May 3, 2019

Ebola vaccine's effectiveness is imperiled by DRC's unrest

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Data: DRC Ministry of Health; Chart: Andrew Witherspoon, Harry Stevens/Axios

The Ebola vaccine — which appears to have an effectiveness of more than 97% when given 10 days before infection — also must be given quickly once an outbreak starts, according to scientists in a study out this week.

Why it matters: One of the few bright spots about this deadly outbreak in the Democratic Republic of the Congo is the preliminary finding that the rVSV-ZEBOV vaccine is very effective. But the violent disruptions of the hard efforts of public health officials there — causing the WHO chief to warn, "The world has never seen anything like this" — are endangering that benefit.

What they did: The research team from the University of Florida used a spatial model examining human mobility, poverty and population density to see how this impacted the effectiveness of the vaccination program during the prior Ebola outbreak in the DRC in 2018.

  • "Our primary purpose was to investigate the timing and pattern of geographical spread of an Ebola outbreak starting from initial cases," study author Burton Singer tells Axios.
  • They used Merck's rVSV-ZEBOV vaccine, as it was the most effective known vaccine and it was available for distribution, Singer says.
  • The outbreak in May 2018 was in a different location than the current outbreak.

What they found: The vaccination program lessened both the geographical area that was at risk and the risk level for infection within that region, the study found.

  • The vaccination program contracted the geographical area at risk for Ebola by up to 70%.
  • The program reduced the level of risk within that region by up to 70%.

Yes, but: It also shows there may be a significant drop in its ability to lower infection rates in an area if it's given even a week after the infection has started. A delay of a week led to the above effects to drop to 33% and 45%, respectively, the authors say.

  • "I was surprised by the dramatic potential impact across a substantial geographical area of a delay of even one week in initiating vaccinations following an outbreak. Vaccinating people as early as possible is critically important," Singer says.

What's happening now: Unfortunately, the vaccination regime is being stymied in the current outbreak by community distrust and violent attacks, including the recent death of a WHO epidemiologist Richard Mouzoko.

"I’m profoundly worried, because the number of cases increases with the frequency of attacks. They are almost every day. It disrupts our operations, and when operations are disrupted, the virus gets a free ride."
"After Richard was killed, we were operating at very low levels for three days. And if we can’t find cases as soon as possible, and if we aren’t able to vaccinate everyone, there is a build-up of the chances of this spreading to other provinces and neighbouring countries. That chance gets higher and higher."
— WHO chief Tedros Adhanom Ghebreyesus, in Q&A published in Nature

By the numbers: DRC says they've vaccinated 109,844 people since they began vaccinating people on Aug. 8.

  • The only vaccine used so far in this epidemic is Merck's rVSV-ZEBOV vaccine.
  • Beth-Ann Coller, executive director of project management and leadership at Merck, tells Axios the company was glad the preliminary data shows a "robust response" to the vaccine, of which the company had agreed to stockpile 300,000 doses as a donation to the WHO.
  • Because it takes roughly one year to produce these vaccines, Coller says, they are already working to replenish their stocks.
  • Merck is moving to have the vaccine licensed in the U.S. and the EU, she adds.
  • WHO spokesperson Tarik Jasarevic says WHO also has used the vaccine for nearly 5,000 health and frontline workers in Uganda, 1,400 in South Sudan, and just started vaccinations in the town of Gisenyi, Rwanda.

Meanwhile, Ghebreyesus called for more funding from the international community, saying, "We have just 50% of what we need."

  • The Paul G. Allen Family Foundation announced yesterday roughly $2.4 million via its Ebola Response Accelerator Challenge to 3 winners, including the WHO, to focus on the community engagement needed to help make the region safer for treatment and vaccination regimes for this Ebola outbreak.

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Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 5 p.m. ET: 716,101 — Total deaths: 33,854 — Total recoveries: 148,900.
  2. U.S.: Leads the world in cases. Total confirmed cases as of 5 p.m. ET: 136,880 — Total deaths: 2,409 — Total recoveries: 2,612.
  3. Federal government latest: The first federal prisoner to die from coronavirus was reported from a correctional facility in Louisiana on Sunday.
  4. Public health updates: Fauci says 100,000 to 200,000 Americans could die from virus.
  5. State updates: Louisiana governor says state is on track to exceed ventilator capacity by end of this week — Cuomo says Trump's mandatory quarantine comments "panicked" some people into fleeing New York
  6. World updates: Italy on Sunday reports 756 new deaths, bringing its total 10,779. Spain reports almost 840 dead, another new daily record that bring its total to over 6,500.
  7. What should I do? Answers about the virus from Axios expertsWhat to know about social distancingQ&A: Minimizing your coronavirus risk
  8. Other resources: CDC on how to avoid the virus, what to do if you get it.

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Trump touts press briefing "ratings" as U.S. coronavirus case surge

Photo: Drew Angerer/Getty Images

President Trump sent about a half-dozen tweets on Sunday touting the high television ratings that his coronavirus press briefings have received, selectively citing a New York Times article that compared them to "The Bachelor" and "Monday Night Football."

Why it matters: The president has been holding daily press briefings in the weeks since the coronavirus pandemic was declared, but news outlets have struggled with how to cover them live — as Trump has repeatedly been found to spread misinformation and contradict public health officials.

World coronavirus updates: Total cases surge to over 700,000

Data: The Center for Systems Science and Engineering at Johns Hopkins, the CDC, and China's Health Ministry. Note: China numbers are for the mainland only and U.S. numbers include repatriated citizens and confirmed plus presumptive cases from the CDC

There are now than more than 700,000 confirmed cases of the coronavirus around the world, according to data from Johns Hopkins. The virus has now killed more than 32,000 people — with Italy alone reporting over 10,000 deaths.

The big picture: Governments around the world have stepped up public health and economic measures to stop the spread of the virus and soften the financial impact. In the U.S., now the site of the largest outbreak in the world, President Trump said Saturday he would issue a "strong" travel advisory for New York, New Jersey and parts of Connecticut.

Go deeperArrowUpdated 3 hours ago - Health