White House on the lookout for BA.4 and BA.5

The people and politics driving global health.

Apr 14, 2022 View in browser   By Daniel Payne With Erin Banco THE BIG IDEA Vaccines might be less effective at preventing infection against the newest Omicron subvariants, say some researchers. | Joe Raedle/Getty Images OMICRON STRIKES AGAIN (AND AGAIN) — The Biden administration, along with other nations and health organizations, is monitoring two emerging Omicron subvariants: BA.4 and BA.5. The two newest subvariants worry some scientists because of a single mutation that could make vaccines less effective against infection. The WHO said it hasn't seen epidemiological changes in the little data available. "We spoke to [South Africa] as recently as Sunday, that they can't make any statements right now about BA.4 or BA.5," Dr. Anthony Fauci, the White House's chief medical adviser, told Global Pulse — adding that it isn't surprising to see mutations, and some of those mutations may cause changes in how the virus behaves. "A phenotypic consequence may mean it makes it a little bit more or less transmissible." In South Africa, researchers are looking at the genetic sequences in significant BA.4 and BA.5 samples and finding the new subvariants are making up an increasing proportion of infections — though the country hasn't had a spike in total infection, according to early data. And the subvariants are already in other parts of the world, including Denmark, Botswana, Scotland and England. One new mutation in BA.4 and BA.5 could mean vaccines are less effective at preventing infection — even compared with BA.1 and BA.2, according to South African researchers. That mutation could allow the virus to get around antibodies from vaccines or early infections in the pandemic, Tulio de Oliveira, director of South Africa's Centre for Epidemic Response and Innovation, told Global Pulse. "That's what we know from the mutation itself," he said, adding that it was too early to know how that change might eventually play out in the real world. This all comes as other subvariants are popping up, like BA.3 — another mutated form of Omicron that has been tracked by the WHO. But a different Omicron subvariant — XE, a combination of BA.1 and BA.2 — seems to spread slightly more easily than BA.2. "These are ones to watch," Maria Van Kerkhove, Covid-19 technical lead for the WHO, said of BA.4 and BA.5 at a press conference Wednesday — also emphasizing the need for increased vaccinations to handle the pandemic more broadly. But there's no guarantee that BA.4 and BA.5 will spread to much of the world. Relatively few samples have been reported between the countries that have recorded any cases at all. And fortunately, the variant will be relatively easy to track, even in places that don't have sophisticated genomic surveillance systems, de Oliveira said. In the next few weeks, scientists will be observing whether the variants cause an increase in cases, hospitalizations or deaths. So far, they haven't, but it's still early. They'll also monitor whether the mutations can get around vaccine protection more easily than past variants — and whether they will cause increased reinfections. "That's the crucial work that has to be done now," de Oliveira said. WELCOME TO GLOBAL PULSE WELCOME BACK TO GLOBAL PULSE — Are you a researcher who is tracking BA.4 and BA.5 — or following the new data for a government or health organization? We want to hear from you. Tell us what you think about the newsletter — and send tips — at dpayne@politico.com. Global Pulse is a team effort. Thanks to editors Eli Reyes and Barbara Van Tine. Follow us on Twitter: @ErinBancoand @_daniel_payne.   INTRODUCING DIGITAL FUTURE DAILY - OUR TECHNOLOGY NEWSLETTER, RE-IMAGINED:  Technology is always evolving, and our new tech-obsessed newsletter is too! Digital Future Daily unlocks the most important stories determining the future of technology, from Washington to Silicon Valley and innovation power centers around the world. Readers get an in-depth look at how the next wave of tech will reshape civic and political life, including activism, fundraising, lobbying and legislating. Go inside the minds of the biggest tech players, policymakers and regulators to learn how their decisions affect our lives. Don't miss out, subscribe today.     