Omicron
Contact tracing revs up in some states as omicron reaches US
The arrival of the omicron variant of the coronavirus in the U.S. has health officials in some communities reviving contact tracing operations in an attempt to slow and better understand its spread as scientists study how contagious it is and whether it can thwart vaccines.
In New York City, officials quickly reached out to a man who tested positive for the variant and had attended an anime conference at a Manhattan convention center last month along with more than 50,000 people. Five other attendees have also been infected with the coronavirus, though officials don’t yet know whether it was with the omicron variant.
“As for what we learned about this conference at the Javits Center and these additional cases, our test and trace team is out there immediately working with each individual who was affected to figure out who else they came in contact with. That contact tracing is absolutely crucial,” New York Mayor Bill de Blasio said.
Once a global epicenter of the pandemic, New York has the country’s biggest contract tracing effort. The city identified four omicron cases Thursday, and a fifth was discovered in nearby Suffolk County on eastern Long Island.
The variant has been detected in a handful of other states so far, including California, Colorado and Hawaii.
Read: India reports first two Covid cases of Omicron variant
Contract tracers have been busy in Nebraska after six cases of omicron were confirmed Friday. One of the people had recently returned from a visit to Nigeria, and the other five were close contacts of that person.
In Philadelphia, officials were working to track down contacts of a man in his 30s who is Pennsylvania’s first resident infected with the variant, the city’s Department of Public Health said.
And in Maryland, officials were rushing to trace, quarantine and test close contacts of three people from the Baltimore area who are the first known cases in the state. Two are from the same household, including a vaccinated person who recently traveled to South Africa, and the third has no recent travel history and is unrelated to the other two.
Read: US reports 1st case of omicron variant in returning traveler
Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials, said “more and more” contact tracing efforts are expected in the coming days, in part because of the uncertainty about how effective vaccines and treatments like monoclonal antibodies will be against omicron.
Contact tracing is a vital tool in the pandemic response, allowing health departments to notify people who had close contact with an infected person and slow the progression of COVID-19.
“Contact tracing can give us information about how it’s spreading and hopefully break chains of transmission to stop clusters and outbreaks, or at least delay them until we know more and understand what our next steps need to be,” said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health.
While much is still unknown about the variant, early reports are raising alarms. New COVID-19 cases in South Africa, which first alerted the world to omicron last week, have burgeoned from about 200 a day in mid-November to more than 16,000 on Friday.
Some of the U.S. cases involve people who hadn’t traveled recently, meaning the variant was likely already circulating domestically in some parts of the country.
In New York, the three-day anime festival in November is presenting a staffing challenge for tracers due to the large number of attendees. The one known omicron infection involved a man from Minnesota.
Officials cautioned against linking the other five coronavirus cases directly to the event.
“The really important point here is that’s five cases from a denominator of tens of thousands of people at this conference. And furthermore, we’ve not established any sort of link between those five cases and widespread transmission at the conference,” said Ted Long, executive director of the NYC Test & Trace Corps, which runs the city’s contact tracing program.
Proof of vaccination was necessary for admission, as mandated by city law, and masks were also required.
Officials said they had reached all 36,500 convention attendees, vendors and exhibitors for whom they had contact information, via email, text message or phone call. But they decided it wasn’t necessary to contact every single attendee since the infected man did not appear to have close contacts based in New York.
In Minnesota, meanwhile, officials are investigating “a circle of contacts” for the man believed to have been infected at the conference, said Kris Ehresmann, the state’s infectious disease director.
“Part of the reason we did indicate where he had been — the anime convention in New York — is because there were so many people that attended that event. It would not be possible for him or really anyone to identify everyone that they were potentially in contact with,” Ehresmann said.
Amid the surge of the delta variant, health investigators across the U.S. became overwhelmed and scaled back contact tracing operations, finding it nearly impossible to keep up with the deluge of new infections, administer vaccines and also do tracing at the same time.
