More than 1.5 million children lost a primary or secondary caregiver due to the COVID-19 pandemic

More than 1.5 million children around the world are estimated to have lost at least one parent, custodial grandparent, or grandparent who lived with them due to death related to COVID-19 during the first 14 months of the pandemic, according to a study published today in The Lancet. 

The study highlights orphanhood as an urgent and overlooked consequence of the pandemic and emphasizes that providing evidence-based psychosocial and economic support to children who have lost a caregiver must be a key part of responding to the pandemic.

The analysis used mortality and fertility data to model rates of COVID-19-associated orphanhood (death of one or both parents) and deaths of custodial and co-residing grandparents (ages 60-84) from March 1, 2020 to April 30, 2021, across 21 countries. This study was funded in part by the National Institute on Drug Abuse (NIDA), part of the National Institutes of Health.

In the paper, “COVID-19-associated deaths” referred to the combination of deaths caused directly by COVID-19 and those caused indirectly by other associated causes, such as lockdowns, restrictions on gatherings and movement, decreased access or acceptability of health care and of treatment for chronic diseases.

Traumatic experiences, such as the loss of a parent or caregiver, are associated with increases in substance use, mental health conditions, and other behavioral and chronic health conditions. NIDA supports research aimed at understanding the impact of trauma on young people, preventing substance use after experiencing hardship, and treating substance use in populations that experience trauma.

“Studies like this play a crucial role in illuminating the COVID-19 pandemic’s long-lasting consequences for families and the future mental health and wellbeing of children across the globe,” said NIDA Director Nora D. Volkow, M.D. “Though the trauma a child experiences after the loss of a parent or caregiver can be devastating, there are evidence-based interventions that can prevent further adverse consequences, such as substance use, and we must ensure that children have access to these interventions.” 

To estimate pandemic-associated orphanhood and caregiver deaths, the study used excess mortality and COVID-19 mortality data for 21 countries that accounted for 77% of global COVID-19 deaths during 2020 and early 2021. These include Argentina, Brazil, Colombia, England and Wales, France, Germany, India, Iran, Italy, Kenya, Malawi, Mexico, Nigeria, Peru, Philippines, Poland, Russian Federation, South Africa, Spain, United States, and Zimbabwe.

The authors estimate that 1,134,000 children lost a parent or custodial grandparent due to COVID-19-associated death. Of these, 1,042,000 children were orphaned of a mother, father, or both – most lost one, not both parents. Overall, 1,562,000 children are estimated to have experienced the death of at least one parent or a custodial or other co-residing grandparent (or other older relative).

The countries with the highest numbers of children who lost primary caregivers (parents or custodial grandparents) included South Africa, Peru, United States, India, Brazil, and Mexico. The countries with rates of COVID-19-associated deaths among primary caregivers (>1/1000 children) included Peru, South Africa, Mexico, Brazil, Colombia, Iran, United States, Argentina, and Russia.

The study found that for every country, COVID-19 associated deaths were greater in men than women, particularly in middle- and older-ages. Overall, there were up to five times more children who lost a father than who lost a mother.

“We know from our research that loss of a parent or caregiver can upend children’s lives and potentially affect their development if they are not in a stable home setting. If we take into consideration variants of concern or possible severity of illness among youth, we must not forget that the pandemic continues to pose a threat to parents and caregivers – and their children,” said Chuck A. Nelson, III, Ph.D., study author, Boston Children’s Hospital.

While research on the science of substance use and addiction remains the primary focus of NIDA’s work, NIDA is supporting COVID-19 research, and has issued over $15 million in funding for COVID-19-related projects since the start of the pandemic that could leverage current infrastructure, projects, or scientific knowledge and resources.

Investigational Malaria Vaccine Gives Strong, Lasting Protection

Two U.S. Phase 1 clinical trials of a novel candidate malaria vaccine have found that the regimen conferred unprecedentedly high levels of durable protection when volunteers were later exposed to disease-causing malaria parasites.

The vaccine combines live parasites with either of two widely used antimalarial drugs—an approach termed chemoprophylaxis vaccination. A Phase 2 clinical trial of the vaccine is now underway in Mali, a malaria-endemic country. If the approach proves successful there, chemoprophylaxis vaccination, or CVac, potentially could help reverse the stalled decline of global malaria. Currently, there is no vaccine in widespread use for the mosquito-transmitted disease. 

