBB.1.5 variant had gradually become the major circulating variant in various parts of the world by the beginning of 2023. With the professional guidance and support from the State Council's Joint Prevention and Control Mechanism's vaccine R&D team, the scientific team of WestVac Biopharma/West China Medical Center, Sichuan University overcame all hurdles and successfully developed a vaccine covering XBB family of variants. Early May, China CDC expert noticed that the transmission and immune escape capability of XBB variants is much stronger than that of the early circulating Omicron variants. The XBB.1 descendent lineages currently predominate SARS-CoV-2 circulation globally. As of the end of May, XBB family of variants accounted for 98.1% of all variants in the United States. In China, newly detected XBB variants have increased gradually and now exceed 90%. The WHO Technical Advisory Group on COVID-19 Vaccine Composition (TAG-CO-VAC) advised on May 18 that new formulations of COVID-19 vaccines should aim to induce antibody responses that neutralize XBB descendent lineages. The rate of "second infection" is rising. Experts urge prompt prevention, immunization against COVID-19, particularly for people with high-risk infection, the elderly, people with underlying diseases and those who are immunocompromised to get a vaccine covering SARS-CoV-2 variants. WestVac Biopharma uses the international advanced insect cell recombinant protein vaccine platform to develop Coviccine® Trivalent XBB.1.5 which has been approved for EUA in China. WestVac's COVID-19 vaccine offers a unique option for COVID-19 prevention, is crucial for the prevention of the current XBB descendent lineages and contributes significantly to the ongoing management of the COVID-19 epidemic.

About WestVac Biopharma

WestVac Biopharma Co., Ltd. is an innovative biopharmaceutical company, capable of doing the full spectrum of research, manufacturing, and commercialization of products. WestVac Biopharma has been selected successfully on the list of unicorn companies from 2021 to 2023. WestVac Biopharma Co., Ltd. is located in Chengdu of West China while WestVac Biopharma (Guangzhou), a wholly-owned subsidiary company of WestVac Biopharma., is located in Guangzhou Economic Development Zone. WestVac Biopharma Co., Ltd. has completed construction of 5,000-litre and 3,000-litre insect cell recombinant protein vaccine production lines with an annual production capacity of 100 million doses. The GMP production lines were well established with the "Drug Production License" in place. WestVac Biopharma (Guangzhou) has completed scale-up construction of insect cell recombinant protein vaccine production lines with an annual production capacity of 100 million doses. In December 2022, Coviccine®-Recombinant COVID-19 Vaccine (Sf9 cell) developed by WestVac Biopharma was approved by relevant authorities for EUA in China.

A woman in southern China has tested positive for H3N8 bird flu, local officials say, making it only the third time that the virus has been found in humans, although a previous strain may have caused the 1889 pandemic. The Guangdong Provincial Center for Disease Control and Prevention, in a brief statement released on Monday, said a 56-year-old woman from Zhongshan City had been infected with H3N8. The woman, who has multiple myeloma and other underlying health conditions, had exposure to live poultry before falling ill, the statement said. Wild birds are also frequently found near her home. Details about her condition have not been released. “No abnormalities have been found in close contacts so far,” the Guangdong CDC said. “Experts believe that this is a sporadic case and the risk of virus transmission is low at this stage.”

The news comes nearly a year after the H3N8 virus was confirmed in humans for the first time, when a 4-year-old boy in central China became seriously ill. The family’s pets – a dog and a cat – were also infected. A second person, a 5-year-old boy from Hunan province, was infected about a month later, in May 2022. He recovered quickly after only mild symptoms, according to the Chinese government. H3N8 is found in birds but also in horses and is one of the two viruses which cause dog flu. The new case in China is only the third confirmed case in humans, and the first in an adult. But while it was never found in humans until 2022, researchers have long believed that a previous strain of the virus may have caused the 1889 pandemic, which was known as “Asiatic flu” or “Russian flu.” More recent research suggests a strain of coronavirus may have caused the pandemic.

