COVID-19 Data Dispatch

Tag: global public health

  • WHO ends the global health emergency for COVID-19

    As the U.S. gears up to end its federal public health emergency for COVID-19, the World Health Organization just declared an end to the global health emergency. WHO Director-General Tedros Adhanom Ghebreyesus announced the declaration on Friday, following a meeting of the organization’s COVID-19 emergency committee the day before.

    Here’s what this declaration means, pulling from Helen Branswell’s article in STAT News and Katelyn Jetelina’s Your Local Epidemiologist post:

    • The world is at a point of transition from considering COVID-19 an unexpected emergency to considering it a part of our daily lives, a disease that we’ll be dealing with in the long term.
    • The WHO will have fewer resources for an international response to COVID-19, such as coordinating between countries and sharing data at a global scale.
    • The WHO will also have less authority when it comes to issuing international guidance to control COVID-19 spread.
    • There will be fewer incentives for countries to accelerate vaccines, treatments, and tests for COVID-19.

    The declaration does not mean that COVID-19 is “over.” We have plenty of long-term issues to deal with here: millions suffering from Long COVID, continued COVID-19 waves around the world, potential new variants, healthcare worker shortages, and declines in childhood vaccination rates, to name a few. Tedros may set up a new committee to make recommendations on long-term COVID-19 management, according to Branswell’s article.

    In fact, the WHO recently publicized the impacts of Long COVID: Tedros delivered a PSA explaining that one in ten coronavirus infections leads to some form of Long COVID, and suggesting that “hundreds of millions of people will need longer-term care.” Shifting out of the emergency phase of our global COVID-19 response should be a call to action for scientists and health experts to now focus on Long COVID needs.

    Still, a lot of people might interpret the WHO’s declaration as an announcement that they no longer need to worry about COVID-19. Some mainstream publications that have covered the change haven’t done a great job of conveying the nuances here, and I’ve already seen some misinterpretation on social media.

    COVID-19 may not be an emergency at this point. But we’re probably going to be living with it for the rest of our lives, and there’s a lot of work left to do.

    More on international data

  • Sources and updates, January 29

    • New York State expands wastewater surveillance program: This week, the New York State health department announced a major investment in the state’s wastewater surveillance program: the program has received a $6.6 million grant from the CDC and $15 million from the governor (over the next three years). With this investment, New York’s wastewater surveillance network will grow from 125 to 215 testing sites and will expand from COVID-19 to include flu, RSV, hepatitis, norovirus, and antimicrobial resistance. This is great news for New York—I hope to see other states make similar investments.
    • Bivalent boosters vs. XBB lineages: The bivalent, Omicron-specific booster shots provide some protection against XBB.1.5 and related Omicron subvariants, according to a new study published this week in the CDC’s Morbidity and Mortality Weekly Report. CDC researchers used data from COVID-19 testing at pharmacies to compare results among people who had received the new booster and those who hadn’t. Booster recipients were significantly less likely to have a symptomatic XBB/XBB.1.5 infection compared to people who hadn’t received the shot, the researchers found (with a vaccine effectiveness value of 48%). While the boosters work less well against XBB.1.5 than they did against BA.4/BA.5, they’re still a valuable protective measure.
    • CDC overhauling data communications: The CDC is creating new internal offices that will change how it processes, publishes, and communicates about data, according to POLITICO. The new offices include an Office of Health Equity and an Office of Public Health Data, Surveillance, and Technology—both of which have new acting directors as of this week. It’s currently unclear what the new offices will do, exactly, or how they will improve upon a fractured nationwide health data system (with decisions about how to store and share key data largely left up to state agencies and private companies). Still, it’s good to see movement on the CDC’s efforts.
    • WHO deliberates ending the global health emergency: On Friday, a World Health Organization committee met to discuss whether the official global health emergency over COVID-19 should be ended. The committee’s decision will be made public tomorrow, as a recommendation to WHO Director-General Tedros Adhanom Ghebreyesus; Tedros will ultimately decide whether or not to end the emergency. Global health experts who spoke to STAT reporter Helen Branswell suggested that the WHO likely isn’t ready to end this emergency yet, but it may happen later in 2023.
    • KFF compiles Long COVID data: A new report from the Kaiser Family Foundation compiles and provides context for Long COVID data reported by the Census and CDC’s Household Pulse Survey. The share of people who reported ever having Long COVID symptoms following a COVID-19 case has declined slightly over time, the KFF report finds; this number went from 35% in June 2022 to 28% in January 2023. However, the number is still high and Long COVID can be debilitating for many, as 79% of people with Long COVID report limitations to their day-to-day activities.
    • Health of Congressional Districts: Finally: a new dashboard, published this week by researchers at NYU Langone Health, provides detailed health metrics for all 435 Congressional districts in the U.S. (plus Washington, D.C.). The dashboard is a helpful source for researchers and policymakers looking to understand health patterns in specific districts. One of its key metrics is a “COVID Local Risk Index” that reflects the risk residents face for severe health, social, and economic outcomes of COVID-19.