Many health officials ultimately focused on exposures at schools or potential super-spreader incidents where large numbers of people were at risk of exposure.
Dr. William Schaffner, a professor of infectious diseases at the Vanderbilt University School of Medicine, expects that will ultimately happen with omicron.
“Contact tracing and sequencing will allow us to paint with a broad brush,” Schaffner said. “But we won’t be able to track it down to each and every case, and at a given point, when you know it is here and spreading, why do we need to do that?”
Omicron may be driving S Africa's surge; wary world watches
Dr. Sikhulile Moyo was analyzing COVID-19 samples in his lab in Botswana last week when he noticed they looked startlingly different from others. Within days, the world was ablaze with the news that the coronavirus had a new variant of concern, which appears to be driving a dramatic surge in South Africa, providing a glimpse of where the pandemic might be headed.
New cases in South Africa have burgeoned from about 200 a day in mid-November to more than 11,500 on Thursday. In the week since omicron was discovered to be present in the country's most populous province, Gauteng, infections have surged 300%, Health Minister Joe Phaahla said Friday.
The variant has also now spread to all of the other eight provinces, he added. Even with the rapid increase, infections are still below the 25,000 daily new cases that South Africa reported in the previous surge in June and July.
Little is known about the new variant, but the spike in South Africa suggests it might be more contagious, said Moyo, the scientist who may have been the first to identify the new variant, though researchers in neighboring South Africa were close on his heels. Omicron has more than 50 mutations — and scientists have called it a big jump in the evolution of the virus.
Read: India reports first two Covid cases of Omicron variant
It's not clear if the variant causes more serious illness or can evade the protection of vaccines. Phaahla noted that only a small number of people who have been vaccinated have gotten sick, mostly with mild cases, while the vast majority of those who have been hospitalized were not vaccinated.
South Africa's hospitals are so far coping with the new surge, he said. Even hospitals in Gauteng province, which accounts for more than 70% of all new daily infections, have the capacity to handle the new admissions, he said.
This picture could change because most of those infected thus far have been younger people, who generally do not get as sick as older patients. But Moyo expressed hope that vaccines would not be sidelined by the new variant.
"I have a lot of hope from the data that we see, that those vaccinated should be able to have a lot of protection," he said.
That dovetails with what officials from the World Health Organization in Asia said Friday.
While warning that cases could well rise quickly because of omicron, Dr. Takeshi Kasai, the WHO regional director for the Western Pacific, said the measures used against the delta variant — which itself caused surges the world over — should remain at the core of the response.
"The positive news in all of this is that none of the information we have currently about omicron suggests we need to change the directions of our response," Kasai told reporters.
Read: US reports 1st case of omicron variant in returning traveler
That means continuing to push for higher vaccination rates, abiding by social-distancing guidelines, and wearing masks, among other measures, said WHO Regional Emergency Director Dr. Babatunde Olowokure.
While more than three dozen countries worldwide have reported omicron infections, the numbers so far are small outside of South Africa. That has led many countries to race to impose travel restrictions on visitors from southern Africa — a move the WHO officials said may buy some time, though the agency has previoulsy urged against border closures.
The travel restrictions have been severely criticized by South Africa, which says it is being punished for being transparent and moving so quickly to alert the world to omicron. WHO said it was notified by the country on Nov. 24 about the new variant.
"What we must reemphasize is that while our scientists and those in Botswana were the first discover and report on the variant, no one knows where it originated," Phaahla said.
With Omicron on the doorstep, Bangladesh announces new travel rules
Amid the global scare over the new Omicron variant of Covid-19, Bangladesh has announced new travel rules, making a 14-day institutional quarantine mandatory for all travellers from seven African countries.
The countries are Botswana, Eswatini, Ghana, Lesotho, Namibia, South Africa and Zimbabwe, the Civil Aviation Authority of Bangladesh (CAAB) said on Thursday in its updated travel restriction notification. The order will come into effect Saturday.
