“This will not be the last pandemic”, says @DrTedros at the @WHO presser on #COVID19. “When the next pandemic comes, the world must be ready - more ready than it was this time."
@DrTedros@WHO Many countries have made huge advances in medicine, says @DrTedros. “But too many have neglected their basic public health systems, which are the foundation for responding to infectious disease outbreaks.” Building back better must mean investing in public health, he says.
@DrTedros@WHO Running through several countries that have responded well, Thailand, Uruguay, Mongolia, Mauritius and more, @DrTedros says: "Many of these countries have done well because they learnt lessons from previous outbreaks of SARS, MERS, measles, polio, Ebola, flu and other diseases."
@DrTedros@WHO “Although Germany's response was strong, it's also learning lessons”, @DrTedros says. Lauds Merkel’s announcement of €4 billion investment in public health. "I call on all countries to invest in public health and especially in primary health care, and follow Germany's example."
@DrTedros@WHO Committee evaluating how International Health Regulations functioned in this pandemic will begin work tomorrow, @DrTedros notes. Will review declaration of #PHEIC etc.
Committee members include @rki_de head Lothar Wieler. Names published yesterday who.int/teams/ihr/ihr-…
@DrTedros@WHO@rki_de "Depending on progress made, the committee may present an interim progress report to the resumed World Health Assembly in November”, sas @DrTedros. Final report probably at #WHA74 in May next year.
@DrTedros@WHO@rki_de (Before we get to Q&A wanted to note something else that @DrTedros said right at the start of the presser: “Health is not a luxury item for those who can afford it. It’s a necessity, and a human right.” Let’s all remember that.)
@DrTedros@WHO@rki_de Q about reinfections.
Several studies are following individuals over time, says @mvankerkhove. “There's some very promising results from these studies. They're showing that the antibody response lasts, it stays strong for a certain number of months."
@DrTedros@WHO@rki_de@mvankerkhove Documented cases of reinfection need to be seen in context”, says @mvankerkhove.
"Out of more than 26 million cases, having some case reports of reinfection tells us that this is possible, but it doesn't tell us what's happening at a population level."
@DrTedros@WHO@rki_de@mvankerkhove Q about COVAX facility.
The covax facility is still evolving, says Bruce Aylward and points again to deadline of 18 September for signing up to COVAX. “Discussions and negotiations are still ongoing with a broad number of countries."
@DrTedros@WHO@rki_de@mvankerkhove “The other challenge that countries need to start thinking about now is how the delivery of these vaccines is going to happen”, adds @doctorsoumya. "This is not a childhood vaccination campaign or immunization campaign. This is going to be very different."
@DrTedros@WHO@rki_de@mvankerkhove@doctorsoumya "It's going to be vaccinating adults of certain high risk groups and vulnerable groups”, says @doctorsoumya. “This is going to be different from what's been done in the past, it's going to be a challenge for countries, particularly those with large populations."
@DrTedros@WHO@rki_de@mvankerkhove@doctorsoumya Q on China
“There's no room for complacency”, says @DrMikeRyan. “There is always the risk that disease can flare up again and sporadic cases can turn into clusters, clusters can turn into community transmission and community transmission can lead to overwhelmed health systems."
@DrTedros@WHO@rki_de@mvankerkhove@doctorsoumya@DrMikeRyan Q about reducing quarantine period from 14 to 7 days (based on French plan).
14 days is based on incubation period explains @mvankerkhove. “The average time is between five and six days, but the upper bound of that is 14 days and that's why we make the quarantine period 14 days."
@DrTedros@WHO@rki_de@mvankerkhove@doctorsoumya@DrMikeRyan Q about loss of trust in public health institutions like the CDC.
“Good decisions are based on having the best information”, says @DrMikeRyan. “It’s really important that such institutions are independent, all over the world."
@DrTedros@WHO@rki_de@mvankerkhove@doctorsoumya@DrMikeRyan "It’s really important that governments listen to that advice, but it's also important that governments have the space to implement policy that is based on that advice but not exclusively based on that advice at all times”, says @DrMikeRyan.