    All featured sources

  • China’s not the only country with unreliable COVID-19 data

    China is currently facing a massive COVID-19 surge, after ending many of its stringent “zero COVID” policies in December. Some estimates suggest that the country is experiencing over a million new cases each day, and widespread travel over the Lunar New Year later this month will likely prolong the surge.

    Among U.S. media outlets covering the situation, a common topic is China’s lack of reliable COVID-19 data. For example: “The country no longer tallies asymptomatic infections or reliably reports COVID deaths—employing not the distortion of statistics but their omission,” writes Dhruv Khullar in The New Yorker.

    Articles like Khullar’s accurately describe how difficult it is to understand the scale of COVID-19’s impact on a country without accurate data. But they fail to explain that this is far from a uniquely Chinese problem. In fact, many of the same claims that writers and health experts have made about China could also apply to the U.S., albeit on a different scale.

    Some examples:

    • Without widespread PCR testing, officially-reported case counts are likely significant underestimates of true infections.
    • Public health agencies are no longer doing widespread contact tracing or attempting to track asymptomatic cases.
    • Official death statistics are also likely underestimates, due to errors and omissions on death certificates.
    • Unchecked spread of the virus could contribute to the development of new variants that evade prior infections and/or vaccinations, but such variants will be hard to quickly identify due to low testing rates.

    This Twitter thread, from the writer and podcast host Artie Vierkant, shows the similarities pretty clearly:

    Don’t get me wrong—the current surge in China is an immense tragedy. But we can’t talk about it in a vacuum, or ignore the very similar problems plaguing the U.S. and many other countries. Poor COVID-19 data is, unfortunately, a global issue right now.

    More international data

  • Sources and updates, July 10

    • CDC adds (limited) Long COVID data to its dashboard: This week, the CDC’s COVID Data Tracker added a new page, reporting data from a study of “post-COVID conditions” (more colloquially known as Long COVID). The study, called Innovative Support for Patients with SARS-CoV-2 Infections (INSPIRE), follows patients who test positive for up to 18 months and tracks their continued symptoms. Among about 4,100 COVID-positive patients in the study, over 10% still had symptoms at three months after their infections, and over 1% still had symptoms at 12 months. This is just one study among many tracking Long COVID, but it is an important step for the CDC to add these data to their dashboard.
    • Air change guidance by state: In recognition of the role ventilation can play in reducing COVID-19 spread, some states have put out recommendations for minimum air changes per hour (ACH), a metric for tracking indoor air quality. Researcher Devabhaktuni Srikrishna has compiled the recommendations on his website, Patient Knowhow, with a map showing ACH guidance by state. (I recently interviewed Srikrishna for an upcoming story about ventilation.)
    • COVID-19 is a leading cause of death in the U.S.: A new study from researchers at the National Institutes of Health’s National Cancer Institute confirms that COVID-19 was the third-leading cause of death in the U.S., in both 2020 and 2021. The researchers utilized death records from the CDC in their analysis, comparing COVID-19 to common causes such as cancer and heart disease. COVID-19 was a top cause of death for every age group over age 15, the study found.
    • COVID-19 disparities in Louisiana: Another notable study this week: researchers at the University of Maryland, College Park examined the roles of social, economic, and environmental factors in COVID-19 deaths in Louisiana, focusing on Black residents. “We find that Black communities in parishes with both higher and lower population densities experience higher levels of stressors, leading to greater COVID-19 mortality rate,” the researchers wrote. The study’s examination of environmental racism in relation to COVID-19 seems particularly novel to me; I hope to see more research in this area.
    • Tracking coronavirus variants in wastewater: And one more new study: a large consortium of researchers, led by scientists at the University of California San Diego, explores the use of wastewater surveillance to track new variants. Variants can show up in wastewater up to two weeks earlier than they show up in samples from clinical (PCR) testing, the researchers found. In addition, some variants identified in wastewater are “not captured by clinical genomic surveillance.”
    • Global COVID-19 vaccine and treatment initiative ending: The ACT-Accelerator, a collaboration between the World Health Organization and other health entities and governments, has run out of funding. This is bad news for low- and middle-income countries that relied on the program for COVID-19 vaccines and treatments—many of which are still largely unvaccinated, more than a year after vaccines became widely available in high-income countries. Global health equity initiatives will likely continue in another form, but funding will be a continued challenge.