A woman in eastern China has tested positive for H5N1 bird flu, the strain of avian influenza which has spread around the world and worried experts. The news comes just a week after two people in Cambodia were infected with a similar variant. The latest case is a 53-year-old woman from Jiangsu province in eastern China, according to WHO. She developed symptoms on January 31 after exposure to poultry and tested positive some time in February. Her current condition is unknown. Last week, an 11-year-old girl in Cambodia died of H5N1 avian influenza after ducks and chickens at her home died suddenly. Her father, a 49-year-old man, tested positive a few days later but did not become seriously ill. Genetic sequencing carried out in China showed that the new case was caused by clade 2.3.4.4b, the same variant which has spread around the world and raised concern about a possible threat to human health. This sets it apart from the cases in Cambodia, which were caused by clade 2.3.2.1c, an older variant. Other details about the new case have not been released.

The new variant of H5N1, which emerged in late 2021, has caused outbreaks around the world, even in countries where bird flu had never been found. Since then, more than 200 million birds have either died or been culled, most of them in Europe and the U.S. The global spread of bird flu has raised concern about the possibility of a future variant which could lead to human-to-human transmission. Recent cases in mammals – including in mink, foxes and sea lions – have added to those concerns. “The global H5N1 situation is worrying given the wide spread of the virus in birds around the world and the increasing reports of cases in mammals, including in humans,” Dr. Sylvie Briand, a WHO official, said on Friday. “WHO takes the risk from this virus seriously and urges heightened vigilance from all countries.” The World Organization for Animal Health (WOAH) echoed those concerns. “The current situation highlights the risk that H5N1 avian influenza may become better adapted to mammals and spill over to humans and other animals,” the agency said on February 13. “Some animals, such as mink, may act as mixing vessels for different influenza viruses, leading to the emergence of new strains and subtypes that could be more harmful to animals and/or humans.” A 9-year-old girl in Ecuador tested positive for H5N1 bird flu in January, making it the first such case in South America. She was hospitalized in critical condition but has since recovered. In September 2022, a 38-year-old woman died of H5N1 in China’s Guangxi after exposure to backyard poultry.

China’s murky statistics are fueling widespread public distrust. Its narrow definition of Covid deaths “will very much underestimate the true death toll,” the W.H.O. says. The hearses bearing black and yellow funeral paper flowers crept in a steady stream toward the Dongjiao crematory in eastern Beijing. Several dozen people crowded around the closed gate waiting to be let in. A man unable to get a spot in line could only watch, wondering what to do with the body of a relative who had just died of Covid. The hospital could not keep the body — there were already too many in its morgue. When he called the crematory, an employee told him he had to wait a week. When he called again, nobody answered. A country trying to mourn its dead from an explosive Covid outbreak is grappling with a system unprepared for the surge in fatalities. Two weeks after China abruptly abandoned its “zero Covid” policy, cases have soared in cities like Beijing, along with reports of people dying. Funeral home directors and sellers of funeral supplies describe a flood of phone calls from families needing help handling the bodies of relatives. On Chinese social media, people are sharing videos and photos of morgues crowded with bodies, as well as their own personal accounts of losing loved ones to the outbreak. But China’s government is painting a less dire picture. In its official statistics and propaganda reports, China has acknowledged only seven deaths from Covid in the past two weeks, and only in Beijing. The National Health Commission even reduced the country’s cumulative Covid death toll on Wednesday by one, to 5,241. Officials have explained that China counts Covid deaths only if the virus was the direct cause of a respiratory failure — a definition the World Health Organization said would lead to a vast underestimate. The ruling Communist Party may have a political incentive to downplay the toll of an epidemic it has suddenly stopped trying to control. Xi Jinping, China’s top leader, has portrayed his country’s earlier success in limiting Covid deaths as evidence of China’s superiority over the West, a claim that would be hard to maintain with numerous deaths.