Neighbouring India Thursday reported its first two known Covid-19 cases of the Omicron variant, discovered in two men in the southern state of Karnataka.
According to the new travel rules in Bangladesh, all passengers from these seven African countries will need to stay at government-designated hotels at their own expense.
Also read: Omicron unravels travel industry's plans for a comeback
On the seventh and 14th day of quarantine, they will have to undergo RT-PCR tests at their own expense, it said.
Omicron coronavirus variant found in multiple US states
The omicron variant of COVID-19, which had been undetected in the U.S. before the middle of this week, had been discovered in at least five states by the end of Thursday, showing yet again how mutations of the virus can circumnavigate the globe with speed and ease.
Just a day after the first known U.S. case was found in California, tests showed the omicron variant had infected at least five people in the New York City metropolitan area, plus a man from Minnesota who had attended an anime convention in Manhattan in late November.
A Colorado woman who had recently traveled to southern Africa, a Hawaii resident with no recent travel history, and another California resident who traveled to South Africa last month also were infected by the variant, officials said.
Much remains unknown about omicron, including whether it is more contagious, as some health authorities suspect, whether it can thwart vaccines and whether it makes people as sick as the original strain.
Also read: US reports 1st case of omicron variant in returning traveler
Health officials in each state said there was no cause for undue alarm. But the spread of the cases, some involving people who hadn't been away from home recently, meant the variant was likely already circulating domestically in some parts of the U.S.
“We gotta assume there’s a lot more behind that and that it has been here for a meaningful amount of time,” New York City Mayor Bill de Blasio said at a news conference with Gov. Kathy Hochul.
The infected New Yorkers included a 67-year-old woman on Long Island who had recently traveled to South Africa, residents of Brooklyn and Queens and another case possibly linked to travel. At least one person had received a dose of a COVID-19 vaccine but officials did not have details about the vaccination status of the four other cases.
In Minnesota, health officials said a man who had not traveled outside the U.S. began experiencing symptoms the day after attending the Anime NYC 2021 convention in New York City. Minnesota Health Commissioner Jan Malcolm said it's likely the man contracted COVID-19 at the convention, but officials did not know for sure.
Officials in New York said they were working to trace attendees of the convention, which was held Nov. 19-21 and drew about 50,000 people, according to event organizers. Attendees were required to wear masks and show proof of having received at least one dose of a COVID-19 vaccine.
It was held at the Jacob K. Javits Convention Center as New York City prepared to host the annual Macy’s Thanksgiving Day Parade and braced for throngs of tourists to return after the U.S. opened up to vaccinated international travelers.
Also read: Omicron unravels travel industry's plans for a comeback
City Health Commissioner Dave Chokshi urged people who attended the event to get tested.
"This is not just due to people who are traveling to southern Africa or to other parts of the world where omicron has already been identified,” Chokshi said Thursday.
The Minnesota man began experiencing mild symptoms Nov. 22. He had been vaccinated and received a booster shot in early November, according to health officials in his home state. He sought COVID-19 testing Nov. 24, and his symptoms have subsided, officials said.
Nov. 22 was the same day the person infected in the first California case returned to the U.S. from South Africa. The California traveler, who was vaccinated, developed mild symptoms and tested positive Monday. The second person in the state didn’t need medical care and was also vaccinated.
The unvaccinated adult infected with the variant in Hawaii had gotten COVID-19 a year ago. The person isn’t currently hospitalized and had “mild-to-moderate” symptoms including headache, body aches and cough, Hawaii Epidemiologist Dr. Sarah Kemble said.
She wouldn’t identify the patient other to say the person lives on the island of Oahu.
Omicron is classified by the World Health Organization as a “variant of concern” as scientists work to determine how it may compare with the predominant delta variant in terms of transmissibility and severity. Scientists also are studying the degree to which existing vaccines and therapies protect against omicron.
Scientists in South Africa first reported it, but the samples came from several countries in southern Africa. And health officials in the Netherlands now say it was found there prior to the South Africa detection.