    All featured sources
  • Russia’s invasion of Ukraine has COVID-19 impacts

    Russia’s invasion of Ukraine has COVID-19 impacts

    While Ukraine’s COVID-19 cases appear to have gone down in recent days, the country is (obviously) not prioritizing COVID-19 reporting during an invasion. Chart via Our World in Data.

    When Russian troops began attacking Ukraine, the country was just recovering from its worst COVID-19 surge of the pandemic. To state the terrifying obvious: war makes it much harder to control a pandemic.

    Here are a few reports on this situation from the past week:

    • The New York Times describes Ukraine’s ability to control COVID-19 as “another casualty of Russia’s invasion.” Reporter Adeel Hassan discusses the challenges of controlling disease spread when people are crowding together in shelters, fleeing to refugee camps, and often unable to access masks or other supplies. The crisis in Ukraine will also impact COVID-19 in nearby countries tasked with caring for refugees, Hassan writes.
    • In addition to COVID-19, Ukraine “has been trying to control a polio outbreak since October,” reports Dana Varinsky at NBC News. About 13% of Ukrainian children under age six had not received their polio shots as of 2020, and are vulnerable to a re-emergence of this disease. Global health experts are highly concerned about the potential impacts of both COVID-19 and polio on Ukraine and neighboring countries.
    • While data on Ukraine’s cases show a decrease in recent weeks, these numbers are pretty unreliable. Our World in Data reports a steep decline from 860 new cases per million on February 12 to zero new cases in the last couple of days. This is unsurprising for a country with pressing issues to deal with than data reporting. “These numbers are going to have to be taken with some sort of salt, understanding it may be underreported, or in many ways not reported at all,” public health expert Sonny Patel told NBC.
    • Meanwhile in the U.S., hospitals are considering a potential increase in Russian cyber threats, POLITICO reports. Earlier in March, the U.S. Cybersecurity and Infrastructure Security Agency issued a warning to hospitals and other healthcare organizations saying they should prepare for Russian cyberattacks. “No “specific or credible” threats have been made yet, but health care organizations are concerned, given Russia’s cyber warfare history,” according to reporter Ben Leonard. (The full story is paywalled, but a summary is available in POLITICO’s newsletter.)

    Over the past year, we’ve seen more and more examples of COVID-19 surges intersecting with other disasters. This includes violence in Palestine last summer, as well as hurricanes, wildfires, and the Texas winter storm here in the U.S. To me, these horrible convergences make it clear that healthcare systems in the U.S. and around the world need a lot more investment to be resilient in these times of crisis.

  • We failed to vaccinate the world in 2021; will 2022 be more successful?

    We failed to vaccinate the world in 2021; will 2022 be more successful?

    According to Bloomberg, the 52 least wealthy places in the world have 5.6% of the vaccinations. Chart from Bloomberg’s vaccine tracker, screenshot taken on December 19.