The trials were conducted at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland. They were led by Patrick E. Duffy, M.D., of the NIH National Institute of Allergy and Infectious Diseases (NIAID), and Stephen L. Hoffman, M.D., CEO of Sanaria Inc., Rockville, Maryland. 

The World Health Organization (WHO) report states that there were an estimated 229 million cases of malaria worldwide in 2019 with an estimated number of malaria deaths at 409 000, adding that children aged under 5 years are the most vulnerable group affected by malaria; in 2019, they accounted for 67% (274 000) of all malaria deaths worldwide. The report further states that total funding for malaria control and elimination reached an estimated US$ 3 billion in 2019 with contributions from governments of endemic countries amounted to US$ 900 million, representing 31% of total funding.

The Sanaria vaccine, called PfSPZ, is composed of sporozoites, the form of the malaria parasite transmitted to people by mosquito bites. Sporozoites travel through blood to the liver to initiate infection. In the CVac trials, healthy adult volunteers received PfSPZ along with either pyrimethamine, a drug that kills liver-stage parasites, or chloroquine, which kills blood-stage parasites.

Malaria sporozoites, the infectious form of the malaria parasite that is injected into people by mosquitoes.
Credit: NIAID

Three months later, under carefully controlled conditions, the volunteers were exposed to either an African malaria parasite strain that was the same as that in the vaccine (homologous challenge) or a variant South American parasite (heterologous challenge) that was more genetically distant from the vaccine strain than hundreds of African parasites. Exposure in both cases was via inoculation into venous blood, which infects all unvaccinated individuals. 

At the lowest PfSPZ dosage, the CVac approach conferred modest protection: only two of nine volunteers (22.2%) who received the pyrimethamine combination were protected from homologous challenge. In contrast, seven out of eight volunteers (87.5%) who received the highest PfSPZ dosage combined with pyrimethamine were protected from homologous challenge, and seven out of nine volunteers (77.8%) were protected from heterologous challenge.

In the case of the chloroquine combination, all six volunteers (100%) who received the higher PfSPZ dosage were completely protected from heterologous challenge. The high levels of cross-strain protection lasted at least three months (the time elapsed between vaccination and challenge) for both higher-dose regimens. One hundred percent protection for three months against heterologous variant parasites is unprecedented for any malaria vaccine in development, the authors note. These data suggest that CVac could be a promising approach for vaccination of travelers to and people living in malaria-endemic areas.

Single-Dose COVID-19 Nasal Vaccine Limits Infection in Monkeys

A single dose of an experimental COVID-19 vaccine delivered into the nose of rhesus macaques protected their lungs and nasal region from SARS-CoV-2 infection, a new study from National Institutes of Health scientists and colleagues shows.

The vaccine, known in its pre-clinical formulation as ChAd-SARS-CoV-2-S, is undergoing clinical trials in India under the name BBV154. 

Scientists at Washington University School of Medicine in St. Louis developed ChAd-SARS-CoV-2-S, which is designed similarly to AZD1222—a COVID-19 vaccine developed by the University of Oxford and pharmaceutical company AstraZeneca, both based in the United Kingdom.

AZD1222 has been authorized for use in parts of the world. Both vaccines use an adenoviral vector that infects chimpanzees to deliver the genetic information for an immune-stimulating protein from SARS-CoV-2, the virus that causes COVID-19. ChAd-SARS-CoV-2-S is based on a different strain of chimp adenovirus than AZD1222 and delivers the genetic information to produce a stabilized form of the spike protein, which is found on the surface of SARS-CoV-2.

The Washington University scientists successfully tested the protective efficacy of ChAd-SARS-CoV-2-S against SARS-CoV-2 in mice and hamsters. They then collaborated for the macaque study, published in Cell Reports Medicine, with colleagues at NIH’s National Institute of Allergy and Infectious Diseases (NIAID).

In work completed at NIAID’s Rocky Mountain Laboratories in Hamilton, Montana, scientists immunized six macaques with ChAd-SARS-CoV-2-S and six with an inactive control; the immunization was delivered into the nose. Three weeks later, scientists detected protective antibodies against SARS-CoV-2 in animals vaccinated with ChAd-SARS-CoV-2-S, but not in the control animals. Four weeks after immunization, scientists exposed all 12 animals to high doses of SARS-CoV-2 delivered to the nose and trachea. Throughout the following week scientists checked animals for disease, virus growth in the lung and virus transmission from the nose. The overall data shows that ChAd-SARS-CoV-2-S protected the upper and lower respiratory tracts of the vaccinated animals from disease and virus transmission compared to the control animals.