As comfort over air travel returns, it’s inevitable that new variants like omicron will spread from country to country and state to state, said professor Danielle Ompad, an epidemiologist at New York University’s School of Global Public Health.
“We shouldn’t panic, but we should be concerned,” she said.
Hochul said the case involving the Minnesota visitor underlined the need for everyone who is eligible to get vaccinated against COVID-19 or receive a booster shot if they have not already.
“There is one way to address this — New Yorkers, get vaccinated, get boosted, and get ready,” the Democrat said.
END/AP/UNB/FA
US reports 1st case of omicron variant in returning traveler
The U.S. recorded its first confirmed case of the omicron variant Wednesday — in a vaccinated traveler who returned to California after a trip to South Africa — as scientists around the world race to establish whether the new, mutant version of the coronavirus is more dangerous than previous ones.
Dr. Anthony Fauci, the United States’ top infectious-disease expert, announced the finding at the White House.
“We knew it was just a matter of time before the first case of omicron would be detected in the United States,” he said.
The infected person was identified as a traveler who had returned from South Africa on Nov. 22, developed mild symptoms and tested positive for COVID-19 Monday. Researchers at the University of California, San Francisco obtained a sample from the patient Tuesday evening and worked feverishly overnight to assemble the genetic sequence.
The person, who had had the full two doses of the Moderna vaccine and wasn’t yet due for a booster shot, is improving, California officials said.
Read: Omicron scare: Bangladesh put on India's 'at-risk' list
Fauci and other medical experts strongly emphasized that Americans should continue to get vaccinated and get their booster shots. The vaccine has been proven to reduce the risk of severe illness and death, and Fauci said it is reasonable to believe it will offer protection against the omicron variant.
The mild nature of the California person’s infection “is a testimony to the importance of the vaccinations,” said California Health Secretary Dr. Mark Ghaly.
All the individual’s close contacts have been reached and have tested negative, officials said. The patient, who agreed to remain in quarantine, was identified only as being between 18 and 49.
California Gov. Gavin Newsom expressed confidence in the state’s efforts to control the virus and said he does not anticipate imposing another stay-at-home order or other shutdown measures.
At least 23 other countries have reported omicron infections since South African authorities first identified the variant a week ago — an announcement that led the U.S. and many other nations to almost immediately bar airline travelers arriving from southern Africa.
In South Africa, new cases of COVID-19 nearly doubled in a single day to almost 8,600, authorities reported Wednesday, and the country’s National Institute for Communicable Diseases said omicron has now overtaken the delta variant among samples now being analyzed at the genetic level.
But the variant is still surrounded by many unknowns, among them: Is it more contagious than other versions, as some scientists are beginning to suspect? Does it make people more seriously ill? And can it evade the vaccine?
Read: Wary, weary world slams doors shut, fearing omicron variant
“Any declaration of what will or will not happen with this variant, I think it is too early to say,” Fauci said.
European Union Commission President Ursula von der Leyen said it will take two to three weeks before it becomes fully clear what omicron can do to the world.
“This is, in normal times, a short period. In pandemic times, it’s an eternity,” she lamented.
In California, the genetic analysis of the patient’s virus from UCSF was confirmed by the Centers for Disease Control and Prevention.
“We will likely see this scenario play out multiple times across the country in the coming days or weeks,” said Scott Becker, CEO of the Association of Public Health Laboratories.
“This particular case shows the system working as it was designed to work — an individual with travel history from South Africa, an astute laboratory and quick prioritization of the specimen for sequencing, and close coordination with public health officials.”
Nigeria and Saudi Arabia also reported omicron infections Wednesday, marking the first known cases in West Africa and the Persian Gulf region.
Going further than many other countries in trying to contain the virus, Japan has banned foreign visitors and asked international airlines to stop taking new reservations for all flights arriving in the country until the end of December.
The U.S. is working toward requiring that all air travelers to the country be tested for COVID-19 within a day before boarding their flights, up from the current three days.