BF.7 is a new version of the coronavirus SARS-CoV-2 that's driving a surge of infection in China. Since the COVID variant omicron emerged in late 2021, it has rapidly evolved into multiple subvariants. One subvariant, BF.7, has recently been identified as the main variant spreading in Beijing, and is contributing to a wider surge of COVID infections in China. But what is this new variant, and should we be worried? Although reports from China about this variant's characteristics are concerning, it doesn't appear to be growing too much elsewhere in the world. Here's what we know. BF.7, short for BA.5.2.1.7, is a sub-lineage of the omicron variant BA.5. Reports from China indicate BF.7 has the strongest infection ability out of the omicron subvariants in the country, being quicker to transmit than other variants, having a shorter incubation period, and with greater capacity to infect people who have had a previous COVID infection, or been vaccinated, or both. To put this into context, BF.7 is believed to have an R0, or basic reproduction number, of 10 to 18.6. This means an infected person will transmit the virus to an average of 10 to 18.6 other people. Research has shown omicron has an average R0 of 5.08. The high transmission rate of BF.7, taken with the risk of hidden spread due to the many asymptomatic carriers, is understood to be causing significant difficulty in controlling the epidemic in China.

The symptoms of an infection with BF.7 are similar to those associated with other omicron subvariants, primarily upper respiratory symptoms. Patients may have a fever, cough, sore throat, runny nose and fatigue, among other symptoms. A minority of people can also experience gastrointestinal symptoms like vomiting and diarrhoea. BF.7 may well cause more serious illness in people with weaker immune systems. As omicron has evolved, we've seen the emergence of new subvariants better able to escape immunity from vaccination or prior infection. BF.7 is no different. BF.7 carries a specific mutation, R346T, in the spike protein of SARS-CoV-2 (a protein on the surface of the virus that allows it to attach to and infect our cells). This mutation, which we also see in BF.7's "parent" variant BA.5, has been linked with enhancing the capacity of the virus to escape neutralising antibodies generated by vaccines or previous infection. A recent study examined the neutralisation of BF.7 in sera (a component of blood that should contain antibodies) from triple-vaccinated healthcare workers, as well as patients infected during the omicron BA.1 and BA.5 waves of the pandemic. BF.7 was resistant to neutralisation, driven partly by the R346T mutation.

BF.7 has been detected in several other countries around the world including India, the U.S., the U.K. and several European countries such as Belgium, Germany, France and Denmark. Despite BF.7's immune-evasive characteristics, and worrying signs about its growth in China, the variant seems to be remaining fairly steady elsewhere. For example, in the U.S. it was estimated to account for 5.7% of infections up to December 10, down from 6.6% the week prior. While the U.K. Health Security Agency identified BF.7 as one of the most concerning variants in terms of both growth and neutralisation data in a technical briefing published in October (it accounted for over 7% of cases at that time), the most recent briefing says BF.7 has been de-escalated due to reduced incidence and low growth rates in the U.K. We don't know exactly why the situation looks different in China. BF.7's high R0 might be due in part to a low level of immunity in the Chinese population from previous infection, and possibly vaccination too.

We should, of course, be cautious about the data from China as it's based on reports, not peer-reviewed evidence yet. Since the emergence of SARS-CoV-2 three years ago, the virus has continued to evolve, acquiring genetic mutations more rapidly than expected. The emergence of BF.7 and other new variants is concerning. But vaccination is still the best weapon we have to fight COVID. And the recent approval by the U.K. drugs regulator of bivalent boosters, which target omicron alongside the original strain of SARS-CoV-2, is very promising.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Scientists hope the immunizations, delivered through the nose or mouth, will prevent even mild cases of illness.  Two needle-free COVID-19 vaccines that are delivered through the nose or mouth have been approved for use in China and India. China’s new vaccine, announced on Sunday, is inhaled through the nose and mouth as an aerosolized mist, and India’s, announced on Tuesday, is administered as drops in the nose. These mucosal vaccines target thin mucous membranes that line the nose, mouth and lungs. By prompting immune responses where SARS-CoV-2 first enters the body, mucosal vaccines could, in theory, prevent even mild cases of illness and block transmission to other people — something COVID-19 shots have been unable to do. Vaccines that produce sterilizing immunity would be game changing for the pandemic.  “These approvals validate the need for mucosal vaccines,” says Marty Moore, co-founder of Meissa Vaccines in Redwood City, California, which is developing a COVID-19 immunization that is delivered through the nose. “That’s the direction we need to go globally, and the United States needs to catch up.” The regulatory nods from China and India bring the number of approved COVID-19 mucosal vaccines in the world to four, including one already approved in Iran and another in Russia. More than 100 mucosal vaccines against the disease are in development globally, and about 20 have reached clinical trials in humans, according to Airfinity, a health-analytics company in London. Delivery methods include sprays, drops, aerosols and pills.

