South Africa’s answer to Omicron

The people and politics driving global health.

Jan 06, 2022 View in browser   By Ashleigh Furlong and Tucker Doherty THE BIG IDEA Travelers arrive from international flights, including from South Africa, at Newark Liberty International Airport on Nov. 30, 2021 in Newark, New Jersey. | Spencer Platt/Getty Images LEARNING TO LIVE WITH COVID — If Covid-19 is here to stay, how do we learn to live with it? It's one of the most vexing questions public health officials around the world are confronting, and in South Africa, the first country to pass the peak of its Omicron wave, the outlines of an answer are beginning to appear. As the fast-moving strain was detected there in late November, health officials took a wait-and-see approach instead of ratcheting up restrictions as the government did during previous waves. So far, it has worked — overall, hospitals weren't overwhelmed and deaths remain low. Staying the course: Now, South Africa appears to be on course to halt almost all contact tracing and isolation for people without symptoms. Richard Lessells, an infectious disease doctor in South Africa, acknowledges the move is controversial but argues governments must prioritize "protecting against severe disease and protecting the health system to deal with the severe cases." Omicron's swift spread and its apparent milder effects have public health experts in the U.S. and Europe thinking along the same lines. Anthony Fauci, President Joe Biden's chief medical adviser, told ABC News on Sunday that it is "much more relevant to focus on the hospitalizations as opposed to the total number of cases." Put your eggs in the right basket: Some believe governments should take the same approach when doling out the world's still-limited supply of vaccines. Vaccination may protect people with Omicron from severe disease, but some argue for more targeted efforts in places like South Africa, where the immunization rate is only about 27 percent. Instead of "doing bean-counting" with vaccination numbers, said Shabir Madhi, a South African government adviser and professor of vaccinology, the focus should be on increasing vaccination rates among those most likely to be hospitalized and die of Covid — the over-50s. "If we were able to get to above 90 percent coverage in people above the age of 50, that will achieve much more than chasing after just numbers," he said. Can't boost your way out of the pandemic: Worries over global supply are increasing as Israel begins administering a fourth shot an, Germany, previously awash with shots, expresses fears of not having enough supplies. Continuous boosting is "completely short-sighted," Madhi said. "I really don't believe that countries that are going with this additional booster dose at the mass population level have got a clear goal unless they truly believe that they can somehow eliminate the virus and then keep the borders shut to the rest of the world to prevent importation of further variants." WELCOME TO GLOBAL PULSE WELCOME BACK TO GLOBAL PULSE, where your hosts welcome you back and wish you a very happy new year! We're holding down the fort for Carmen, who is on maternity leave. Global Pulse is a team effort. Thanks to editors Eli Reyes and Barbara Van Tine. Follow us on Twitter: @ashleighfurlong and @tucker_doherty. GLOBAL PULSE NUMBER 7 The number of African countries that reached the World Health Organization target of fully vaccinating 40 percent of their populations against Covid-19 by the end of 2021.   DON'T MISS CONGRESS MINUTES: Need to follow the action on Capitol Hill blow-by-blow? Check out Minutes, POLITICO's new platform that delivers the latest exclusives, twists and much more in real time. Get it on your desktop or download the POLITICO mobile app for iOS or Android. CHECK OUT CONGRESS MINUTES HERE.     AROUND THE WORLD Dr. Stephaun Wallace receives his second injection from Dr. Tia Babu during the Phase 3 trial of Novavax Covid-19 vaccine at the UW Virology Research Clinic in Seattle. | Karen Ducey/Getty Images BIDEN OFFICIALS FEAR BOOSTER PROGRAMS WILL LIMIT GLOBAL SUPPLY — As the U.S., Europe and parts of Asia consume more booster doses than expected, global health advocates hope the emerging vaccine produced by Maryland-based Novavax will fill the supply gap in low- and middle-income countries in 2022, POLITICO's Erin Banco, Adam Cancryn and Sarah Owermohle report. But while Novavax — after partnering with India's Serum Institute — obtained regulatory approvals from the World Health Organization and European Commission last month, crucial questions remain about its ability to both obtain Food and Drug Administration approval and produce enough doses in manufacturing sites other than the Serum Institute. Without signoffs from world regulators to produce vaccines at its U.S. and European sites, Novavax could struggle to meet its 2022 targets, setting back the global vaccination effort, according to two senior officials working on the Biden administration's international pandemic response. If that happens, and countries across the world continue to roll out booster campaigns, U.S. officials fear the world might not have enough vaccine doses to meet the WHO's goals. ONTARIO SHUTS BACK DOWN — The premier of Canada's biggest province opened 2022 with a shutdown notice for Ontarians entering their third year of Covid, POLITICO's Nick Taylor-Vaisey reports. "We face a tsunami of new cases," Doug Ford said Monday as he shut schools, canceled surgeries, closed theaters and forbid indoor dining. Indoor social gatherings will be restricted to five, and outdoor gatherings will be capped at 10 as the province aims to slow the spread of the Omicron variant in a population in which 81 percent of eligible Ontarians are double vaccinated — and one in four has already received a booster. The verdict from health experts: Too little, too late, told you so. Public health experts across the country had warned for weeks that Omicron's off-the-charts transmissibility would fuel a startling new wave of infections at a time when Covid-weary families — boosted or not — were making plans to gather. WHY ARE EU COUNTRIES CUTTING QUARANTINE AS OMICRON CASES EXPLODE? Europe risks facing critical labor shortages as the Omicron coronavirus strain surges across the bloc and infected and traced individuals hunker down in isolation, POLITICO's Helen Collis reports. While countries are reimposing measures such as mandatory masks in Paris to try to contain infections and protect hospitals, they're also reassessing isolation rules in a bid to manage the risks of infection while mitigating the effects of stalled vital services and the impact on the economy. Greece is the first country in Europe to announce it is moving to an all-time low of five days' quarantine for infected people, halving the period from 10 days previously. Elsewhere in Europe, the U.K. moved to a seven-day isolation period for infected people just before Christmas. Spain and Ireland have also just dropped their isolation periods to seven days from 10, while Italy has scrapped quarantine for close contacts if a person is vaccinated. Germany should also reduce the duration of quarantine to seven days from 14 for vaccinated people who have Covid-19, the country's 16 regional health ministers said Wednesday. A group of Eritrean men sit next to a bakery in the market of Shagarab refugee camp on Aug. 15, 2021, in Shagarab, Sudan. | Abdulmonam Eassa/Getty Images EXPERTS PONDER LACK OF REPORTED OUTBREAKS AT REFUGEE CAMPS — U.N. refugee agency officials are taking another look at the pandemic's effects in refugee camps after two years without major reported outbreaks, despite fears that the situation was a disaster waiting to happen, Vedaste Ngabo Ndagijimana and Carol Guensburg report for Voice of America. Potential explanations: Undercounting is a real possibility, experts say, but that would require most cases to have had milder symptoms. A lack of funding for more blood testing also makes it difficult to confirm the level of infection or immunity. Another theory is that the camps avoided larger outbreaks by locking down early and limiting outsiders' access, said Paul Spiegel, an epidemiologist who directs Johns Hopkins University's Center for Humanitarian Health. WHAT WE'RE CLICKING STAT: WHO official weighs in on Covid vaccines and mistakes that were made. Japan Times: Tokyo researchers work toward 'dream' Covid-19 vaccine. The Washington Post: In coronavirus-hit Mexico, many women are 'determined to not have babies'. Nature: Lessons for the world after two years of Covid-19 in Africa.   STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.       Follow us

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