    In January, COVAX set a goal that many global health advocates considered modest: delivering 2.3 billion vaccine doses to low- and middle-income countries by the end of 2021. COVAX (or COVID-19 Vaccines Global Access) is an initiative to provide equitable access to vaccines; its leadership includes the United Nations, the World Health Organization (WHO), and other organizations.

    Despite COVAX’s broad support, the initiative has revised its vaccine delivery projections down again and again this year. Now, the initiative is saying it’ll deliver just 800 million vaccine doses by the end of 2021, according to the Washington Post, and only about 600 million had been delivered by early December.

    Considering that most COVID-19 vaccines are two-dose series—and boosters will likely be necessary to combat Omicron—those doses are just a drop in the bucket. According to Bloomberg’s vaccine tracker: “The least wealthy 52 places have 5.6% of the vaccinations, but 20.5% of the world’s population.”

    Why this access gap? Many scientists and advocates in low- and middle-income nations blame vaccine manufacturers and rich countries like the U.S., I found when I reported a story on this topic for Popular Science.

    “We basically have artificial scarcity of vaccine doses,” says Robbie Silverman, a vaccine advocate at Oxfam America. The pharmaceutical companies control “where doses are produced, where they’re sold, and at what price.” The world’s vaccine supply is thus limited by contracts signed by a small number of big companies; and many of those contracts, [Fatima Hassan, health advocate from South Africa] says, are kept secret behind non-disclosure agreements.

    While rich countries claimed to support COVAX, the Washington Post reports, “they also placed advance orders with vaccine manufacturers before COVAX could raise enough money to do so.” This practice pushed COVAX to the back of the vaccine line—and then, when rich countries decided they needed booster shots, that pushed COVAX to the back of the line again. India’s spring 2021 surge didn’t help either, as the country blocked vaccine supplies produced at the Serum Institute of India from being exported to other nations.

    According to Our World in Data, low-income nations have administered about 60 million doses total, while high-income nations have administered more than 300 million booster shots. At times this winter, there were more booster shots administered daily than first and second doses in low-income countries.

    Even taking booster shots into consideration, there should be enough vaccine supplies produced by the end of this year to vaccinate 40% of the world’s population by the end of this year, meeting WHO targets, according to STAT News’ Olivia Goldhill. The world is on track to manufacture about 11 billion vaccines in total this year, Goldhill reports, while about 850 million doses are needed to get all countries to a 40% vaccination benchmark.

    But again, rich countries pose a problem: the countries currently focused on administering booster shots have stockpiled hundreds of millions of doses, and are unwilling to send their stockpiles abroad. From STAT News:

    “That number can be redistributed from what high-income countries expect to have by the end of this year. So it’s not an overall supply challenge,” said [Krishna Udayakumar, founding director of Duke’s Global Health Innovation Center]. “It’s very much an allocation challenge, as well as getting high income countries more and more comfortable that they don’t need to hold on to hundreds of millions of doses, for contingencies.”

    The vaccine shortage for low-income countries is less than the surplus vaccines within the G7 countries and the European Union, according to separate analyses from both Duke and Airfinity, a life sciences analytics firm that is tracking vaccine distribution.

    While leaders in the U.S., the U.K., and other nations with large stockpiles maintain that they can both administer booster shots at home and send doses for primary series shots abroad, their true priorities are clear. The U.S., for example, has pledged to donate 1.2 billion doses to other countries, but about 320 million—under one-third—of those doses have been shipped out so far.

    Another challenge is the type of vaccines being used in wealthy nations, as opposed to low- and middle-income nations. Wealthy nations have been particularly eager to horde Pfizer and Moderna’s vaccines, which are more effective against Omicron and other variants of concern. On the other hand, many low-income nations have relied on Sputnik, CoronaVac, and other vaccines which are less effective.

    “We’re now entering an era of second-class vaccines for second-class people,” Peter Maybarduk, director at the DC-based nonprofit Public Citizen, told me in October, discussing these differences in vaccine effectiveness. As Omicron spreads around the world, this concern is only growing.