New arrivals

China’s inhaled vaccine, developed by CanSino Biologics in Tianjin, contains the same ingredients as the company’s COVID-19 shot that is already available in the country. A device called a nebulizer turns the liquid vaccine into an aerosol spray that is inhaled. China’s health department and National Medical Products Administration approved the vaccine to be used as a booster dose. India’s vaccine, developed by Bharat Biotech in Hyderabad, is approved as a two-dose primary inoculation, rather than a booster. Both companies have produced ‘viral vector’ vaccines that use a harmless adenovirus to deliver SARS-CoV-2 genetic material into host cells. Neither company has published phase III clinical-trial data, but both say they have completed those studies. Data from a phase II trial of CanSino’s inhaled vaccine found that, when given as a booster, the vaccine raised blood-serum antibody levels significantly more than did a boost from an injection. This suggests that the inhaled vaccine will offer protection that is as good as, or better than, that provided by the shot. Similarly, Bharat compared its intranasal vaccine to Covaxin, a COVID-19 jab available in India, by measuring antibody levels in the blood. The company did not release results of this study, but deemed the trial “successful”. Exactly how successful these vaccines will be is unclear. Expecting a vaccine to stop transmission of a virus or prevent even mild illness — achieving what is called sterilizing immunity — is a high bar. Bharat and CanSino won’t know whether their vaccines can achieve this until they have conducted further efficacy studies. Scant data are available on the efficacy of the two other mucosal COVID-19 vaccines. Iran approved a COVID-19 vaccine administered as a nasal spray and made by Razi Vaccine and Serum Research Institute in Karaj in October 2021. More than 5,000 doses have been delivered to the public. And Russia’s health ministry is reported to have approved an intranasal-spray version of Sputnik V, the country’s injected COVID-19 vaccine. Mucosal vaccines have been developed for other diseases, including polio, influenza and cholera. Most of these vaccines are taken orally, and one, against flu, is administered through the nose.

The episode underscores once again why a serious investigation is needed to get to the bottom of how the pandemic began.  The morning of Dec. 26, 2019, began as usual at Vision Medicals in Guangzhou in southern China. This commercial laboratory, a private start-up barely a year and a half old, was also known by its Chinese name, Weiyuan Gene Technology. It specialized in next-generation sequencing, called mNGS, and offered applications that can identify most infectious agents — viruses, bacteria and others — in a single test. A researcher browsed through the latest test results, as she did every day, before turning to her other work. She was proud of the laboratory’s metagenomic sequencing capabilities. Only a month before, her company played a key role in quickly detecting a plague outbreak in Beijing. The previous day, her laboratory had received a bronchoalveolar lavage fluid sample from Wuhan, a city of 11 million people and a major transportation hub, where a 65-year-old man was hospitalized with a pneumonia-like respiratory ailment. When she checked the test results that morning, they indicated the man was infected by a virus similar to the one that causes SARS, or severe acute respiratory syndrome, which was first identified in China in 2002 and ultimately killed 774 people worldwide. The researcher was alarmed. She wrote to a co-worker on WeChat, a messaging service, at 9:28 a.m., saying the sample was brimming with something that looked like SARS.