On Wednesday, the World Health Organization warned that blanket travel bans are complicating the sharing of lab samples from South Africa that could help scientists understand the new variant.
At the same time the omicron variant is spreading new fear and uncertainty, the dominant delta variant is still creating havoc, especially in Europe. Many countries there are dealing with a surge in infections and hospitalizations, despite a relatively high vaccination rate of 67% of the European Union’s population.
For the first time, von der Leyen said EU nations should consider making vaccinations mandatory. Greece plans to fine people over 60 who don’t get the shot. And German Chancellor-designate Olaf Scholz said he will back a proposal to require everyone to get vaccinated.
Maintain health protocols to keep HSC exams undisturbed: Dipu Moni
Education Minister Dipu Moni has urged all to maintain health protocols so that the Higher Secondary Certificate (HSC) examinations can be held without any disruption.
“Concerns are growing as the new variant of coronavirus, ‘Omicron’, has been identified. It’s more infectious. We need to remain very careful,” she told a programme at Chandpur Press Club on Tuesday evening.
Read: Next year’s public exams won’t be held as per schedule: Dipu Moni
The minister, however, expressed dissatisfaction as many people are not wearing masks. “We should follow the hygiene rules and avoid public gatherings to contain the spread of the virus so that we don’t have to postpone the HSC exams.”
“HSC exams are scheduled to begin on Thursday, which is very important in the academic life of a student,” the minister added.
This year the SSC and the HSC examinations could not be held as per the schedules due to the Covid-19 pandemic and then the government decided to hold the examinations with shortened syllabuses.
Read: Students to get new textbooks in time next year: Dipu Moni
According to the schedule, the HSC and its equivalent examinations will end on December 30.
Last year’s HSC examinees were evaluated on the basis of the results of JSC and SSC exams of students, a decision which received a mixed reaction.
India announces new travel rules amid Omicron scare
Amid a global scare over the new Omicron variant of Covid, India on Tuesday issued new rules for international travellers to limit the possible spread of the virus.
In a statement, the Indian government said that all passengers from "at-risk" countries will have to undergo a mandatory Covid-19 test -- RT-PCR -- and can't leave the airport till its results are available.
If any passenger from any "at-risk" country is found positive, they will be isolated and treated, and their samples will immediately be sent for genome sequencing to find out the strain of the virus, the government said.
Read: Omicron scare: Bangladesh put on India's 'at-risk' list
Those found Covid negative will have to undergo a seven-day home quarantine and be re-tested on the eighth day, according to the government.
The new travel rules, effective from the midnight of November 30, were announced barely four days after India's Civil Aviation Ministry said that it would resume regular international flights from December 15.
"The matter of resumption of scheduled commercial international passenger services, to and from India, has been examined in consultation with the Ministry of Home Affairs, the Ministry of External Affairs and the Ministry of Health, and it has been decided... may be resumed from December 15," the Ministry had said.
Read: Wary, weary world slams doors shut, fearing omicron variant
However, restrictions on regular international flights to and from 14 countries include the UK, France, Germany, China, Botswana and South Africa, will continue, according to the government.
The Indian government put curbs on all domestic and international flights in March last year in the wake of the Covid-induced lockdown.
Though it allowed domestic flights from May 2020, restrictions prevailed on international flights till it allowed the entry of all foreigners except tourists in October that year.
Covid-related death in Bangladesh drops to 1
Bangladesh logged one Covid-linked death along with 273 fresh cases in 24 hours till Tuesday morning amid the growing concern over the new ‘Omicron’ variant of coronavirus.
With the latest cases, the daily-case positivity rate rose to 1.38 per cent from Monday’s 1.34 per cent, said the Directorate General of Health Services (DGHS).
Read: Govt decides to administer Covid booster dose to above-60 citizens
With the fresh numbers, the total fatalities rose to 27,981 while the caseload mounted to 15,76,284.
The latest deceased was a woman in her 60s and was from the Dhaka division.