    The more the coronavirus spreads across the world, particularly in regions with less immunity from vaccines, the more it can mutate and create new variants. Delta and Omicron provide clear examples, demonstrating the need to vaccinate the world in 2022.

    And there are some reasons to hope that this goal may be feasible. COVAX’s global supply forecast shows major jumps in vaccine supplies in the first three months of 2022. At the same time, vaccine companies are increasing their production capacity, and donations from the U.S. and other countries are expected to kick in. In South Africa, an mRNA vaccine hub is working to train African companies to manufacture COVID-19 vaccines similar to Pfizer and Moderna’s, without violating patents.

    Still, additional variants—and the need for additional booster shots—could be a major hurdle, as vaccine companies continue to prioritize wealthy nations. These companies continue to refuse to share their intellectual property with other manufacturers, even as they make patents for COVID-19 antiviral drugs widely available. And, once vaccines are delivered, getting them from shipments into arms will be a challenge.

    More international data

  • First COVID-19 antiviral pill gains authorization

    This week, an antiviral pill for COVID-19 was authorized in the U.K. The drug, made by American pharmaceutical company Merck, is the first COVID-19 treatment in pill form to gain approval by any regulatory agency.

    Some scientists have called this pill a “game-changer,” and for good reason. In Merck’s clinical trial, the drug approximately halved COVID-19 patients’ risk of hospitalization or death, compared to a placebo. The pill is designed for—and was tested on—adults who are particularly vulnerable to the virus, including seniors and those with preexisting conditions such as diabetes and heart disease.

    The pill, formally called molnupiravir, works by interfering with the coronavirus’ ability to replicate itself, stopping it from reaching further into the body and causing severe symptoms. (This STAT News article includes a video that explains the process in more detail.) Adults who show mild or moderate COVID-19 symptoms can take the pill soon after they realize they’re infected, in order to improve their chances of recovery without a hospital stay.

    In Merck’s clinical trial, patients started taking the pill five days after they began to experience COVID-19 symptoms. Each patient took four capsules, twice a day, for five days—adding up to 40 pills for a single patient.

    The U.K. government has bought almost 500,000 courses of molnupiravir. The U.S. government has brought about 1.7 million courses, and our FDA is slated to consider the pill for emergency use authorization later this month. Several other countries including France, Australia, Malaysia, and Singapore also have contracts in place to purchase the pills.

    But unlike other COVID-19 treatments and vaccines, molnupiravir may be more broadly available to people who don’t live in wealthy nations. Last week, Merck announced that it signed a voluntary licensing agreement with the Medicines Patent Pool, a public health organization backed by the United Nations that increases treatment access in over 100 low- and middle-income countries. As a result, a number of companies besides Merck will be able to manufacture and distribute their own versions of molnupiravir.

    Still, some global health advocates have criticized Merck for making a deal with the Medicines Patent Pool rather than the World Health Organization’s COVID-19 Technology Access Pool, which would provide access to a broader group of countries. The current deal leaves out some middle-income countries that are particularly poised to manufacture versions of molnupiravir, including countries like Brazil and Peru that have seen high COVID-19 death tolls.

    In short, Merck’s efforts to make its COVID-19 drug widely available are much better than anything we’ve seen from the major vaccine companies. But this is still far from the most equitable scenario.

  • Booster shots exacerbate global vaccine inequity

    At the end of last week’s post on booster shots, I wrote that these additional doses take up airtime in expert discussions and in the media, distracting from discussions of what it will take to vaccinate the world.

    But these shots do more harm than just taking over the media cycle. When the U.S. and other wealthy nations decide to give many residents third doses, they jump the vaccine supply line again—leaving low-income nations to wait even longer for first doses.

    I explained how this process works in a new article for Popular Science. Essentially, the big vaccine manufacturers (Pfizer, Moderna, Johnson & Johnson, etc.) have created artificial scarcity of vaccine doses, by insisting on controlling every single dose of their products—rather than sharing the vaccine technology with other manufacturers around the world.