ChAd-SARS-CoV-2-S is licensed in India to Bharat Biotech as BBV154. In the United States and Europe, Precision Virologics, Inc., holds the license for the investigational vaccine.

Sierra Leone: President Bio Takes COVID-19 Vaccine, Assures Citizens of vaccine safety

Sierra Leone president Julius Maada Bio has taken the first shot of the COVID-19 vaccine at State House, where Vice President Mohamed Juldeh Jalloh and opposition politicians also took the jab. 

The National COVID-19 Emergency Response Centre, NaCOVERC, said the combined total of 296,000 SinoPharm and Oxford-AstraZeneca vaccines being offered by the Government of Sierra Leone undergone many tests and proven to be safe and effective because millions of people around the world had taken them.  

Minister of Health and Sanitation, Dr Austin Demby, said the day was a very special day for Sierra Leone, adding that with the show of political will, they now had the tools to get ahead of the COVID-19 virus instead of reacting to it. 

“When I asked the President if he would publicly take the vaccine, his response was ‘absolutely’.

He also said, ‘as a leader, I would not ask people to take a vaccine that I am not willing to take myself’. His Excellency, thank you Sir for your leadership.

“We have shown resilience at every step of the way and today, with the new safe and efficacious COVID-19 vaccines, we take a bold new step in our march to get rid of COVID-19 from our country,” he said. 

He added that in addition to other globally renowned regulatory agencies, both vaccines are cleared for use in Sierra Leone through an Emergency Use Authorization issued by the country’s Pharmacy Board.

“We expect more vaccines to come soon. As a result, for this first round of vaccinations, we will prioritize: Healthcare Workers, Political Leaders, Social Workers, Teachers and lecturers, Military, Police, Customs and Immigrations workers including Sea Ports and Airports, Prison Officers, Fire Force Officers, People over 70,” he said.

WHO, UNICEF and Partners Receive First Batch of Billion Dollars Project of COVID-19 Vaccines

By Isaac Unisa Kamara.

Sierra Leone country representatives of WHO, unicef, and other partners receive the first batch of 96,000 doses of Astra Seneca COVID-19 vaccines under the COVAX Facility.

 The consignment according to WHO Country Chief is donor driven, and has it main supporters from USA with $2.5 bill, Germany – $1.097bill, £735 mill, European Union $485 mill, Japan $200mill, and among others.

The consignment consist of the first batch of 528,000 of the vaccine that was produced by Serum Institute of India and approved by the World Health Organization for emergency response on COVID-19 virus.

Country Representative of WHO, Dr. Steven Velabo Shongwe, on the 8th March, 2021, at the Lungi International Airport, while receiving the consignment said the moment was a historic one. 

“We gather here to witness the arrival of this first batch out of the 528,000 allocated for Sierra Leone,” Dr. Shongwe said, continuing that, the COVAX Facility through a very strong collaboration is supporting low and middle-income countries including Sierra Leone under its Advance Market Commitment (AMC). “The global COVAX Facility partnership brings together Coalition for Epidemic  Preparedness Innovation (CEPI), Gavi, UNICEF and WHO,” he added. 

Further, he said the arrival of the first consignment provides the country with an additional public health tool in the fight against the COVID-19 pandemic. This initial batch and immediat subsequent shipment will prioritize critical target groups like frontline health professionals, vulnerable groups like the age and people with underlying health conditions informed the WHO Boss

Shongwe assured that, the vaccines are safe and efficacious, will help to save lives, reduce the severity of the viruses and improve the quality of life for individuals. “The deployment of the vaccine should be one of the critical measures that have to be taken in addition to the strict adherence to other public health measures,” he cautioned, while commending the government for providing leadership in the development of national COVID-19 vaccine deployment plan with the support of implementing partners.