@DrTedros@WHO@rki_de@mvankerkhove@doctorsoumya@DrMikeRyan “There is a gap between sometimes the pure science and the actual policies that work”, says @DrMikeRyan. "And that's where a government has to operate and be accountable for that translation of science into effective affordable policy that allows a society to move forward."
@DrTedros@WHO@rki_de@mvankerkhove@doctorsoumya@DrMikeRyan "No one expects governments to be perfect. And certainly, no one expects politicians to be perfect”, says @DrMikeRyan. "But the reality is: Everyone is expected to make the best effort, based on the best interests of citizens, based on the best evidence."
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So what have I learnt about #misinformation research? I tried to condense it into a list of the 5 biggest challenges the field faces.
Second story in my package of stories about misinformation research is up here (and thread to come):
Let me start with the first:
What even is misinformation?
When I started reporting on the field, eager to delve into things I was really frustrated that I kept coming back to this basic question. I told friends it felt like trying to take a deep dive in a puddle, always forced back to the surface.
In retrospect, it seems obvious that this was going to be a thorny problem that I would have to spend a lot of time on. The definition you use really defines the shape of the problem and it also kinda helps to be sure you're talking about the same thing as your interview partner...
I’ve reported on infectious diseases for 15 years, but during the covid-19 pandemic and even more during the global outbreak of mpox clade IIb, I was shocked by the amount of misinformation I was seeing. Misinfo had always been part of any outbreak, but this felt different.
I ended up spending almost a year at MIT as a Knight Science Journalism Fellow (@KSJatMIT) to try and understand misinformation/disinformation better, to - I hope - be a better infectious disease journalist.
It’s been an interesting experience in turns fascinating and frustrating and when I went back to full-time science writing earlier this year I decided to try and put at least some of what I’ve learnt into words.
I'm seeing a lot of confusion already out there about #mpox and the differences between clades and lineages. I will get into this in more detail later, but for now:
We really don't know for sure whether there is any material difference between clade Ia, Ib, IIa and IIb.
The differences we see might have very little to do with the virus and everything to do with it affecting different populations in different places and spreading different ways once it gets into certain contact networks. Real world data is not comparing apples and apples here...
We will learn a lot in the coming weeks and months and things will become much clearer. But for now there is a lot of uncertainty. My advice as always: Don’t trust anyone who pretends that things are clear and obvious.
In May I wrote about researchers' plans to infect cows in high-security labs with avian influenza #H5N1 to better understand the infections and how easily the virus is transmitted. The results from two of these experiments are now out here in a preprint: biorxiv.org/content/10.110…
WHAT DID THEY DO?
In one experiment (at Kansas State University) 6 calves were infected with an #H5N1 isolate from the current outbreak oronasally and then housed together with three uninfected animals ("sentinels") two days later.
In the other experiment (at Friedrich Loeffler Institut) 3 lactating cows were infected through the udder with an #H5N1 isolate from the US outbreak and 3 other lactating cows the same way with a different #H5N1 isolate from a wild bird in Europe.
One question at the heart of the #h5n1 outbreak in US cows has been: Is there something special about this virus? Or is H5N1 generally able to do this and this particular version was just "in the right place at the right time"?
Quick thread, because it seems we have an answer
Researchers in Germany have done an experiment in a high-security lab infecting cows directly with the strain of #H5N1 circulating in cows in the US (B3.13) and infecting others with an #h5n1 strain from a wild bird in Germany.
(I wrote about the plans here: )science.org/content/articl…
In both cases they infected the udders directly through the teats and in both cases the animals got sick. They "showed clear signs of disease such as a sharp drop in milk production, changes in milk consistency and fever." That suggests there is nothing special about B3.13.
The thing that I find most frustrating about the entire mpox/gain-of-function debate is how the uncertainties that lie at the base of it all just become cemented as certainties that are then carried forward.
(If you know anything about me you know I love me some uncertainty...)
Most importantly: The interim report on the investigation into these experiments released on Tuesday numerous times calls clade II "more transmissible" or even "much more transmissible".
But that is a claim that has very little evidence at all.
In fact you can find plenty of literature that argue the exact opposite, that in fact clade I is more transmissible.
Just, as an example, here is Texas HHS:
"Clade I MPXV, which may be more transmissible and cause more severe infection than Clade II..." dshs.texas.gov/news-alerts/he…