    Then, out of this limited supply of doses, the big companies sell to wealthy nations first. The wealthy nations are “easier markets to service,” WHO spokesperson Margaret Harris told me, since they can pay more money and have logistical systems in place already to deliver the vaccine doses.

    If a wealthy nation wants boosters, it’s in the vaccine companies’ best interests to sell them boosters—before sending primary series doses to other parts of the world. Or, as South Africa-based vaccine advocate Fatima Hassan put it: “Supplies that are currently available are diverted” for boosters. “Just to serve preferred customers in the richer North.”

    The FDA and CDC authorized booster shots for Moderna, Johnson & Johnson, and mix-and-match regimens this week. Advisory committee discussions did not mention that, worldwide, three in five healthcare workers are not fully vaccinated.

    More international data

    • The case for a moratorium on booster shots

      The case for a moratorium on booster shots

      Chart from Nature revealing the unequal global distribution of COVID-19 vaccines.

      This week, the World Health Organization (WHO) called for wealthy nations to stop giving out booster shots in a push towards global vaccine equity. 

      These nations should stall any booster shots until at least September, said WHO Director-General Tedros Adhanom Ghebreyesus at a press conference on Wednesday. Instead, excess vaccines should be donated to COVAX, the international vaccine distributor that aims to mitigate COVID-19 in low-income countries. When 10% of the population in every country has been vaccinated, then wealthy countries could resume administering boosters, Tedros said.

      Here’s what he said at the conference (h/t Helen Branswell, STAT News):

      I understand the concern of all governments to protect their people from the Delta variant. But we cannot and we should not accept countries that have already used most of the global supply of vaccine using even more of it while the world’s most vulnerable people remain unprotected.

      It may seem counterintuitive for a country to not provide its citizens with extra protection when it has the means to do so. But the global numbers are staggering. About 50% of the U.S. population has now been fully vaccinated, and we have doses to spare (some of which are going to waste). Meanwhile, in most African countries, 1% or less of the population is vaccinated. This is even though vaccine demand is actually far higher in low-income nations than in the U.S.

      Nature’s Amy Maxmen has a great piece unpacking this inequity. She cites a rather damning WHO analysis:

      An internal analysis from the World Health Organization (WHO) estimates that if the 11 rich countries that are either rolling out boosters or considering it this year were to give the shots to everyone over 50 years old, they would use up roughly 440 million doses of the global supply. If all high-income and upper-middle-income nations were to do the same, the estimate doubles.

      About 3.5 billion people in low- and lower-middle-income countries have yet to be vaccinated, Maxmen estimates. Give one dose to 10% of that number, and you use 350 million doses—less than the 440 million that rich nations would use up with boosters.

      The longer that these low-income countries go without widespread vaccination, the more likely it is that new variants will emerge from their outbreaks. This is because, with every new COVID-19 case, the virus has a new opportunity to mutate. We’re already seeing Delta adapt to become even more transmissible and monitoring other potentially-concerning variants, like Lambda.

      It’s unclear how much power the WHO has to enforce a booster shot moratorium, especially now that some countries (like Israel) have already gotten started on administering these extra shots. And it’s also worth noting that public health officials in the U.S. are shifting away from using “booster” to describe third shots for immunocompromised people or second shots who for those who received the one-and-done Johnson & Johnson vaccine; they say that these shots rather bring patients up to the same immunity levels as those who received two mRNA doses.