THE STATE OF THE PANDEMIC A patient who has recovered from COVID-19, is disinfected as he leaves a makeshift hospital in Shanghai on Saturday, April 9, 2022. | Jin Liwang/Xinhua via AP The pandemic goes on — The WHO and the United States are not moving out of the emergency phase of the pandemic. "Far from being the time to drop our guard, this is the moment to work even harder to save lives," WHO Director-General Tedros Adhanom Ghebreyesus said at a press conference Wednesday. The U.S. made a similar announcement, extending its public health emergency as it sees an uptick of BA.2 cases — and as some lobbyists and lawmakers work to keep emergency-phase rules in place permanently. SAGE advice — This week, the WHO's Strategic Advisory Group of Experts on Immunization discussed its updated guidance across multiple immunizations: — Delays in immunization campaigns persist, now going into the pandemic's third year — an issue that puts millions of children at risk, SAGE said. More data to understand the problem's extent is expected this summer. — A single dose of HPV vaccines offers significant protection for women under 21, a discovery that "could be a game-changer" in reaching more people with the vaccines and stopping more disease around the world, the group said. — The group noted the need to increase Covid-19 vaccinations in high-risk groups, saying that only 65 percent of health workers and 69 percent of older adults worldwide have been vaccinated. The figures vary widely, with some regions seeing as little as 24 percent vaccination coverage in vulnerable groups. — The group reviewed data on the CanSino Covid-19 vaccine but won't release recommendations until the WHO lists it for emergency use. The Chinese vaccine has already been used in several countries. Pharma rails against IP waivers — Leaders from some of the world's most powerful pharmaceutical companies warned Wednesday that long-discussed WTO proposals of intellectual property waivers for some medicines and vaccines would work against the cooperation displayed through the pandemic. Their comments were in sharp contrast to political leaders and activists who have blamed vaccine inequity on the companies producing the shots. The group of pharmaceutical executives, from Pfizer, Eli Lilly and Roche, said IP waivers wouldn't help get more vaccines into arms because supply is plentiful at this point in the pandemic. They said governments should have better prepared the infrastructure for those vaccines to be absorbed worldwide. GLOBAL PULSE NUMBER 24 percent The decrease in Covid-19 cases worldwide last week compared with the week before. AROUND THE WORLD A new plan to stop noncommunicable diseases — Leaders from Ghana, Norway and the WHO met this week to discuss making more progress on reducing deaths caused by diseases like cancer, diabetes and heart disease. Mental health conditions, a growing concern in the shadow of the pandemic, were also included in the plan. The prominence of noncommunicable diseases — like most public health priorities in the age of coronavirus — was framed as a pandemic in itself, and the leaders will focus on risk factors like air pollution, alcohol, tobacco and unhealthy diets. By 2030, the group hopes to stop nearly 50 million deaths through the new strategy. They launched a compact, with commitments to increase access to drugs to treat those diseases as well as integrate treatments into primary care and universal coverage goals. Hepatitis surge in U.K. kids — This week, the EU's infectious diseases agency flagged a series of mysterious cases of acute hepatitis in children in the U.K., POLITICO Europe's Carlo Martuscelli reports. About 60 cases were reported in England and 10 in Scotland — leading health officials to be on the lookout for more cases in the region. Ignoring Tigray? — Conflict in the Tigray region of Ethiopia has meant lifesaving aid could not reach those in need, even after a truce was declared recently. Yet there hasn't been much outcry for change compared to the massive outpouring of support for Ukraine, WHO Director-General Tedros Adhanom Ghebreyesus, who is from Ethiopia, said. "I don't know if the world really gives equal attention to Black and white lives," he said. "The whole attention to Ukraine is very important, of course … but even a fraction of it is not being given to Tigray, Yemen, Afghanistan, Syria and the rest."   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.     WHAT WE'RE CLICKING The New York Times: From the U.S. to China: A three-month quarantine horror story The Associated Press: Shanghai eases two-week shutdown, letting some residents out The Atlantic: The pandemic has trapped millions in unending grief   Follow us

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