However, the mortality rate remained static at 1.78 per cent.
The fresh cases were detected after testing 19,924 samples, the DGHS added.
Besides, the recovery rate increased to 97.76 per cent with the recovery of 368 more patients during the 24-hour period.
On November 20, Bangladesh logged this year’s first zero Covid-linked death with 178 cases.
Read: Omicron: What we know about the COVID-19 Variant so far
So far, 3,66,82,766 people have fully been vaccinated in the country while 6,02,36,018 received the first dose as of Monday, according to the DGHS.
However, public health experts fear a slow pace of vaccination, waning vaccine immunity, disregard for Covid safety protocols, reopening of schools and increased travel may set the stage for another Covid wave in Bangladesh -- a trend many European countries are witnessing now.
Authorities to red flag houses of 7 South Africa returnees in Brahmanbaria
Amid a global alarm over the new Omicron variant of Covid, authorities in Brahmanbaria have decided to hang red flags outside the houses of seven South Africa returnees.
The decision was taken at an emergency meeting of the Corona Prevention Committee on Monday evening, chaired by district commissioner Hayat-Ud-Doula-Khan.
Also read: Omicron: DGHS recommends enforcement of 15 instructions
The committee also issued directions to the Akhaura land port authorities for ensuring strict screening of people entering the country.
The committee also decided to initiate immediate steps to vaccinate the two lakh people waiting for the Covid shots.
Recently, three residents of Kasba upazila, two of Sadar upazila, and one each from Bancharampur and Nabinagar upazilas in Brahmanbaria district returned from South Africa, where the new variant is said to have originated.
Nearly two years into the Covid-19 pandemic, the world raced Friday to contain the new coronavirus variant potentially more dangerous than the one that has fuelled relentless waves of infection on nearly every continent.
Also read: NTAC recommends travel ban to contain new variant Omicron
A World Health Organization panel named the variant 'Omicron' and classified it as a highly transmissible virus of concern, the same category that includes the predominant Delta variant, which is still a scourge driving higher cases of sickness and death in Europe and parts of the US.
Omicron brings COVID-19 vaccine inequity 'home to roost'
The emergence of the new omicron variant and the world's desperate and likely futile attempts to keep it at bay are reminders of what scientists have warned for months: The coronavirus will thrive as long as vast parts of the world lack vaccines.The hoarding of limited COVID-19 shots by rich countries — creating virtual vaccine deserts in many poorer ones — doesn’t just mean risk for the parts of the world seeing shortages; it threatens the entire globe.That's because the more the disease spreads among unvaccinated populations, the more possibilities it has to mutate and potentially become more dangerous, prolonging the pandemic for everyone.
READ: Wary, weary world slams doors shut, fearing omicron variant
“The virus is a ruthless opportunist, and the inequity that has characterized the global response has now come home to roost,” said Dr. Richard Hatchett, CEO of CEPI, one of the groups behind the U.N.-backed COVAX shot-sharing initiative.Perhaps nowhere is the inequality more evident than in Africa, where under 7% of the population is vaccinated. South African scientists alerted the World Health Organization to the new omicron variant last week, though it may never be clear where it first originated. Researchers are now rushing to determine whether it is more infectious or able to evade current vaccines.COVAX was supposed to avoid such inequality — but instead the initiative is woefully short of shots and has already abandoned its initial goal of 2 billion doses.Even to reach its scaled-back target of distributing 1.4 billion doses by the end of 2021, it must ship more than 25 million doses every day. Instead, it has averaged just over 4 million a day since the beginning of October, with some days dipping below 1 million, according to an Associated Press analysis of the shipments.Shipments in recent days have ramped up, but nowhere near the amount needed.Meanwhile, richer nations often have a glut of shots, and many are now offering boosters — something the WHO has discouraged because every booster is essentially a dose that is not going to someone who's never even gotten their first shot. Despite the U.N. health agency's appeal to countries to declare a moratorium on booster shots until the end of the year, more than 60 countries are now administering them.
