Month: June 2022

A top official at the World Health Organization said the U.N. health agency assumes the coronavirus outbreak in North Korea is “getting worse, not better,” despite the secretive country’s recent claims that COVID-19 is slowing there.

At a press briefing on Wednesday, WHO’s emergencies chief, Dr. Mike Ryan, appealed to North Korean authorities for more information about the COVID-19 outbreak there, saying, “We have real issues in getting access to the raw data and to the actual situation on the ground.”

He said WHO has not received any privileged information about the epidemic — unlike in typical outbreaks, when countries may share more sensitive data with the organization so it can evaluate the public health risks for the global community.

Tough to analyze

“It is very, very difficult to provide a proper analysis to the world when we don’t have access to the necessary data,” he said.

WHO has previously voiced concerns about the impact of COVID-19 in North Korea’s population, which is believed to be largely unvaccinated and whose fragile health systems could struggle to deal with a surge of cases prompted by the highly infectious omicron and its subvariants.

Ryan said WHO had offered technical assistance and supplies to North Korean officials multiple times, including offering COVID-19 vaccines at least three times.

Last week, North Korean leader Kim Jong Un and other top officials discussed revising stringent anti-epidemic restrictions, state media reported, as they maintained a widely disputed claim that the country’s first COVID-19 outbreak is slowing.

The discussion at the North’s Politburo meeting on Sunday suggested it would soon relax a set of draconian curbs, imposed after its admission of the omicron outbreak this month, out of concern about its food and economic situations.

North Korea’s claims to have controlled COVID-19 without widespread vaccination, lockdowns or drugs have been met with widespread disbelief, particularly its insistence that only dozens have died among many millions infected — a far lower death rate than seen anywhere else in the world.

The North Korean government has said there are about 3.7 million people with fever or suspected COVID-19. But it disclosed few details about the severity of illness or how many people have recovered, frustrating public health experts’ attempt to understand the extent of the outbreak.

Help sought from China, South Korea

“We really would appeal for a more open approach so we can come to the assistance of the people of [North Korea], because right now we are not in a position to make an adequate risk assessment of the situation on the ground,” Ryan said. He said WHO was working with neighboring countries like China and South Korea to ascertain more about what might be happening in North Korea, saying that the epidemic there could have global implications.

WHO’s criticism of North Korea’s failure to provide more information about its COVID-19 outbreak stands in contrast to the U.N. health agency’s failure to publicly fault China in the early days of the coronavirus pandemic.

In early 2020, WHO chief Tedros Adhanom Ghebreyesus repeatedly praised China publicly for its speedy response to the emergence of the coronavirus, even as WHO scientists privately grumbled about China’s delayed information-sharing and stalled sharing of the genetic sequence of COVID-19.

Source: Voice of America

As health authorities in Europe and elsewhere roll out vaccines and drugs to stamp out the biggest monkeypox outbreak beyond Africa, some doctors acknowledge an ugly reality: The resources to slow the disease’s spread have long been available, just not to the Africans who have dealt with it for decades.

Countries including Britain, Spain, Portugal, Italy, Switzerland, the United States, Israel and Australia have reported more than 500 monkeypox cases, many apparently tied to sexual activity at two recent raves in Europe. No deaths have been reported.

Authorities in numerous European countries and the U.S. are offering to immunize people and considering the use of antivirals. On Thursday, the World Health Organization will convene a special meeting to discuss monkeypox research priorities and related issues.

Meanwhile, the African continent has reported about three times as many cases this year.

There have been more than 1,400 monkeypox cases and 63 deaths in four countries where the disease is endemic — Cameroon, Central African Republic, Congo and Nigeria — according to the Africa Centers for Disease Control and Prevention. So far, sequencing has not yet shown any direct link to the outbreak outside Africa, health officials say.

Monkeypox is in the same family of viruses as smallpox, and smallpox vaccines are estimated to be about 85% effective against monkeypox, according to WHO.

