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Dr Alexandra Phelan Profile picture
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29 Jan, 6 tweets, 4 min read
Today, @ThinkGlobalHlth is celebrating its one year anniversary. @RebeccaKatz5 & I were fortunate enough to be invited to write a piece for this new @CFR_org blog, led by @TomBollyky.

Some reflections from that piece on why global governance matters.
thinkglobalhealth.org/article/why-gl…
From the outset, it was obvious that global governance was about to be seriously tested. Unfortunately, over this pandemic we've seen that play out to be the case – not only globally but also national governance.
There was a huge risk that WHO would be sidelined because states rejected WHO advice (for a range of reasons), but also because it has been woefully underfunded for years.
This is the big issue facing us going forward – through the rest of the pandemic and in preparation for future health threats, like pandemic influenza.
If you're interested in more about governance and COVID19, Dr Katz & I prepared this report for the @TheGPMB
apps.who.int/gpmb/assets/th…
And to celebrate @ThinkGlobalHlth's one year anniversary, check out the many great articles mentioned in this fantastic thread below:

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Dr Alexandra Phelan Profile picture
29 Jan
*Public health actions to control new SARS-CoV-2 variants*

Our paper just published in @CellCellPress w wonderful co-authors @NathanGrubaugh @firefoxx66 @JosephFauver & @mugecevik

We describe actions govts should urgently take to protect health.

🧵1/7

cell.com/cell/fulltext/…
New SARS-CoV-2 variants of concern will continue to emerge: exacerbating already crippling outbreaks & potentially reducing efficacy of some vaccines, cause increased rates of reinfections and prolonging the pandemic.

2/7
As SARS-Cov-2 variants of concern to date have shown: these are global issues. There must be urgent multilateral cooperation between countries to:
– build local sequencing capacities
– rapidly share sequence data globally
*and separately*

3/7 Image
Read 7 tweets
Dr Alexandra Phelan Profile picture
22 Dec 20
I disagree with folks dismissing the implications of the UK variant of concern.

While individual behaviors to avoid transmission may not change, the impact at the population level is serious: hospitals are already at capacity.

Quick thread
/1
Any factor that ramps up transmission (biological or behavioral) amplifies cases, and as a result, severe cases and deaths. When hospitals hit capacity, cases that could have been treated successfully will be triaged along increasingly stringent crisis standards of care.
/2
At the population level, this also impacts government responses about control measures, which impacts now & future justifications
Short thread on that here:
/3
Read 6 tweets
Dr Alexandra Phelan Profile picture
21 Dec 20
Public Health England has just released their updated report on the UK #SARSCoV2 variant

"Investigation of novel SARS-CoV-2 variant: Variant of Concern 202012/01"

I'll do a quick summary thread below & link to report:
A cluster was identified & used to assess increasing incidence of the Variant of Concern (designated as such 18 Dec) in Kent, UK:
- 4% (255/6130) of Kent cases had available genomes
- in Kent: 117 genomically similar cases identified (10-19 Nov)
- in UK: 962 genomes of VoC(8 Dec)
Out of that 962 UK wide, epi data was available for 915 individuals.

As of 20 Dec, VoC present mainly in London, South East & East of England regions.

The report goes into the details of how the VoC testing is carried out.
Read 8 tweets
Dr Alexandra Phelan Profile picture
20 Dec 20
A lot of good discussion today about what we know and don't know about the new #SARSCoV2 variant in the UK.

But what does this mean (if anything) for government responses & public health law control measures, even if greater transmissibility is confirmed?

Quick notes (1/7)
Firstly, the virus is already sufficiently transmissible to be a concern. As others have noted, already important critical public health measures (avoiding crowds, social distancing, mask wearing, hand washing) will address variants that emerge:
(2/7)
First "but": any potential increase in transmissibility might shift how we weigh the stringency or priority of certain interventions, and how justifications for public health laws determine what is "the least restrictive measure".
(3/7)
Read 7 tweets
Dr Alexandra Phelan Profile picture
10 Dec 20
Vaccine news that may not be covered outside of Australia:

The University of Queensland/CSL #covid19 vaccine trial has reportedly been abandoned for really interesting reasons, with one less potential vaccine for global COVAX Facility pool.

Quick thread:
smh.com.au/politics/feder…
The UQ/CSL vaccine (V451) uses a molecular clamp vaccine platform with the COVID-19 spike protein: the clamp "locks" the spike protein to be more stable for purification & manufacture. It contains a small component derived from HIV that cannot infect people & poses no health risk
However, this component resulted in some participants (out of 200 volunteers inc. placebo & vaccine) in Phase 1 trial producing "a partial antibody response" which interfered with HIV screening tests (which detect HIV antibodies, not virus) resulting in false positive HIV tests.
Read 5 tweets
Dr Alexandra Phelan Profile picture
9 Dec 20
With the vaccine Executive Order now up, President Trump has ordered that "Americans" have priority to "US Govt COVDI19 Vaccines".

I want to push back on some arguments dismissing the risk of this as there are very concerning impacts.

whitehouse.gov/presidential-a…
United States Government COVID-19 Vaccines are defined in the EO as "COVID-19 vaccines developed in the United States or procured by the United States Government"

This does not limit the scope of the EO to those purchased under APAs, but includes vaccines developed here.
That said, implementation of EO will likely start w vaccines purchased by US Govt under APAs. This alone is concerning:

US govt has bought signif. number of global mRNA vaccines:
– Moderna: 100m doses/266m in APAs + 400m option
– Pfizer: 100m doses/590m in APAs + 500m option
Read 6 tweets

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