Country Representative of UNICEF, Dr. Suliaman Braimoh congratulated the government for its leadership and commitment in signing up to the COVAX Facility. He said through this global collaboration, the vaccine would be accessible to everyone regardless of ones economic status. He noted that, for the fact that they have come together to complement government effort on the fight, their collective strides towards tackling the virus will prove worthy results.”UNICEF hereby reiterate its commitment to support the COVAX vaccine deployment in the country through ensuring that the population is well informed of the vaccination,” he disclosed, while commending the conserted efforts of frontline health workers and the Ministry of Health and Sanitation, which he said has helped to slowdown the transmission of the disease.

Minister of Health and Sanitation said the arrival of the vaccines will switch on the vaccination of 20% of the country’s 8,000,000 population. “Our health facilities throughout 2020 have been challenged by the task of responding to the pandemic while trying to balance our roles towards our normal health services,”  he said, adding that Sierra Leone is delighted to receive its first COVAX vaccine doses as it looks forward to the launching of the vaccination campaign in the coming days.

 “This arrival of the vaccine is a testimony of global solidarity in response to a global health and development  crises,” said Mr. Babatunde Ahons, United Nations Resident Coordinator in Sierra Leone.

Joint statement by UNICEF Executive Director Henrietta Fore and WHO Director-General Dr. Tedros Adhanom Ghebreyesus

Of the 128 million vaccine doses administered so far, more than three quarters of those vaccinations are in just 10 countries that account for 60% of global GDP.

As of today, almost 130 countries, with 2.5 billion people, are yet to administer a single dose.

This self-defeating strategy will cost lives and livelihoods, give the virus further opportunity to mutate and evade vaccines and will undermine a global economic recovery.

Today, UNICEF and WHO – partners for more than 70 years – call on leaders to look beyond their borders and employ a vaccine strategy that can actually end the pandemic and limit variants.

Health workers have been on the frontlines of the pandemic in lower- and middle-income settings and should be protected first so they can protect us.

COVAX participating countries are preparing to receive and use vaccines. Health workers have been trained, cold chain systems primed. What’s missing is the equitable supply of vaccines. 

To ensure that vaccine rollouts begin in all countries in the first 100 days of 2021, it is imperative that:  

  • Governments that have vaccinated their own health workers and populations at highest risk of severe disease share vaccines through COVAX so other countries can do the same.
  • The Access to COVID-19 Tools (ACT) Accelerator, and its vaccines pillar COVAX, is fully funded so that financing and technical support is available to lower- and middle-income countries for deploying and administering vaccines. If fully funded, the ACT Accelerator could return up to US$ 166 for every dollar invested.
  • Vaccine manufacturers allocate the limited vaccine supply equitably; share safety, efficacy and manufacturing data as a priority with WHO for regulatory and policy review; step up and maximize production; and transfer technology to other manufacturers who can help scale the global supply.

We need global leadership to scale up vaccine production and achieve vaccine equity.

COVID-19 has shown that our fates are inextricably linked. Whether we win or lose, we will do so together.”

COVID-19 potentially has negative impacts on male fertility

If calls for masking and distancing aren’t strong enough to change your thinking, the new review about Covid-19 and male fertility may do just that.

photo credit: Specimen News

A review recently published in the Journal of Medical Virology has discussed some of the effects that infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the agent that causes coronavirus disease 2019 (COVID-19) – may have on male fertility.

In the paper, Cemile Seymen from Gazi University Institute of Health Sciences, in Ankara, Turkey, summarizes study findings showing how the infection can negatively affect male reproductive health.

Seymen says further studies are needed to investigate the roles that the host cell proteins angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) may play in infection since both of these proteins, which are involved in viral entry, are highly expressed in the male reproductive system.Study: The other side of COVID-19 pandemic: Effects on male fertility. Image Credit: Blackboard / Shutterstock

Very little data are available on the effects of COVID-19 on male fertility

Since SARS-CoV-2 was first identified in Wuhan, China, late last year (2019), studies have shown that the virus not only causes respiratory disease but can affect various different organs, including those of the male reproductive system.

“There is a very limited number of data about the effects of COVID-19 on male fertility, so it has become an important topic for researchers,” says Seymen.

ACE2 is highly expressed in the male genital tract

To gain viral entry, SARS-CoV-2 uses a surface structure called the spike protein to bind to the ACE2 receptor present on host cells.

One study published earlier this year showed that ACE2 messenger RNA was expressed in both germ and somatic cells of the testis. Other studies have found that ACE2 is expressed in spermatogonia, Leydig cells, and Sertoli cells.

Credit: News Medical Life Science