Since identifying cases earlier this month, Britain has vaccinated more than 1,000 people at risk of contracting the virus and bought 20,000 more doses. European Union officials are in talks to buy more smallpox vaccine from Bavarian Nordic, the maker of the only such vaccine licensed in Europe.

U.S. government officials have released about 700 doses of vaccine to states where cases were reported.

Such measures aren’t routinely employed in Africa.

Dr. Adesola Yinka-Ogunleye, who leads Nigeria’s monkeypox working group, said there are currently no vaccines or antivirals being used against monkeypox in her country. People suspected of having monkeypox are isolated and treated conservatively, while their contacts are monitored, she said.

Generally, Africa has only had “small stockpiles” of smallpox vaccine to offer health workers when monkeypox outbreaks happen, said Ahmed Ogwell, acting director of the Africa CDC.

Limited vaccine supply and competing health priorities have meant that immunization against monkeypox hasn’t been widely pursued in Africa, said Dr. Jimmy Whitworth, a professor of international public health at the London School of Hygiene and Tropical Medicine.

“It’s a bit uncomfortable that we have a different attitude to the kinds of resources we deploy depending on where cases are,” he said. “It exposes a moral failing when those interventions aren’t available for the millions of people in Africa who need them.”

WHO has 31 million doses of smallpox vaccines, mostly kept in donor countries and intended as a rapid response to any re-emergence of the disease, which was declared eradicated in 1980.

Doses from the U.N. health agency’s stockpile have never been released for any monkeypox outbreaks in central or western Africa.

Dr. Mike Ryan, WHO’s emergencies chief, said the agency was considering allowing rich countries to use the smallpox vaccines to try to limit the spread of monkeypox. WHO manages similar mechanisms to help poor countries get vaccines for diseases like yellow fever and meningitis, but such efforts have not been previously used for countries that can otherwise afford shots.

Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory boards, said releasing smallpox vaccines from the agency’s stockpile to stop monkeypox from becoming endemic in richer countries might be warranted, but he noted a discrepancy in WHO’s strategy.

“A similar approach should have been adopted a long time ago to deal with the situation in Africa,” he said. “This is another example of where some countries are more equal than others.”

Some doctors pointed out that stalled efforts to understand monkeypox were now complicating efforts to treat patients. Most people experience symptoms including fever, chills and fatigue. But those with more serious disease often develop a rash on their face or hands that spreads elsewhere.

Dr. Hugh Adler and colleagues recently published a paper suggesting the antiviral drug tecovirimat could help fight monkeypox. The drug, approved in the U.S. to treat smallpox, was used in seven people infected with monkeypox in the U.K. from 2018 to 2021, but more details are needed for regulatory approval.

“If we had thought about getting this data before, we wouldn’t be in this situation now where we have a potential treatment without enough evidence,” said Adler, a research fellow at the Liverpool School of Tropical Medicine.

Many diseases only attracted significant money after infecting people from rich countries, he noted.

For example, it was only after the catastrophic Ebola outbreak in West Africa in 2014-2016 — when several Americans were sickened by the disease among the more than 28,000 cases in Africa — that authorities finally sped up the research and protocols to license an Ebola vaccine, capping a decades-long effort.

At a press briefing on Wednesday, WHO’s Ryan said the agency was worried about the continued spread of monkeypox in rich countries and was evaluating how it could help stem the disease’s transmission there.

“I certainly didn’t hear that same level of concern over the last five or 10 years,” he said, referring to the repeated epidemics of monkeypox in Africa, when thousands of people in the continent’s central and western parts were sickened by the disease.

Jay Chudi, a development expert who lives in the Nigerian state of Enugu, which has reported monkeypox cases since 2017, hopes the increased attention might finally help address the problem. But he nevertheless lamented that it took infections in rich countries for it to seem possible.

“You would think the new cases are deadlier and more dangerous than what we have in Africa,” he said. “We are now seeing it can end once and for all, but because it is no longer just in Africa. It’s now everybody is worried.”

Source: Voice of America