The co-worker wrote back, recalling the Beijing plague outbreak they had worked on together

This exchange took place 28 days before Wuhan was locked down because of human-to-human transmission of the novel coronavirus. In late December and early January, a number of researchers and the Chinese government were aware the virus could spread rapidly, but the truth was kept from the public. In those weeks, the virus exploded, leading to a pandemic that has killed more than 6 million people, by official tally. The actual toll is probably twice as many, or more. The researcher went by the online moniker Little Mountain Dog, with an avatar of a furry pup sitting alone in a field of lush grass. Her reflections and observations were posted in a blog on Jan. 28, 2020, which she took down two days later, saying it was written “for myself to read in the future, but it spread online and I didn’t want to get involved in anything, so I deleted it.” She asked that no one reprint it, and said the company’s leaders were “understanding and forgiving” after she posted it. “I don’t want to cause trouble to anyone, and I don’t want to stir up public opinion,” she added. At the time, her posts were quoted in news accounts online, including by the magazine Caixin, which published a detailed article, then took down parts of it. “I have to admire the reporters from Caixin.com, who dug up so much accurate information from the messy information in the early days,” she later wrote. Recently, the research group DRASTIC, which has been probing the pandemic’s origins, retrieved and translated her blog posts, including attached screenshots of WeChat messages.

The research group has withheld her real name, and we agreed to do so as well to protect her privacy. It provided her email and we sent a request for comment, but got no response. The company also did not respond. Her story points to a coverup with tragic consequences of historic proportion. A severe danger was concealed until it was too late. It came about because of a culture that prioritizes political stability at any cost, extraordinary state secrecy, and missteps by public health officials who did not speak out. The episode serves to underscore once again why a serious investigation is needed to get to the bottom of how the pandemic began. The virus’s origins might have been caused by a zoonotic spillover, a bat coronavirus jumping to humans, possibly with an intermediate host. Or it might have been an inadvertent leak from a laboratory in Wuhan studying bat coronaviruses. Only by learning what really transpired can we reach any conclusions about how to prevent it from happening again. China could go a long way toward finding the answers, but instead it has slammed the door on further inquiry....

China reported thousands of new local Covid-19 cases Sunday as the Omicron variant drove the worst outbreak in the country since Wuhan in early 2020, according to the National Health Commission (NHC).  Health officials said 2,125 cases were reported across 58 cities in 19 of 31 mainland provinces, marking the fourth consecutive day China reported more than 1,000 daily local cases. More than 10,000 cases have been reported since the latest outbreak began in early March, the NHC said. Saturday, the commission reported 3,122 local cases -- the highest number of daily infections since the Wuhan outbreak and the first time new cases have exceeded 3,000 in a day, NHC data showed. Throughout the pandemic, China has adhered to a strict zero-Covid policy that aims to stamp out all outbreaks and chains of transmission using a combination of border controls, mass testing, quarantine procedures and lockdowns.  Nearly half of the total infections in the latest outbreak have been reported in northeastern Jilin province, with 4,605 cases since March 1, when the first clusters of cases in Jilin's border city Yanbian were identified, according to the provincial government. The bulk of cases on Sunday, 1,026, were also reported in Jilin province, according to the NHC. Jilin province's city of Jilin has locked down 504 neighborhoods and launched eight rounds of mass testing, the municipal government said.

Two new studies say the virus was present in animals at the Huanan seafood market in 2019. Scientists released a pair of extensive studies on Saturday that point to a market in Wuhan, China, as the origin of the coronavirus pandemic. Analyzing data from a variety of sources, they concluded that the coronavirus was very likely present in live mammals sold in the Huanan Seafood Wholesale Market in late 2019 and suggested that the virus twice spilled over into people working or shopping there. They said they found no support for an alternate theory that the coronavirus escaped from a laboratory in Wuhan.  “When you look at all of the evidence together, it’s an extraordinarily clear picture that the pandemic started at the Huanan market,” said Michael Worobey, an evolutionary biologist at the University of Arizona and a co-author of both studies.