READ: Omicron: DGHS recommends enforcement of 15 instructions
“What it highlights are the continuing and fundamental risks to everyone associated with not seriously addressing the inequalities still at play globally in the fight against disease and poor health," said Dr. Osman Dar, director of the One Health Project at the Chatham House think tank.Anna Marriott, health policy manager for Oxfam, said COVAX was limited from the outset after being pushed to the back of the vaccine queue by rich countries.“The COVAX team may be delivering as fast as they can, but they can’t deliver vaccines they haven’t got,” Marriott said.Just 13% of vaccines COVAX contracted for and 12% of promised donations have actually been delivered, according to calculations by the International Monetary Fund from mid-November. About a third of the vaccines dispensed by COVAX have been donations, according to the vaccine alliance known as Gavi, and the initiative is now partly a clearinghouse for those donated doses, the very situation it was set up to avoid.Last week, COVAX sent out a news release praising a European Union pledge to ship 100 million vaccines to Africa by the end of the year — but only 1/20 of that amount was actually on planes.Asked about the logistical challenges of distributing the other 94 million doses in only six weeks, Aurelia Nguyen, managing director of COVAX maintained that arrangements “are in place to move a vast number of doses between now and the end of the year."In a statement, she said the issue was ensuring that “conditions are right on the ground for doses to be administered.”In minutes released ahead of an executive meeting this week, Gavi fretted that the perception that rich countries are dumping older or lesser vaccines on poor countries could undermine the whole project. On Monday, in a joint statement with WHO and the African Union among others, it admonished that “the majority of the donations to date have been ad hoc, provided with little notice and short shelf lives.”Fury over dose dumping is already very real. In Malawi and South Sudan, tens of thousands of out-of-date doses were destroyed.But it's not just getting the vaccines into poorer countries that's a problem, according to some experts. COVAX is “falling short on getting vaccines from the (airport) tarmac into people’s arms,” said Dr. Angela Wakhweya, senior director for health equity and rights at CARE.Authorities in Congo, for instance, returned their entire COVAX shipment this summer when they realized they would not be able to administer doses before they expired.In a “risk management” report on COVAX, Gavi warned that “poor absorption” of vaccines by developing countries could lead to “wastage” of some doses. One problem is logistics — just getting the doses in the right country at the right time. But just as important is the ability of often underfunded national health systems to distribute the shots where they're most needed, along with syringes and other necessary gear. A third issue is persuading sometimes hesitant people to get the vaccines.World Health Organization Director-General Tedros Adhanom Ghebreyesus, however, has disputed distribution is a problem, saying the only obstacle to immunization in poor countries is supply.Most COVAX doses distributed so far have been AstraZeneca’s vaccine, a shot that has yet to be authorized in the U.S. and whose botched rollout in Europe helped fuel anti-vaccine sentiment when the vaccine was linked to rare blood clots. The vaccines mostly used in the U.S. and much of Europe — made by Pfizer-BioNTech and Moderna — have only been available in tiny amounts via COVAX.The U.S., which blocked vaccine sales overseas and exports of key ingredients for months, has donated 275 million doses in all, more than any other country but still less than a third of what the Biden administration pledged. The European Union, which has in general allowed vaccines manufactured in the bloc to be sold anywhere in the world, has actually delivered about a third of its 400 million promised doses.Efforts to ramp up global production beyond a select group of manufacturers have stalled, which many activists and scientists blame on pharmaceutical companies' opposition to waive intellectual property rights for the highly lucrative vaccines.Given that the pandemic has so far not devastated Africa as many had initially feared, some scientists on the continent are now discussing whether to withdraw their vaccine requests.“I think what Africa could do to really shame the world is to stop asking for vaccines,” said Christian Happi, a Nigerian virologist who sat on the scientific advisory board of CEPI. “The vaccines have not arrived, and anyways it may turn out that we don’t need them as much as the West.”