      More vaccine reporting

      • Sources and updates, November 12
        Sources and updates for the week of November 12 include new vaccination data, a rapid test receiving FDA approval, treatment guidelines, and more.
      • How is the CDC tracking the latest round of COVID-19 vaccines?
        Following the end of the federal public health emergency in May, the CDC has lost its authority to collect vaccination data from all state and local health agencies that keep immunization records. As a result, the CDC is no longer providing comprehensive vaccination numbers on its COVID-19 dashboards. But we still have some information about this year’s vaccination campaign, thanks to continued CDC efforts as well as reporting by other health agencies and research organizations.
      • Sources and updates, October 8
        Sources and updates for the week of October 8 include new papers about booster shot uptake, at-home tests, and Long COVID symptoms.
      • COVID source shout-out: Novavax’s booster is now available
        This week, the FDA authorized Novavax’s updated COVID-19 vaccine. Here’s why some people are excited to get Novavax’s vaccine this fall, as opposed to Pfizer’s or Moderna’s.
      • COVID-19 vaccine issues: Stories from COVID-19 Data Dispatch readers across the U.S.
        Last week, I asked you, COVID-19 Data Dispatch readers, to send me your stories of challenges you experienced when trying to get this fall’s COVID-19 vaccines. I received 35 responses from readers across the country, demonstrating issues with insurance coverage, pharmacy logistics, and more.
    • The Delta variant is taking over the world

      The Delta variant is taking over the world

      The Delta variant is now dominant in the U.S., but our high vaccination rates still put us in a much better position than the rest of the world—which is facing the super-contagious variant largely unprotected.

      Let’s look at how the U.S.’s situation compares:

      U.S.: Delta now causes 52% of new cases, according to the latest Nowcast estimate from the CDC. (This estimate is pegged to July 3, so we can assume the true number is higher now.) It has outcompeted other concerning variants here, including Alpha/B.1.1.7 (now at 29%), Gamma/P.1 (now at 9%), and the New York City and California variants (all well under 5%). And Delta has taken hold in unvaccinated parts of the country, especially the Midwest and Mountain West.

      Israel and the U.K.: Both of these countries—lauded for their successful vaccination campaigns—are seeing Delta spikes. Research from Israel has shown that, while the mRNA vaccines are still very good at protecting against Delta-caused severe COVID-19, these vaccines are not as effective against Delta-caused infection. As a result, public health experts who previously said that 70% vaccination could confer herd immunity are now calling for higher goals.

      Japan: The Tokyo Olympics will no longer allow spectators after Japan declared a state of emergency. The country is seeing another spike in infections connected to the Delta variant, and just over a quarter of the population has received a dose of a COVID-19 vaccine. I argued in a recent CDD issue that, if spectators are allowed, the Olympics could turn into a superspreading event.

      Australia: Several major cities are on lockdown in the face of a new, Delta-caused surge following a party where every single unvaccinated attendee was infected. Unlike other large countries that faced significant outbreaks, Australia has successfully used lockdowns to keep COVID-19 out: the country has under 1,000 deaths total. But the lockdown strategy has diminished incentives for Australians to get vaccinated; under 5% of the population has received a shot. Will lockdowns work against Delta, or does Australia need more shots now?

      India: Delta was first identified in India, tied to a massive surge in the country earlier this spring. Now, India has also become the site of a Delta mutation, unofficially called “Delta Plus.” This new variant has an extra spike protein mutation; it may be even more transmissible and even better at invading people’s immune systems than the original Delta, though scientists are still investigating. India continues to see tens of thousands of new cases every day.

      Africa: Across this continent, countries are seeing their highest case numbers yet; more than 20 countries are experiencing third waves. Most African countries have fewer genetic sequencing resources than the U.S. and other wealthier nations, but the data we do have are shocking: former CDC Director Dr. Tom Frieden reported that, in Uganda, Delta was detected in 97% of case samples. Meanwhile, vaccine delivery to these countries is behind schedule—Nature reports that many people in African countries and other low-income nations will not get their shots until 2023. 

      South America: This continent is also under-vaccinated, and is facing threats from Delta as well as Lambda, a variant detected in Peru last year. While Lambda is not as fast-spreading as other variants, it has become the dominant variant in Peru and has been identified in at least 29 other countries. Peru has the highest COVID-19 death rate in the world, and scientists are concerned that Lambda may be more fatal than other variants. Studies on this variant are currently underway.

      In short: basically every region of the world right now is seeing COVID-19 spikes caused by Delta. More than 20 countries are experiencing exponential case growth, according to the WHO:

      We’ve already seen more COVID-19 deaths worldwide so far in 2021 than in the entirety of 2020. Without more widespread vaccination, treatments, and testing, the numbers will only get worse.

      More international reporting