The two reports have not yet been published in a scientific journal that would require undergoing peer review. Together, they represent a significant salvo in the debate over the beginnings of a pandemic that has killed nearly 6 million people globally and sickened more than 400 million. The question of whether the coronavirus outbreak began with a spillover from wildlife sold at the market, a leak from a Wuhan virology lab or some other way has given rise to pitched geopolitical battles and debates over how best to stop the next pandemic. But some outside scientists who have been hesitant to endorse the market origin hypothesis said they remained unconvinced. Jesse Bloom, a virologist at the Fred Hutchinson Cancer Research Center, said in an interview that there remained a glaring absence of direct evidence that animals at the market had themselves been infected with the coronavirus. “I think what they’re arguing could be true,” Dr. Bloom said of the new studies. “But I don’t think the quality of the data is sufficient to say that any of these scenarios are true with confidence.” In their new study, Dr. Worobey and his colleagues present evidence that wild mammals that might have harbored the coronavirus were being sold in December 2019. But no wildlife was left at the market by the time Chinese researchers arrived in early 2020 to collect genetic samples...

Preprints cited available at (Feb.25, 2022)

https://zenodo.org/record/6299600#.YhsH6e7MKLH

https://www.researchsquare.com/article/rs-1370392/v1

BEIJING (AP) — In a rare admission of the weakness of Chinese coronavirus vaccines, the country's top disease control official says their effectiveness is low and the government is considering mixing them to get a boost.  Chinese vaccines “don’t have very high protection rates,” said the director of the China Centers for Disease Control, Gao Fu, at a conference Saturday in the southwestern city of Chengdu. Beijing has distributed hundreds of millions of doses abroad while trying to promote doubt about the effectiveness of the Pfizer-BioNTech vaccine made using the previously experimental messenger RNA, or mRNA, process. “It’s now under formal consideration whether we should use different vaccines from different technical lines for the immunization process,” Gao said.  Officials at a news conference Sunday didn’t respond directly to questions about Gao’s comment or possible changes in official plans. But another CDC official said developers are working on mRNA-based vaccines. Gao did not respond to a phone call requesting further comment. “The mRNA vaccines developed in our country have also entered the clinical trial stage,” said the official, Wang Huaqing. He gave no timeline for possible use.

Experts say mixing vaccines, or sequential immunization, might boost effectiveness. Researchers in Britain are studying a possible combination of Pfizer-BioNTech and the traditional AstraZeneca vaccine. The coronavirus pandemic, which began in central China in late 2019, marks the first time the Chinese drug industry has played a role in responding to a global health emergency. Vaccines made by Sinovac, a private company, and Sinopharm, a state-owned firm, have made up the majority of Chinese vaccines distributed to several dozen countries including Mexico, Turkey, Indonesia, Hungary, Brazil and Turkey. The effectiveness of a Sinovac vaccine at preventing symptomatic infections was found to be as low as 50.4% by researchers in Brazil, near the 50% threshold at which health experts say a vaccine is useful. By comparison, the Pfizer-BioNTech vaccine has been found to be 97% effective. Health experts say Chinese vaccines are unlikely to be sold to the United States, Western Europe and Japan due to the complexity of the approval process.

A Sinovac spokesman, Liu Peicheng, acknowledged varying levels of effectiveness have been found but said that can be due to the age of people in a study, the strain of virus and other factors. Beijing has yet to approve any foreign vaccines for use in China.

Gao gave no details of possible changes in strategy but cited mRNA as a possibility. “Everyone should consider the benefits mRNA vaccines can bring for humanity,” Gao said. “We must follow it carefully and not ignore it just because we already have several types of vaccines already.” Gao previously questioned the safety of mRNA vaccines. He was quoted by the official Xinhua News Agency as saying in December he couldn’t rule out negative side effects because they were being used for the first time on healthy people. Chinese state media and popular health and science blogs also have questioned the safety and effectiveness of the Pfizer-BioNTech vaccine. As of April 2, some 34 million people in China have received both of the two doses required for Chinese vaccines and about 65 million received one, according to Gao. The Sinovac spokesman, Liu, said studies find protection “may be better” if time between vaccinations is longer than the current 14 days but gave no indication that might be made standard practice.